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Renal replacement therapy in B runei D arussalam: Comparing standards with international renal registries
Author(s) -
Tan Jackson
Publication year - 2014
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12228
Subject(s) - medicine , peritoneal dialysis , renal replacement therapy , dialysis , transplantation , incidence (geometry) , end stage renal disease , hemodialysis , intensive care medicine , physics , optics
Background and Aim B runei Darussalam is a small South East Asian country with a high prevalence and incidence of end stage kidney disease ( ESRD ). This study aims to compare key performance indicators recorded in the B runei Dialysis and Transplant Registry and department records against international practice. Registries from the USA ( USRDS ), UK ( UK Renal Registry), Australasia ( ANZDATA ), Europe ( ERA‐EDTA Registry) and M alaysia ( MDTR ) were used for comparisons. Methods and Results Haemodialysis (83%) and renal transplantation (6%) were the most and least favoured modality of renal replacement therapy in B runei. Diabetes mellitus as a cause of ESRD (57%) was high in B runei but on par with other South East Asian countries. Dialysis death rates (11%) and living‐related transplant survival rates (5 year graft and patient survival 91% and 96% respectively) were favourable compared with other registries. Anaemia and mineral bone disease management were similar to M alaysia but slightly inferior to the others, but generally in keeping with KDOQI and KDIGO targets. Haemodialysis adequacy (48% achieving urea reduction ratio of >65%) was relatively poorer due to poor dialysis flow rates and low fistula usage (71%). Peritoneal dialysis peritonitis (24.5 patient‐month/episode) and adequacy (78% achieving kt/v of 1.7) were in keeping with ISPD targets and international registries' results. Conclusion B runei has achieved reasonable and commendable standards in many areas pertaining to the renal services. This report has identified several key areas for developments but this is to be expected for a service making its first foray into international benchmarked practice.