Dialysis adequacy at two haemodialysis units in Jamaica

A prospective study on adequacy of dialysis was conducted at the haemodialysis units of Kingston Public Hospital (KPH) and the University Hospital of the West Indies (UHWI). Dialysis adequacy was better at KPH and morbidity, as measured by patient admission days, was increased at UHWI. Diabetics had a lower mean serum albumin and urea reduction ratio (URR) than non-diabetics. Multiple regression analyses revealed that age of patient (F = 5.30; p = 0.0241) and hospital (F = 7.85; p = 0.007) were the variables significantly associated with serum albumin level when the effect of other variables was controlled (F = 2.12; p = 0.34). Similar analyses showed that the hospital at which dialysis was done was the only factor which accounted for significantly higher URR, with KPH having higher rates (F = 13; p = 0.006). The differences between hospitals necessitate further investigations, explanations and intervention strategies. The study provides opportunities for improving patient care and for dialysis health care professionals to assess clinical performance measures and reduce variation between dialysis centres.