Haemodialysis dose and serum bicarbonate (chapter 7)

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Therapy

Background:

• The Renal Association audit standard guides quality in renal replacement therapy.
• Previous reports highlighted variability in dialysis adequacy and acidosis correction.

Purpose of the Study:

• To assess the achievement of Renal Association audit standards for urea reduction ratio (URR) and serum bicarbonate levels in UK dialysis patients in 2005.
• To identify factors associated with achieving these standards.

Main Methods:

• Analysis of data from UK renal units, focusing on prevalent haemodialysis and peritoneal dialysis patients.
• Assessment of urea reduction ratio (URR) and serum bicarbonate concentrations against established standards.

Main Results:

• A progressive increase in patients meeting the URR standard was observed, with 81% of prevalent haemodialysis patients achieving it in 2005.
• Higher median URR within units correlated with greater standard achievement. Patients on dialysis longer had better URR achievement.
• Serum bicarbonate correction remained variable; 64% of haemodialysis and 50% of peritoneal dialysis patients met the standard.

Conclusions:

• UK renal units demonstrated improvement in achieving the URR standard for haemodialysis patients.
• Significant variability persists in correcting acidosis, indicating a need for further investigation and potential guideline refinement.
• Ongoing monitoring is crucial for optimizing dialysis quality and patient outcomes.