UK Renal Registry 13th Annual Report (December 2010): Chapter 3: demographic and biochemistry profile of kidney transplant recipients in the UK in 2009: national and centre-specific analyses.

Introduction: National transplant registries routinely focus on centre-specific patient and graft survival rates following renal transplantation. However other outcomes such as graft function (as measured by eGFR), haemoglobin, biochemical variables and blood pressure are also important quality of care indicators.

Methods: Renal transplant activity, incident graft survival data and donor information were obtained from NHS Blood and Transplant.

UK Renal Registry 13th Annual Report (December 2010): Chapter 15: UK renal centre survey results 2010: RRT incidence and use of home dialysis modalities.

Introduction: RRT incidence rates and the proportion of patients using a home dialysis modality (peritoneal or home haemodialysis) varies widely between centres and persists even after area differences in age, ethnicity and social deprivation structure are taken into account. A nationwide survey was undertaken to identify possible drivers of this variation.

Methods: A systematic literature review followed by a two-stage Delphi consensus technique was employed to identify renal centre characteristics and practice patterns that may be important in determining either RRT incidence or home modality usage.

Inequalities in rates of renal replacement therapy in England: does it matter who you are or where you live?

Unlabelled: Introduction. This study explores the geographical variation in renal replacement therapy (RRT) incidence and prevalence after adjusting for general population socio-demographics, renal unit treatment patterns and travel times.

Methods: The UK Renal Registry provided data on all patients in England commencing RRT in 2007 and receiving RRT on 31 December 2007.

Patterns and effects of missing comorbidity data for patients starting renal replacement therapy in England, Wales and Northern Ireland.

Background: Renal Registries play a key role in assessing quality of care and outcomes of renal replacement therapy and comparisons of outcomes between groups should adjust for differences in comorbidities. This study aimed to describe patterns of missing comorbidity data and differences in survival between patients with comorbidity data returned and those with missing comorbidity data.

Methods: Trends in comorbidity data returns by year (1998-2006) and within centres were examined using descriptive statistics.

Global variation in renal replacement therapy for end-stage renal disease.

Background: Incidence rates of renal replacement therapy (RRT) for end-stage renal disease vary considerably worldwide. This study examines the independent association between the general population, health care system and renal service characteristics and RRT incidence rates.

Methods: RRT incidence data (2003-2005) were obtained from renal registries; general population age and health and macroeconomic indices were collected from secondary sources.

International Quotidian Dialysis Registry: Annual report 2010.

The International Quotidian Dialysis Registry (IQDR) is a global initiative designed to study practices and outcomes associated with the use of hemodialysis (HD) regimens of increased frequency and/or duration. The IQDR grew out of the initiative that lead to the randomized prospective studies of nocturnal HD and short hours daily dialysis vs. conventional thrice weekly HD that are conducted by the Frequent Hemodialysis Network sponsored by the National Institutes of Health.

Social deprivation, ethnicity, and access to the deceased donor kidney transplant waiting list in England and Wales.

Background: Socioeconomic and ethnic inequity in access to kidney transplant waiting list has been described in the United States but not examined in a universal healthcare system.

Methods: Eleven thousand two hundred ninety-nine patients aged 18 to 69 years starting renal replacement therapy (January 1, 1997 to December 31, 2004) in England and Wales were included. Multivariable Cox proportional hazards models were used to assess time to activation on the transplant waiting list for socially deprived patients among white patients.

UK Renal Registry 12th Annual Report (December 2009): chapter 6: comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses.

Introduction: The prevalence of comorbidities in incident renal replacement therapy (RRT) patients changes with age and varies between ethnic groups. This study describes these associations and the independent effect of comorbidities on outcomes.

Methods: Adult patients starting RRT between 2003 and 2008 in centres reporting to the UK Renal Registry (UKRR) with data on comorbidity (n (1/4) 14,909) were included.

The EVEREST study: an international collaboration.

Rates of initiation of renal replacement therapy (RRT), use of home modalities of treatment and patient outcomes vary considerably between countries. This paper reports the methods and baseline characteristics of countries participating in the EVEREST study (n = 46), a global collaboration examining the association between medical and non-medical factors and RRT incidence, modality mix and survival. Numbers of incident and prevalent patients were collected for current (2003-05) and historic (1983-85, 1988-90, 1993-95 and 1998-2000) periods stratified, where available, by age, gender, treatment modality and cause of end stage renal disease (diabetic versus non-diabetic).

Socio-economic status, ethnicity and geographical variations in acceptance rates for renal replacement therapy in England and Wales: an ecological study.

Background: It is not known to what extent the reported regional variations in renal replacement therapy (RRT) acceptance rates in England and Wales are due to differences in the socio-demographic characteristics of the population.

Methods: The authors calculated age-gender indirectly standardised RRT rates in 2007 for Primary Care Trusts (PCT)/Local Health Boards (LHB) in England and Wales and Government Office Regions (GOR) in England. Multivariable Poisson regression was used to examine the regional variations in the age-gender standardised RRT rates before and after adjustment for area deprivation (Townsend index) and the proportion of non-white people living in an area.

International Quotidian Dialysis Registry: annual report 2009.

The International Quotidian Dialysis Registry (IQDR) is a global initiative designed to study practices and outcomes associated with the use of hemodialysis regimens of increased frequency and/or duration. Several small studies suggest that compared with conventional hemodialysis (HD), short-daily, nocturnal, and long conventional HD regimens may improve surrogate endpoints and quality of life. However, methodologically robust comparisons on hard outcomes are sorely lacking.

UK Renal Registry 11th Annual Report (December 2008): Chapter 14 UK Renal Registry and international comparisons.

Background: The aim of this study is to report Renal Replacement Therapy (RRT) incidence and prevalence rates, the percentage of incident patients with diabetes mellitus as cause of renal disease, the RRT modality mix and the transplant rate in different countries. The number of national or regional registries collecting and reporting data pertaining to traditional cardiovascular (CV) risk factors in prevalent dialysis patients is also examined.

Methods: Data on numbers of incident and prevalent RRT patients in England, Wales, Scotland and Northern Ireland for the year 2007 were collected from the UK Renal Registry (UKRR) database and collated to meet the specifications on the US Renal Data System (USRDS) international data collection form.

Ethnicity, socioeconomic status, and attainment of clinical practice guideline standards in dialysis patients in the United kingdom.

Background And Objectives: The role of socioeconomic status (SES) and its contribution to ethnic differences in standards attainment among dialysis patients is not known.

Design, Setting, Participants, & Measurements: We examined associations between area- level SES (Townsend index) and ethnicity (white, black, South Asian) and standards attainment in 14,117 incident dialysis patients (1997-2004) in the UK.

Results: Deprived patients were less likely to achieve hemoglobin (Hb) > or = 10 g/dl (trend P < 0.

Blood pressure and mortality risk on peritoneal dialysis.

Background: The association of baseline blood pressure (BP) and mortality in incident peritoneal dialysis patients has not been adequately studied.

Study Design: Cohort study.

Setting & Participants: 2,770 patients on PD therapy at 180 days from start of renal replacement therapy in England and Wales between 1997 and 2004.

alpha1-antitrypsin (A1AT) deficiency presenting with IgA nephropathy and nephrotic syndrome: is renal involvement caused by A1AT deposition?

The role of severe a1-antitrypsin (A1AT) deficiency in the predisposition of early-onset pulmonary emphysema and juvenile hepatic cirrhosis is well-established. Associated glomerulonephritis is unusual although it is well-recognized in children and young adults with the severe phenotype. We report the first adult case of A1AT deficiency presenting with nephrotic syndrome secondary to IgA nephropathy and explore the direct role of A1AT deposits in the pathogenesis of the renal involvement.

International comparison of UK registry data (chapter 17).

In 2005, the incidence of renal replacement therapy (RRT) in the United Kingdom was 110 per million of the population (pmp) using the day 0 definition and 103 pmp using the day 90 definition. Relative to the 42 countries reporting data to the USRDS, the day 0 and day 90 rates for RRT incidence in the UK are the 32nd and 35th lowest, respectively. However, the overall incidence for the UK masks higher rates in Scotland, Wales and Northern Ireland (123, 129 and 140 pmp, respectively).

Patients with diabetic nephropathy on renal replacement therapy in England and Wales.

Background: The incidence of patients with diabetic nephropathy (DN) who start renal replacement therapy (RRT) is increasing.

Aim: To describe the characteristics and survival of patients with DN starting RRT in the UK.

Design: Retrospective cohort study.

Social deprivation and survival on renal replacement therapy in England and Wales.

This study examines the association between social deprivation and patient characteristics and outcomes in a nationally representative cohort of incident renal replacement therapy (RRT) patients. All Caucasian patients reported to the UK Renal Registry between 1997 and 2004 by centers in England and Wales with high data completeness were included. Social deprivation was assessed using the Townsend index.

Exploring the differences in epidemiology of treated ESRD between Germany and England and Wales.

Background: The aim of this study is to investigate reasons for the large reported differences in renal replacement therapy (RRT) incidence between Germany and England and Wales (E&W).

Methods: Age- and sex-standardized incidence rates were calculated at day 0, day 90, and day 180 by using registry data, and early RRT mortality was studied as an indicator of ascertainment differences. Nationally representative health survey data were analyzed to provide general population prevalence data for major chronic kidney disease risk factors: hypertension, diabetes, vascular disease, obesity, and smoking.

Collecting unit cost data in multicentre studies. Creating comparable methods.

International comparisons of health care systems and services have created increased interest in the comparability of cost results. This study compared top-down and bottom-up approaches to collecting unit cost data across centres in the context of examining the cost-effectiveness of dialysis therapy across Europe. The study tested whether health care technologies in different countries can be costed using consistent and transparent methods to increase the comparability of results.

Early referral and planned initiation of dialysis: what impact on quality of life?

Background: Early patient referral correlates with improved patient survival on dialysis. We examine whether early referral and a planned first dialysis affect quality of life (QoL).

Methods: All patients commencing dialysis in nine centres in seven European countries between 1 July 1998 and 31 October 1999 were recruited.