Using patient data to improve dialysis treatment in the UK

In 2010 Kidney Research UK awarded Dr James Fotheringham, a Consultant Nephrologist at the Sheffield Kidney Institute, a fellowship to analyse the performance of renal care services and associated health outcomes.

Patient data from the Renal Registry, the Hospital Episode Statistics, and mortality data from the Office of National Statistics were linked and anonymised before being analysed.

Project results

James and his team studied data from over 5,800 patients who had dialysis between 2002 and 2006.

They found that patients who dialyze three times a week with a two-day break before their next session were 69 per cent more likely to be admitted to hospital upon returning to their next session.

The two-day dialysis gap also increased deaths by 22 per cent. Previously it had been thought that this ‘dialysis gap’ was only a problem in America where people had shorter, poorer quality dialysis.

The harm from the two-day gap also affects patients on a day-to-day basis. They told James they felt more nauseous after the two-day break in dialysis and often when they went home felt more tired as the dialysis had removed two days’ worth of fluid and toxins from their body.

The initial study created a range of new tools to measure quality and performance of UK Renal Replacement Therapy Services. This enabled the identification of those treatment centres with poorer health outcomes and areas for their subsequent improvement.

Next steps

The success of the project enabled James to successfully apply for a subsequent and much larger National Institute for Health Research (NIHR) Fellowship. He is now looking into how harm associated with the two-day break in dialysis can be reduced.

James and his team want to make recommendations to improve how dialysis treatment is delivered to improve patients’ quality of life.

Watch a short video of James taking about his work, with thanks to Understanding Patient Data.