What is already known about this topic and why is it important?
Until recently, only individuals who received a diagnosis of ‘end-stage kidney disease’ were included in the UK Renal Registry (UKRR) report. To receive this diagnosis,
- an individual’s clinical team must recognise and document that they feel that the person is in a state of irreversible kidney failure, or
- an individual must still be on dialysis 90 days after starting (in which case the UKRR automatically applies the diagnosis).
In the past two UKRR annual reports, individuals who have received dialysis without an end-stage kidney disease diagnostic code have been included – accounting for an extra 1700 people in 2016 who started dialysis then recovered renal function or died. The UKRR has not yet attempted to report on the rates of recovery or death amongst these individuals. This application for individual patient data relates to analysis of these recovery and death rates and will help us to understand how to analyse and report them.
How will you carry out your study?
We plan to use routinely collected UKRR data to describe the survival and recovery patterns for individuals starting dialysis with and without a diagnosis of end-stage kidney disease. This study will be conducted within the UKRR. Results will also form a peer-reviewed publication.
How will you decide which patients are included in your study?
This preliminary work will use data for individuals starting dialysis during a 12-month period in 2015-2016 as we have up-to-date 90-day survival and recovery data for them.
How many patients do you anticipate including?
Approximately 7,000 individuals will be in this dataset. Only 90-day survival/recovery data will be presented in this work – longer-term survival/recovery data will form the basis of a future application.
What new information will your study generate and how will this benefit patients?
This information would be of use to patients, their families and clinicians making decisions about how to manage unanticipated indications for dialysis initiation – often in the setting of acute kidney injury.