title: UK Renal Registry 16th annual report: chapter 12 biochemical variables amongst UK adult dialysis patients in 2012: national and centre-specific analyses.
abstract: BACKGROUND
  The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement.
  
  
  METHODS
  Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2012. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition, longitudinal analyses were performed (2002-2012) to show changes in achievement of clinical performance measures over time.
  
  
  RESULTS
  Fifty-six percent of HD and 61% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-seven percent of HD and 78% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Fifty-eight percent of HD and 65% of PD patients had parathyroid hormone between 16-72 pmol/L. Fifty-nine percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied.
  
  
  CONCLUSIONS
  The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK.
authors.affiliation: Royal Wolverhampton NHS Trust, UK.
authors.forename: Johann
authors.initials: J
authors.lastname: Nicholas
authors.forename: Catriona
authors.initials: C
authors.lastname: Shaw
authors.forename: David
authors.initials: D
authors.lastname: Pitcher
authors.forename: Anne
authors.initials: A
authors.lastname: Dawnay
mesh_terms: D000328:Adult; D000847:Annual Reports as Topic; D001639:Bicarbonates / Q000097:blood; D002118:Calcium / Q000097:blood; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000639:trends*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008137:Longitudinal Studies; D010281:Parathyroid Hormone / Q000097:blood; D010530:Peritoneal Dialysis / Q000592:standards; D010710:Phosphates / Q000097:blood; D017410:Practice Guidelines as Topic; D012042:Registries / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000592:standards*; D006113:United Kingdom
chemical_list: D001639:Bicarbonates; D010281:Parathyroid Hormone; D010710:Phosphates; D002784:Cholesterol; D002118:Calcium