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Graham-Brown MPM, Casula A, Savino M, Humphrey T, Pyart R, Amaran M, Williams J, Crowe K, Medcalf JF. A National audit of the care of patients with acute kidney injury in England and Wales in 2019 and the association with patient outcomes. Clin Med (Lond) 2024; 24:100028. [PMID: 38387536 DOI: 10.1016/j.clinme.2024.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND Acute kidney injury (AKI) is a common complication of hospitalisations. This national audit assessed the care received by patients with AKI in hospital Trusts in England and Wales. METHODS Twenty four hospital Trusts across England and Wales took part. Patients with AKI stage2/3 were identified using the UK Renal Registry AKI master patient index. Data was returned through a secure portal with linkage to hospital episode statistic mortality and hospitalisation data. Completion rates of AKI care standards and regional variations in care were established. RESULTS 989 AKI episodes were included in the analyses. In-hospital 30-day mortality was 31-33.1% (AKI 2/3). Standard AKI interventions were completed in >80% of episodes. Significant inter-hospital variation remained in attainment of AKI care standards after adjustment for age and sex. Recording of urinalysis (41.9%) and timely imaging (37.2%) were low. Information on discharge summaries relating to medication changes/re-commencement and follow-up blood tests associated with reduced mortality. No quality indicators relating to clinical management associated with mortality. Better communication on discharge summaries associated with reduced mortality. CONCLUSIONS Outcomes for patients with AKI in hospital remain poor. Regional variation in care exists. Work is needed to assess whether improving and standardising care improves patient outcomes.
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Affiliation(s)
- M P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, LE1 9HN, United Kingdom; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, United Kingdom.
| | - A Casula
- UK Renal Registry, United Kingdom
| | - M Savino
- UK Renal Registry, United Kingdom; Bristol Royal Infirmary, Division of Acute Medicine
| | - T Humphrey
- Department of Renal Medicine, Cambridge University Hospitals NHS Foundation Trust, United Kingdom
| | - R Pyart
- UK Renal Registry, United Kingdom
| | - M Amaran
- Renal Unit, St George's Hospital, London, United Kingdom
| | - J Williams
- School of Medicine, University of Exeter, United Kingdom
| | - K Crowe
- Glasgow Renal & Transplant Unit, NHS Greater Glasgow & Clyde, United Kingdom
| | - J F Medcalf
- John Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester NHS Trust, United Kingdom; UK Renal Registry, United Kingdom
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Lloyd A, Jefferies H, Pyart R, Roberts G. Barriers to Home Haemodialysis. Blood Purif 2023; 52:86-90. [PMID: 36209726 DOI: 10.1159/000525331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/14/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Significant variation exists in the prevalence of home haemodialysis (HHD) among UK renal centres. Our centre has a HHD prevalence of 2%, and we aimed to study how many patients who chose HHD as their preferred mode of renal replacement therapy (RRT) went on to receive this treatment and the barriers to starting this treatment. METHODS A retrospective single-centre analysis of electronic medical records for all patients who chose HHD at the time of RRT education was performed, and data were collected on patient demographics, comorbidity, frailty, RRT events, and barriers to HHD. RESULTS 116 patients chose HHD as their preferred mode of RRT between 2006 and 2018. Of these patients, 93 required RRT, but only 28 patients ever received HHD. No statistical difference was identified between those patients who only received unit haemodialysis (UHD) and those who went onto receive HHD with respect to age, gender, comorbidity, frailty, and socioeconomic deprivation. Patient choice, change in clinical condition, transplantation, home environment, vascular access problems, and training delays were identified as reasons patients did not start HHD. No documented reason could be found in 9 patients with a breakdown of communication between clinics and peripheral dialysis units attributed as a significant contributor in some of these patients. Of the 26 patients who started HHD after UHD, 19 did so within 1 year of starting UHD. CONCLUSION Most patients who choose HHD do not receive HHD. Many patients never start HHD because of potentially reversible barriers including inadequate communication among clinicians about patient choices, patients changing their minds once in a dialysis unit, and inadequate timely training support.
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Affiliation(s)
- Aled Lloyd
- University Hospital of Wales, Cardiff, UK
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Edwards GM, Notzing J, Frost P, Pyart R. Pregnancy-induced atypical haemolytic uraemic syndrome. Clin Med (Lond) 2022; 21:e403-e404. [PMID: 35192483 DOI: 10.7861/clinmed.2021-0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hole BD, Evans KM, Pyart R, Davids MR, Bedat CG, Hanafusa N, Harris DCH, Jager KJ, Jha V, Johansen KL, McDonald S, Masakane I, Rosa-Diez G, Saran R, Wetmore JB, Caskey FJ. International collaborative efforts to establish kidney health surveillance systems. Kidney Int 2021; 98:812-816. [PMID: 32998808 PMCID: PMC7526596 DOI: 10.1016/j.kint.2020.06.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Barnaby D Hole
- UK Renal Registry, Renal Association, Bristol, UK; Population Health Sciences, University of Bristol, Bristol, UK; Department of Renal Medicine, North Bristol NHS Trust, Bristol, UK
| | | | - Rhodri Pyart
- UK Renal Registry, Renal Association, Bristol, UK
| | - M Razeen Davids
- Division of Nephrology, Stellenbosch University, Cape Town, South Africa; Division of Nephrology, Tygerberg Hospital, Cape Town, South Africa; South African Renal Registry, Cape Town, South Africa; African Renal Registry, Cape Town, South Africa
| | | | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan; Japanese Society for Dialysis Therapy Renal Data Registry (JRDR), Tokyo, Japan
| | - David C H Harris
- The Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia; Western Sydney Renal Service, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kitty J Jager
- European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, Amsterdam University Medical Centers, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales, New Delhi, India; George Institute for Global Health, University of Oxford, Oxford, UK; Manipal Academy of Higher Education, Manipal, India
| | - Kirsten L Johansen
- Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA; Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minnesota, USA; United States Renal Data System, Minneapolis, Minnesota, USA
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australia Health and Medical Research Institute, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia; Renal Unit, Royal Adelaide Hospital, Adelaide, Australia
| | - Ikuto Masakane
- Japanese Society for Dialysis Therapy Renal Data Registry (JRDR), Tokyo, Japan; Global Chronic Kidney Disease (CKD) Management Division, Yabuki Hospital, Yamagata, Japan
| | - Guillermo Rosa-Diez
- Latin American Dialysis & Renal Transplantation Registry, SLANH, Montevideo, Uruguay; Division of Nephrology, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Rajiv Saran
- Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, Michigan, USA
| | - James B Wetmore
- Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA; Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minnesota, USA; United States Renal Data System, Minneapolis, Minnesota, USA
| | - Fergus J Caskey
- Population Health Sciences, University of Bristol, Bristol, UK; Department of Renal Medicine, North Bristol NHS Trust, Bristol, UK.
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Cox L, Wong E, Evans KM, Medcalf J, Pyart R. The Challenges of Using UK Renal Registry Data to Audit the Care of Patients with Diabetes on Renal Replacement Therapy. Nephron Clin Pract 2020; 144:440-446. [PMID: 32698181 DOI: 10.1159/000508637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/08/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Diabetes is a major cause of CKD and of mortality in patients on renal replacement therapy (RRT). Auditing the care of patients with diabetes on RRT against published guidelines relies on robust data collection. OBJECTIVE This article assesses the completeness of data items collected by the UK Renal Registry (UKRR) that are required to audit the care of patients with diabetes on RRT. METHODS The UKRR receives data on all patients receiving RRT in the UK. Patients with diabetes, diabetes type, and method of renal diagnosis were identified from primary renal disease (PRD) codes and comorbidity data for patients commencing RRT at one of the 57 renal centres in England and Wales between 2010 and 2016. The completeness of demographic and clinical data (blood pressure, cholesterol, glycated haemoglobin [HbA1c], and smoking status) was assessed for the first year of RRT. RESULTS Ninety-three per cent of all patients on RRT irrespective of diagnosis had a PRD code, but only 28/57 renal centres had comorbidity data completeness ≥70%; 34.9% of patients with diabetic nephropathy (DN) had type 1 diabetes, but this varied between centres (9.2-100%). Overall, 4.2% of DN diagnoses were by biopsy. Data completeness in the first year of RRT for cardiovascular risk factors ranged between 50.0 and 80.0%, with HbA1c data completeness being 63.0%. Of 57 centres, 20 had HbA1c data for ≥70% of patients in the first year of RRT. CONCLUSIONS There is persistent variation between renal centres in the completeness of data collected on patients with diabetes on RRT, impacting on the ability to undertake robust audit. Data linkages and expanded data permissions could see registry data play a key role in ongoing audit and research into patients with diabetes and CKD, provided adequate data can be collected.
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Affiliation(s)
- Louise Cox
- UK Renal Registry, Bristol, United Kingdom
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Pyart R, Aggett J, Goodland A, Jones H, Prichard A, Pugh J, Thomas N, Roberts G. Exploring the choices and outcomes of older patients with advanced kidney disease. PLoS One 2020; 15:e0234309. [PMID: 32520955 PMCID: PMC7286495 DOI: 10.1371/journal.pone.0234309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 05/24/2020] [Indexed: 02/08/2023] Open
Abstract
A lack of data on patient choices and outcomes at the time of pre-dialysis planning limits meaningful shared decision making, particularly in older frailer patients. In this large retrospective cohort study of patients aged over 70 seen by the pre-dialysis clinic (2004–2016) of a large single centre in the United Kingdom (1,216 patients), age, sex, comorbidity, poverty and frailty were used to predict choice of renal replacement therapy (RRT) over maximum conservative management (MCM). The impact of patient choice of RRT versus MCM was used to predict survival from the time of choice using multivariable Cox proportional hazards regression. Older age, female sex, greater poverty and greater frailty were associated with choosing MCM, whilst comorbidity had no significant impact on choice. At 5 years of follow up, 49% of all patients had died without receiving RRT. Over 70% of the patients choosing MCM died with better kidney function than the median level at which those starting RRT initiated treatment. Frailty and age were better predictors of survival than comorbidity and in patients with at least moderate frailty, RRT offered no survival benefit over MCM. In conclusion, analysing outcomes from the time of choice may improve shared decision making. Frailty should be routinely assessed and collected and further work may help predict which patients are unlikely to survive or progress to end stage renal disease and may not need to be burdened with making a pre-dialysis choice.
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Affiliation(s)
- Rhodri Pyart
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
- * E-mail:
| | - Justine Aggett
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Annwen Goodland
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Hayley Jones
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Alison Prichard
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Julia Pugh
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Nerys Thomas
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Gareth Roberts
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
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Abstract
BACKGROUND It is unclear whether discharging patients from renal clinic to primary care is safe. AIM To determine the characteristics, primary care monitoring and renal outcomes of patients discharged from renal clinic. DESIGN AND SETTING A retrospective study of 2236 adults discharged from a tertiary renal clinic between 2013-2018. METHOD Patient demographics, primary renal disease, laboratory results and timeline dates were collected from the renal IT system. Timing of blood tests, renal progression, needing dialysis and patient survival were analysed. Reasons for discharge and cause of disease progression were reviewed in patients developing new estimated glomerular filtration rate <20 ml/min/1.73 m2. RESULTS Patients were older (median age 75; interquartile range 63-84) with non-progressive, seemingly non-proteinuric renal disease. Median time to repeat blood test post-discharge was 75 days with 90% tested within 12 months. Sixty-six percent saw an improvement in kidney function post-discharge and only 13% had a decline of >10 ml/min/1.73 m2. Only 132 patients (6%) developed new advanced chronic kidney disease (estimated glomerular filtration rate < 20 ml/min/1.73 m2) of whom 40% were palliative, 36% had developed acute kidney injury and 23% discharged for failing to attend clinic. One hundred and thirty-four patients (6%) were referred back to nephrology and eight started dialysis of whom six were discharged for failure to attend clinic. CONCLUSION Most discharged patients are low risk of progressive renal disease and need infrequent monitoring. Non-adherent patients discharged for failing to attend appear to be at risk of poor outcomes and new strategies are needed to better support this population.
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Affiliation(s)
- Rhodri Pyart
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
| | - Sheryl Lim
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
| | - Bilal Hussein
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
| | - Steve Riley
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
| | - Gareth Roberts
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
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Plumb L, Casula A, Pyart R, Evans KM, Inward C, Medcalf J, Marks SD. The 21st UK Renal Registry Annual Report: A Summary of Analyses of Paediatric Data in 2017. Nephron Clin Pract 2019; 144:67-71. [PMID: 31825936 DOI: 10.1159/000504852] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/17/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Lucy Plumb
- UK Renal Registry, Bristol, United Kingdom, .,Population Health Sciences, University of Bristol Medical School, Bristol, United Kingdom,
| | | | | | | | - Carol Inward
- Department of Paediatric Nephrology, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | | | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,University College London Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
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Pyart R, Evans KM, Steenkamp R, Casula A, Wong E, Magadi W, Medcalf J. The 21st UK Renal Registry Annual Report: A Summary of Analyses of Adult Data in 2017. Nephron Clin Pract 2019; 144:59-66. [PMID: 31825944 DOI: 10.1159/000504851] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/17/2019] [Indexed: 11/19/2022] Open
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HOLE B, Pyart R, Davids R, Gonzalez-Bedat C, Jager K, McDonald S, Pisoni R, Rosa-Diez G, Saran R, Caskey F. SAT-027 ESTABLISHING REGISTRIES FOR KIDNEY HEALTH ADVOCACY – RESULTS FROM THE SharE-RR SURVEY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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EVANS K, Pyart R, Davids M, Gonzalez Bedat M, Jager K, McDonald S, Pisoni R, Rosa-Diez G, Saran R, Caskey F. SAT-025 DATA ITEM COLLECTION BY RENAL REGISTRIES AROUND THE WORLD – RESULTS FROM THE SharE-RR SURVEY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pyart R, Donovan K, Carrington C, Roberts G. Peritoneal Dialysis: Turning Choice into Reality. Perit Dial Int 2018; 38:328-333. [DOI: 10.3747/pdi.2018.00011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/26/2018] [Indexed: 11/15/2022] Open
Abstract
Background Peritoneal dialysis (PD) utilization rates vary widely between UK renal centers. Currently there are only limited data available on how many patients choose PD but subsequently fail to start their chosen modality. In the current analysis we sought to explore the outcomes of patients who chose PD in our center where all PD catheters are inserted via a mini-laparotomy with no acute-start PD service. Methods We retrospectively analyzed the outcomes of 658 patients over a 12-year period who, following predialysis education had chosen PD as their preferred renal replacement therapy (RRT) modality. Data were collected on patient demographics, start modality, transplantation, patient survival, and the reasons patients failed to start PD. Results Predialysis education was given to 2,749 patients, and 658 (24%) chose PD. Of the 566 (86%) who either started RRT or died, less than half started PD ( n = 273, 48%). The commonest reason to start hemodialysis (HD) was an acute decline in kidney function leading to an effective ‘unplanned’ start on RRT. As a result, despite adjusting for older age and higher comorbidity, the transplant-censored survival at 3 years from the time of start of RRT was predictably worse in patients starting HD. Less than half the patients who started HD went on to commence PD later. Conclusion Unanticipated decline in kidney function leading to unplanned start on HD contributes to the worse outcomes associated with failing to start PD. How and when we insert PD catheters appears to be key, and we have identified ways to improve our service.
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Affiliation(s)
- Rhodri Pyart
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Kieron Donovan
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Christopher Carrington
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
| | - Gareth Roberts
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, United Kingdom
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Evans K, Pyart R, Steenkamp R, Whitlock T, Stannard C, Gair R, McCann J, Slevin J, Medcalf J, Caskey F. UK Renal Registry 20th Annual Report: Introduction. Nephron Clin Pract 2018; 139 Suppl 1:1-12. [PMID: 29990996 DOI: 10.1159/000490958] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pyart R, Wong E, Sharples E, Casula A, Byrne C. Chapter 3 Demographic and Biochemistry Profile of Kidney Transplant Recipients in the UK in 2016:. Nephron Clin Pract 2018; 139 Suppl 1:75-104. [DOI: 10.1159/000490961] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pyart R, Magadi W, Steenkamp R, Davenport A. Chapter 6 Adequacy of Haemodialysis in UK Adult Patients in 2016: National and Centre-specific Analyses. Nephron Clin Pract 2018; 139 Suppl 1:151-164. [PMID: 29991002 DOI: 10.1159/000490964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Steenkamp R, Pyart R, Fraser S. Chapter 5 Survival and Cause of Death in UK Adult Patients on Renal Replacement Therapy in 2016. Nephron Clin Pract 2018; 139 Suppl 1:117-150. [PMID: 29991001 DOI: 10.1159/000490963] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Evans KM, Pyart R, Steenkamp R, Caskey FJ. The UK Renal Registry: making patient data matter. Br J Hosp Med (Lond) 2018; 79:246-248. [PMID: 29727240 DOI: 10.12968/hmed.2018.79.5.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katharine M Evans
- Research Project Manager, UK Renal Registry, Southmead Hospital, Bristol BS10 5NB
| | - Rhodri Pyart
- Registrar, UK Renal Registry, Southmead Hospital, Bristol
| | - Retha Steenkamp
- Head Statistician, UK Renal Registry, Southmead Hospital, Bristol
| | - Fergus J Caskey
- Medical Director, UK Renal Registry, Southmead Hospital, Bristol, and Population Health Sciences, University of Bristol, Bristol
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Pyart R, Casula A, Nicholas J, Dawnay A. Chapter 8 Biochemical Variables in UK Adult Dialysis Patients in 2016: National and Centre-specific. Nephron Clin Pract 2018; 139 Suppl 1:191-240. [DOI: 10.1159/000490966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pyart R, Gilg J, Williams AJ. Chapter 7 Haemoglobin, Ferritin and Erythropoietin in UK Adult Dialysis Patients in 2016: National and. Nephron Clin Pract 2018; 139 Suppl 1:165-190. [DOI: 10.1159/000490965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Griffiths B, Edwards G, Beaton C, Pyart R, Ramasamy V. SO043AKI ELECTRONIC ALERT TRIGGERED INTERVENTION IMPROVES PATIENT OUTCOMES. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx107.so043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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