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CHAPTER 11: Haemodialysis Practices

CHAPTER 11: Haemodialysis Practices. Shahnaz Shah Firdaus Khan Tan Chwee Choon Rafidah Abdullah Norleen Bt Zulkarnain Sim. Source: 21 st MDTR Report 2013, NRR. Table 11.1.1: Vascular access on haemodialysis, 2004-2013.

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CHAPTER 11: Haemodialysis Practices

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  1. CHAPTER 11:Haemodialysis Practices Shahnaz Shah Firdaus Khan Tan Chwee Choon Rafidah Abdullah Norleen Bt Zulkarnain Sim Source: 21st MDTR Report 2013, NRR

  2. Table 11.1.1: Vascular access on haemodialysis, 2004-2013 *AVF = arteriovenoous fistula, BBF = Brachiobasilic fistula, BCF = brachiocephalic fistula Source: 21st MDTR Report 2013, NRR

  3. Table 11.1.2: Difficulties report with vascular access, 2004-2013 Source: 21st MDTR Report 2013, NRR

  4. Table 11.1.3: Complications reported with vascular access, 2004-2013 Source: 21st MDTR Report 2013, NRR

  5. Table 11.2.1: Blood flow rates in HD centers, 2004-2013 Source: 21st MDTR Report 2013, NRR

  6. Figure 11.2.1: Blood flow rates in HD centers, 2004-2013 <150 ml/min 150-199 ml/min 200-249 ml/min 250-299 ml/min 300-349 ml/min >=350 ml/min 40 30 % 20 10 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year Source: 21st MDTR Report 2013, NRR

  7. Table 11.2.2: Number of HD sessions per week, 2004-2013 Source: 21st MDTR Report 2013, NRR

  8. Table 11.2.3: Duration of HD, 2004-2013 Source: 21st MDTR Report 2013, NRR

  9. Table 11.2.4: Dialyser membrane types in HD centres, 2004-2013 Source: 21st MDTR Report 2013, NRR

  10. Figure 11.2.4: Dialyser membrane types in HD centres, 2004-2013 Modified Cellulose Regenerated Cellulose Hydrophobic/Hypdrophilic Hydrophilized copolymers 100 90 80 70 60 % 50 40 30 20 10 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year Source: 21st MDTR Report 2013, NRR

  11. Table 11.2.5: Dialyser reuse frequency in HD centres, 2004-2013

  12. Table 11.2.6(a): Distribution of prescribed Kt/V, HD patients 2004-2013 Source: 21st MDTR Report 2013, NRR

  13. Figure 11.2.6(a): Cumulative distribution of prescribed Kt/V, HD patients 2004-2013 2005 2007 2009 2011 2013 1 .75 Cumulative distribution .5 .25 0 1 1.2 1.4 1.6 1.8 2 2.2 2.4 KT/V Source: 21st MDTR Report 2013, NRR

  14. Table 11.2.6(b): Distribution of delivered Kt/V, HD patients 2009-2013 *Variance = (prescribed KT/V – delivered KT/V)/ Prescribed KT/V Source: 21st MDTR Report 2013, NRR

  15. Figure 11.2.6(b): Cumulative distribution of delivered Kt/V, HD patients 2009-2013 2009 2010 2011 2012 2013 1 .75 Cumulative distribution .5 .25 0 .8 1 1.2 1.4 1.6 1.8 2 2.2 KT/V Source: 21st MDTR Report 2013, NRR

  16. Table 11.2.6(c): Distribution of URR, HD patients 2009-2013 Source: 21st MDTR Report 2013, NRR

  17. Figure 11.2.6 (c): Cumulative distribution of URR, HD patients 2009-2013 2009 2010 2011 2012 2013 1 .75 Cumulative distribution .5 .25 0 55 60 65 70 75 80 85 90 URR Source: 21st MDTR Report 2013, NRR

  18. Table 11.2.7(a): Variation in median blood flow rates in HD patients, HD centres, 2004-2013 Source: 21st MDTR Report 2013, NRR

  19. Figure 11.2.7 (a): Variation in median blood flow rates in HD patients among centres 2013 Median blood flow rate (lower quartile, upper quartile) 400 350 300 Blood flow rate, ml/min 250 200 150 100 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  20. Table 11.2.7 (b): Proportion of patients with blood flow rates ≥ 300 ml/min, HD centres 2004-2013 Source: 21st MDTR Report 2013, NRR

  21. Figure 11.2.7 (b): Variation in Proportion of patients with blood flow rates >= 300 ml/min among HD centres 2013 % with blood flow rate >=300 ml/min (lower 95% CI, upper 95% CI) 100 90 80 70 60 % patients 50 40 30 20 10 0 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  22. Table 11.2.7(c): Proportion of patients with 3 HD sessions per week, HD centres 2004-2013 Source: 21st MDTR Report 2013, NRR

  23. Figure 11.2.7(c): Variation in proportion of patients with 3 HD sessions per week among HD centres 2013 Source: 21st MDTR Report 2013, NRR

  24. Table 11.2.7(d): Median prescribed Kt/V in HD patients, HD centres 2004-2013 Source: 21st MDTR Report 2013, NRR

  25. Figure 11.2.7(d): Variation in median prescribed Kt/V in HD patients among HD centres 2013 Median prescribed KT/V (lower quartile, upper quartile) 3.5 3 2.5 KT/V 2 1.5 1 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  26. Table 11.2.7(e): Proportion of patients with prescribed Kt/V ≥ 1.3, 2004-2013 Source: 21st MDTR Report 2013, NRR

  27. Figure 11.2.7(e): Variation in proportion of patients with prescribed Kt/V ≥ 1.3 among HD centres 2013 % with prescribed KT/V >=1.3 (lower 95% CI, upper 95% CI) 100 90 80 70 60 % patients 50 40 30 20 10 0 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  28. Table 11.2.7(f): Median delivered Kt/V in HD patients, HD centres 2009-2013 Source: 21st MDTR Report 2013, NRR

  29. Figure 11.2.7(f): Variation in median delivered Kt/V in HD patients among HD centres 2013 Median delivered KT/V (lower quartile, upper quartile) 2.4 2.2 2 1.8 1.6 KT/V 1.4 1.2 1 .8 .6 0 30 60 90 120 150 180 210 240 270 300 330 360 390 420 Centre Source: 21st MDTR Report 2013, NRR

  30. Table 11.2.7(g): Proportion of patients with delivered Kt/V ≥ 1.2, HD centres 2009-2013 Source: 21st MDTR Report 2013, NRR

  31. Figure 11.2.7(g): Variation in proportion of patients with delivered Kt/V ≥ 1.2, HD centres 2013 % with delivered KT/V >=1.2 (lower 95% CI, upper 95% CI) 100 90 80 70 60 % patients 50 40 30 20 10 0 0 30 60 90 120 150 180 210 240 270 300 330 360 390 420 Centre Source: 21st MDTR Report 2013, NRR

  32. Table 11.2.7(h): Median URR among HD patients, HD centres 2009-2013 Source: 21st MDTR Report 2013, NRR

  33. Figure 11.2.7(h): Variation in median URR among HD patients, HD centres 2013 Median URR (lower quartile, upper quartile) 100 90 80 URR % 70 60 50 40 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  34. Table 11.2.7(i): Proportion of HD patients with URR ≥ 65%, HD centres 2009-2013 Source: 21st MDTR Report 2013, NRR

  35. Figure 11.2.7(i): Variation in proportion of patients with URR ≥ 65% among HD centres 2013 % with URR >=65% (lower 95% CI, upper 95% CI) 100 90 80 70 60 % patients 50 40 30 20 10 0 0 50 100 150 200 250 300 350 400 450 500 550 600 Centre Source: 21st MDTR Report 2013, NRR

  36. Table 11.3.1(a): Unadjusted technique survival by year of entry, 2004-2013 Source: 21st MDTR Report 2013, NRR

  37. Figure 11.3.1(a): Unadjusted technique survival by year of entry, 2004-2013 Source: 21st MDTR Report 2013, NRR

  38. Table 11.3.1(b): Unadjusted technique survival by year of entry (censored for death & transplant), 2004-2013 Source: 21st MDTR Report 2013, NRR

  39. Figure 11.3.1(b): Unadjusted technique survival by year of entry (censored for death & transplant), 2004-2013 Source: 21st MDTR Report 2013, NRR

  40. Table 11.3.2(a): Unadjusted technique survival by age, 2004-2013 Source: 21st MDTR Report 2013, NRR

  41. Figure 11.3.2(a): Unadjusted technique survival by age, 2004-2013 Source: 21st MDTR Report 2013, NRR

  42. Table 11.3.2(b): Unadjusted technique survival by age (censored for death & transplant), 2004-2013

  43. Figure 11.3.2(b): Unadjusted technique survival by age (censored for death & transplant), 2004-2013 Source: 21st MDTR Report 2013, NRR

  44. Table 11.3.3(a): Unadjusted technique survival by diabetes status, 2004-2013 Source: 21st MDTR Report 2013, NRR

  45. Figure 11.3.3(a): Unadjusted technique survival by diabetes status, 2004-2013 Kaplan-Meier survival estimates, by Diabetes 1.00 0.75 Non-diabetic Cumulative survival 0.50 Diabetic 0.25 0.00 0 12 24 36 48 60 72 84 96 108 120 Duration in months Source: 21st MDTR Report 2013, NRR

  46. Table 11.3.3(b): Unadjusted technique survival by diabetes status (censored for death & transplant), 2004-2013 Source: 21st MDTR Report 2013, NRR

  47. Figure 11.3.3(b): Unadjusted technique survival by diabetes status (censored for death & transplant), 2004-2013 Kaplan-Meier survival estimates, by Diabetes 1.00 Non-diabetic Diabetic 0.75 Cumulative survival 0.50 0.25 0.00 0 12 24 36 48 60 72 84 96 108 120 Duration in months Source: 21st MDTR Report 2013, NRR

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