End-stage renal disease in Scotland: Outcomes and standards of care

W. Metcalfe, I. H. Khan, Gordon James Prescott, K. Simpson, Alison Murray MacLeod, R. R. Scottish, Scottish Renal Registry

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background. The number of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) in the United Kingdom rises annually. Patients are increasingly elderly with a greater prevalence of comorbid illness. Unadjusted survival, from the time of starting RRT, is not improving. The United Kingdom Renal Association has published recommended standards of treatment, which all United Kingdom nephrologists strive to attain. This study was devised to define the impact of attaining recommended treatment standards, adjusting for patient age and comorbid illnesses, upon survival on RRT in the United Kingdom population.

Methods. A prospective, registry based, observational study of all patients starting RRT in Scotland over a 1-year period, followed for the first 2 years of RRT.

Results. Of the 523 patients who were studied, 217 (41.5%) had died by 2 years of follow-up, 32% excluding deaths within the first 90 days. Age, comorbidity, weight when starting RRT, and attaining the recommended standards for albumin and hemoglobin had a significant impact upon survival.

Conclusion. This study has emphasized the very high mortality of patients starting RRT in Scotland. By paying close attention to the attainment of recommended standards of care for patients with ESRD, it may be possible to improve upon current mortality figures. The monitoring of such success is only possible if correction is made for age and comorbidity.

Original languageEnglish
Pages (from-to)1808-1816
Number of pages8
JournalKidney International
Volume64
Issue number5
DOIs
Publication statusPublished - Nov 2003

Keywords

  • Scottish Renal Registry
  • comorbidity
  • standards of care
  • PERITONEAL-DIALYSIS PATIENTS
  • HEMODIALYSIS-PATIENTS
  • REPLACEMENT THERAPY
  • SERUM-ALBUMIN
  • UNITED-STATES
  • CLINICAL-OUTCOMES
  • COMORBIDITY INDEX
  • PREDICTIVE VALUE
  • MORTALITY
  • SURVIVAL

Cite this

Metcalfe, W., Khan, I. H., Prescott, G. J., Simpson, K., MacLeod, A. M., Scottish, R. R., & Scottish Renal Registry (2003). End-stage renal disease in Scotland: Outcomes and standards of care. Kidney International, 64(5), 1808-1816. https://doi.org/10.1046/j.1523-1755.2003.00271.x

End-stage renal disease in Scotland: Outcomes and standards of care. / Metcalfe, W.; Khan, I. H.; Prescott, Gordon James; Simpson, K.; MacLeod, Alison Murray; Scottish, R. R.; Scottish Renal Registry.

In: Kidney International, Vol. 64, No. 5, 11.2003, p. 1808-1816.

Research output: Contribution to journalArticle

Metcalfe, W, Khan, IH, Prescott, GJ, Simpson, K, MacLeod, AM, Scottish, RR & Scottish Renal Registry 2003, 'End-stage renal disease in Scotland: Outcomes and standards of care', Kidney International, vol. 64, no. 5, pp. 1808-1816. https://doi.org/10.1046/j.1523-1755.2003.00271.x
Metcalfe, W. ; Khan, I. H. ; Prescott, Gordon James ; Simpson, K. ; MacLeod, Alison Murray ; Scottish, R. R. ; Scottish Renal Registry. / End-stage renal disease in Scotland: Outcomes and standards of care. In: Kidney International. 2003 ; Vol. 64, No. 5. pp. 1808-1816.
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abstract = "Background. The number of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) in the United Kingdom rises annually. Patients are increasingly elderly with a greater prevalence of comorbid illness. Unadjusted survival, from the time of starting RRT, is not improving. The United Kingdom Renal Association has published recommended standards of treatment, which all United Kingdom nephrologists strive to attain. This study was devised to define the impact of attaining recommended treatment standards, adjusting for patient age and comorbid illnesses, upon survival on RRT in the United Kingdom population.Methods. A prospective, registry based, observational study of all patients starting RRT in Scotland over a 1-year period, followed for the first 2 years of RRT.Results. Of the 523 patients who were studied, 217 (41.5{\%}) had died by 2 years of follow-up, 32{\%} excluding deaths within the first 90 days. Age, comorbidity, weight when starting RRT, and attaining the recommended standards for albumin and hemoglobin had a significant impact upon survival.Conclusion. This study has emphasized the very high mortality of patients starting RRT in Scotland. By paying close attention to the attainment of recommended standards of care for patients with ESRD, it may be possible to improve upon current mortality figures. The monitoring of such success is only possible if correction is made for age and comorbidity.",
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N2 - Background. The number of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) in the United Kingdom rises annually. Patients are increasingly elderly with a greater prevalence of comorbid illness. Unadjusted survival, from the time of starting RRT, is not improving. The United Kingdom Renal Association has published recommended standards of treatment, which all United Kingdom nephrologists strive to attain. This study was devised to define the impact of attaining recommended treatment standards, adjusting for patient age and comorbid illnesses, upon survival on RRT in the United Kingdom population.Methods. A prospective, registry based, observational study of all patients starting RRT in Scotland over a 1-year period, followed for the first 2 years of RRT.Results. Of the 523 patients who were studied, 217 (41.5%) had died by 2 years of follow-up, 32% excluding deaths within the first 90 days. Age, comorbidity, weight when starting RRT, and attaining the recommended standards for albumin and hemoglobin had a significant impact upon survival.Conclusion. This study has emphasized the very high mortality of patients starting RRT in Scotland. By paying close attention to the attainment of recommended standards of care for patients with ESRD, it may be possible to improve upon current mortality figures. The monitoring of such success is only possible if correction is made for age and comorbidity.

AB - Background. The number of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) in the United Kingdom rises annually. Patients are increasingly elderly with a greater prevalence of comorbid illness. Unadjusted survival, from the time of starting RRT, is not improving. The United Kingdom Renal Association has published recommended standards of treatment, which all United Kingdom nephrologists strive to attain. This study was devised to define the impact of attaining recommended treatment standards, adjusting for patient age and comorbid illnesses, upon survival on RRT in the United Kingdom population.Methods. A prospective, registry based, observational study of all patients starting RRT in Scotland over a 1-year period, followed for the first 2 years of RRT.Results. Of the 523 patients who were studied, 217 (41.5%) had died by 2 years of follow-up, 32% excluding deaths within the first 90 days. Age, comorbidity, weight when starting RRT, and attaining the recommended standards for albumin and hemoglobin had a significant impact upon survival.Conclusion. This study has emphasized the very high mortality of patients starting RRT in Scotland. By paying close attention to the attainment of recommended standards of care for patients with ESRD, it may be possible to improve upon current mortality figures. The monitoring of such success is only possible if correction is made for age and comorbidity.

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