UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence

Dasgupta, Indranil; Farrington, Ken; Davies, Simon J.; Davenport, Andrew; Mitra, Sandip

Abstract

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.

Citation

Dasgupta, I., Farrington, K., Davies, S. J., Davenport, A., & Mitra, S. (2016). UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence. Blood Purification, 41(4), 324-331. https://doi.org/10.1159/000444246

• Journal Article Type: Article
• Online Publication Date: Feb 11, 2016
• Publication Date: 2016
• Deposit Date: Nov 29, 2023
• Journal: Blood Purification
• Print ISSN: 0253-5068
• Electronic ISSN: 1421-9735
• Publisher: Karger Publishers
• Peer Reviewed: Peer Reviewed
• Volume: 41
• Issue: 4
• Pages: 324-331
• DOI: https://doi.org/10.1159/000444246
• Keywords: Residual renal function, Volume control, Bio-impedance, Fluid overload, Haemodialysis