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Date: 15 June 2021
Renal medicine quality indicators
Percentage of haemodialysis programme patients with a urea reduction ratio (URR) of >65%
What is haemodialysis?
The kidneys are paired organs with several functions. Two of their main functions are to regulate the amount of water and salts in the body as well as eliminating waste products such as urea. Renal failure, or kidney failure, is a situation in which the kidneys fail to function adequately.
Haemodialysis is a method for removing waste products and water from the blood in severe kidney failure. Haemodialysis is one of three renal replacement treatments, the other two being kidney transplantation and peritoneal dialysis.
Patients with established (permanent) kidney failure enter the Trust’s chronic dialysis programme. UHB is one of the largest dialysis centres in the world with over 1000 patients currently on the dialysis programme.
How is the Trust doing?
|Rolling year to date (February 2019 – January 2020)||95.3%|
|Rolling 2 years (February 2018 – January 2020)||95.1%|
Higher percentage indicates better performance.
The Trust’s performance has improved over time with over 90% of regular haemodialysis patients achieving a URR greater than the recommended standard.
Data collected from 71 adult kidney units in the UK for 2013 shows that 88.6% of regular haemodialysis patients achieved the UK Renal Association standard (data source: UK Renal Registry 17th Annual Report (2014) - see "External links" below).
Why is this indicator important?
Several studies have shown that the delivered dose of haemodialysis is an important predictor of patient outcome and survival. The most commonly used measure of dialysis dose is the urea reduction ratio (URR) which is defined as the percentage fall of urea during a single dialysis session. The UK Renal Association recommends that all patients on regular haemodialysis have a URR greater than 65%.
How do we measure this indicator?
This indicator looks at the percentage reduction in urea from pre-dialysis to post-dialysis levels, for patients who have been receiving regular haemodialysis under the care of UHB for more than three months.
All these patients have their blood tested for urea before and after their midweek dialysis session (Wednesday or Thursday) on a monthly basis.
Where does the data come from?
The data for the indicators is compiled from MARS, which collects data about UHB patients undergoing dialysis.
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