title: Chapter 7 Adequacy of haemodialysis in UK adult patients in 2010: national and centre-specific analyses.
abstract: BACKGROUND
  Outcome in patients treated with haemodialysis (HD) is influenced by the delivered dose of dialysis. The UK Renal Association (RA) publishes clinical practice guidelines which include recommendations for dialysis dose. The urea reduction ratio (URR) is a widely used measure of dialysis dose.
  
  
  OBJECTIVE
  To determine the extent to which patients received the recommended dose of HD in the UK.
  
  
  METHODS
  All seventy-two UK renal centres submitted data to the UK Renal Registry (UKRR). Two groups of patients were included in the analyses: the prevalent patient population on 31st December 2010 and the incident patient population for 2010. Centres returning data on <50% of their patient population or centres with <20 patients were excluded from centre-specific comparisons.
  
  
  RESULTS
  Data regarding URR were available from 64 renal centres in the UK. Forty nine centres provided URR data on more than 90% of prevalent patients. The proportion of patients in the UK who met the UK clinical practice guideline for URR (>65%) increased from 56% in 1998 to 86% in 2010. There was persistent variation observed between centres, with 19 centres attaining the RA clinical practice guideline in >90% of patients and 39 centres attaining the guideline in 70-90%. The overall proportion of prevalent patients with a URR >65% has continued to improve over time.
  
  
  CONCLUSIONS
  The delivered dose of HD for patients with established renal failure has increased over the last decade. Whilst the majority of UK patients achieved the target URR there was considerable variation between centres in the percentage of patients achieving the guideline.
authors.affiliation: UK Renal Registry, Bristol, UK. renalregistry@renalregistry.nhs.uk
authors.forename: Catriona
authors.initials: C
authors.lastname: Shaw
authors.forename: Retha
authors.initials: R
authors.lastname: Steenkamp
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D001800:Blood Specimen Collection / Q000592:standards; D002391:Catchment Area, Health; D005260:Female; D019983:Guideline Adherence; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012042:Registries / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000592:standards / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014508:Urea / Q000097:blood; D055815:Young Adult
chemical_list: D014508:Urea