title: UK Renal Registry 17th Annual Report: Chapter 8 Biochemical Variables amongst UK Adult Dialysis Patients in 2013: 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 2013. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone and bicarbonate.In addition, longitudinal analyses were performed (2002–2013) to show changes in achievement of clinical performance measures over time.
  
  
  RESULTS
  Fifty-seven percent of HD and 62% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-eight percent of HD and of PD patients had adjusted calcium between 2.2–2.5 mmol/L. Fifty-seven percent of HD and 63% of PD patients had parathyroid hormone between 16–72 pmol/L. Fifty-nine percent of HD and 79% 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: UK Renal Registry, Bristol, UK.
authors.forename: Catriona
authors.initials: C
authors.lastname: Shaw
authors.forename: Johann
authors.initials: J
authors.lastname: Nicholas
authors.forename: David
authors.initials: D
authors.lastname: Pitcher
authors.forename: Anne
authors.initials: A
authors.lastname: Dawnay
mesh_terms: D000328:Adult; D015331:Cohort Studies; D006801:Humans; D012042:Registries; D006435:Renal Dialysis; D006113:United Kingdom