title: UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence.
abstract: BACKGROUND
  Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice.
  
  
  METHODS
  An online questionnaire was distributed to all UK renal centres.
  
  
  RESULTS
  Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this.
  
  
  CONCLUSIONS
  There is an urgent need for establishing an evidence base on the optimal approaches to fluid management.
authors: Heartlands Hospital and University of Birmingham, Birmingham, UK.
authors: Indranil
authors: I
authors: Dasgupta
authors: Ken
authors: K
authors: Farrington
authors: Simon J
authors: SJ
authors: Davies
authors: Andrew
authors: A
authors: Davenport
authors: Sandip
authors: S
authors: Mitra
mesh_terms: D004032:Diet / Q000379:methods; D019468:Disease Management; D004232:Diuretics / Q000627:therapeutic use; D017097:Electric Impedance; D005440:Fluid Therapy / Q000379:methods / Q000592:standards*; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D006435:Renal Dialysis / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D006113:United Kingdom; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: D004232:Diuretics