BACKGROUND: Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. METHODS: An online questionnaire was distributed to all UK renal centres. RESULTS: Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. CONCLUSION: There is an urgent need for establishing an evidence base on the optimal approaches to fluid management.
BACKGROUND: Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. METHODS: An online questionnaire was distributed to all UK renal centres. RESULTS: Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. CONCLUSION: There is an urgent need for establishing an evidence base on the optimal approaches to fluid management.
Authors: Michael J Germain; Jyovani Joubert; Daniel O'Grady; Brian H Nathanson; Yossi Chait; Nathan W Levin Journal: Hemodial Int Date: 2017-08-10 Impact factor: 1.812
Authors: Indranil Dasgupta; G Neil Thomas; Joanne Clarke; Alice Sitch; James Martin; Brian Bieber; Manfred Hecking; Angelo Karaboyas; Ronald Pisoni; Friedrich Port; Bruce Robinson; Hugh Rayner Journal: Clin J Am Soc Nephrol Date: 2019-02-05 Impact factor: 8.237
Authors: Simon J Davies; Fergus J Caskey; David Coyle; Elizabeth Lindley; Jamie Macdonald; Sandip Mitra; Martin Wilkie; Andrew Davenport; Ken Farrington; Indranil Dasgupta; Paula Ormandy; Lazaros Andronis; Ivonne Solis-Trapala; Julius Sim Journal: BMC Nephrol Date: 2017-04-26 Impact factor: 2.388
Authors: Mary C Mallappallil; Steven Fishbane; Rimda Wanchoo; Edgar Lerma; Andrea Roche-Recinos; Moro Salifu Journal: BMC Nephrol Date: 2018-06-22 Impact factor: 2.388
Authors: David Keane; Megan Glyde; Indranil Dasgupta; Claire Gardiner; Elizabeth Lindley; Sandip Mitra; Nicholas Palmer; Louise Dye; Mark Wright; Ed Sutherland Journal: BMC Nephrol Date: 2021-05-20 Impact factor: 2.388