title: Hemodialysis practice patterns in the Russia Dialysis Outcomes and Practice Patterns Study (DOPPS), with international comparisons.
abstract: There is little comparable information about hemodialysis (HD) practices in low- and middle income countries, including Russia. Evaluation of HD in Russia and its international comparisons could highlight factors providing opportunities for improvement.
  
  
  
  We examined treatment patterns for 481 prevalent HD patients in 20 Russian facilities, and compared them to contemporary data for 8512 patients from 311 facilities in seven European countries, Japan, and North America. Data were collected according to the uniform methodology of the Dialysis Outcomes and Practice Patterns Study, phase 5.
  
  
  
  Compared to other regions, Russian patients were younger (mean age 53.4 years), had a lower percent of males (52.5%), higher arteriovenous fistula use (89.7%), and longer treatment time (mean: 252 minutes, SD: 37 minutes). Mean single pool Kt/V was 1.49 (SD 0.58). Prescription of dialysate calcium 3.5 mEq/L and aluminum-based phosphate binders were high (15.2% and 17.6% of patients, respectively), while intravenous vitamin D and cinacalcet were low (3.3% and 2.2%, respectively). The percents with parathyroid hormone >600 pg/mL (30.9%) and serum phosphate >1.78 mmol/L (37.7%) were high. Use of erythropoetin stimulating agents (78%) was lower, but hemoglobin, ferritin, and transferrin saturation were generally comparable to North America and Europe.
  
  
  
  These detailed data for hemodialysis in Russia demonstrate that many practice patterns contrasted sharply to those in Europe, Japan, and North America, while other features were similar. Our analysis revealed several positive and some less favorable treatment patterns in Russia that represent opportunities for improving patient care and outcomes.
authors: Department of Nephrology, A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation.|Department of Nephrology Issues of Transplanted Kidney, Academician V.I.Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation.
authors: Boris
authors: B
authors: Bikbov
authors: Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
authors: Brian
authors: B
authors: Bieber
authors: Department of Nephrology, A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation.|Moscow City Nephrology Center, City Clinical Hospital #52 of Moscow City Health Department, Moscow, Russian Federation.
authors: Anton
authors: A
authors: Andrusev
authors: Department of Nephrology, A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation.|Department of Nephrology Issues of Transplanted Kidney, Academician V.I.Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation.|Moscow City Nephrology Center, City Clinical Hospital #52 of Moscow City Health Department, Moscow, Russian Federation.
authors: Natalia
authors: N
authors: Tomilina
authors: Department of Nephrology and Dialysis, I.P.Pavlov First St-Petersburg State Medical University, St. Petersburg, Russia.
authors: Alexander
authors: A
authors: Zemchenkov
authors: Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
authors: Junhui
authors: J
authors: Zhao
authors: Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
authors: Friedrich
authors: F
authors: Port
authors: Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
authors: Bruce
authors: B
authors: Robinson
authors: Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.
authors: Ronald
authors: R
authors: Pisoni
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D012426:Russia
keywords: Anemia; calcium; hemodialysis; parathyroid hormone; phosphate; practice patterns