UK Renal Registry 10th Annual Report 2007

UK Renal Registry 10th Annual Report 2007

Fig 8.1 Median haemoglobin for incident dialysis patients at start of dialysis treatment

8.0

8.5

9.0

9.5

10.0

10.5

11.0

11.5

12.0

12.5

13.0

13.5

1 L

Wes

t

4 L

iv R

I

7 B

ango

r

37 W

irral

0 T

ruro

2 M

anW

st

1 O

xfor

d

2 N

ewc

0 S

hrew

9 C

helm

s

2 C

ardf

f

4 L

Rfr

ee

0 R

edng

0 S

und

1 L

eeds

2 B

radf

d

3 H

ull

0 G

louc

1 W

olve

28 L

Guy

s

29 P

lym

th

2 Y

ork

1 M

iddl

br

0 B

risto

l

5 Ip

swi

0 P

orts

6 N

orw

ch

12 L

iv A

in

4 C

arsh

1 N

ottm

6 C

ovnt

1 S

wan

se

0 S

then

d

0 S

heff

0 D

orse

t

17 B

elfa

st

13 T

yron

e

6 S

tevn

g

0 E

xete

r

3 L

Kin

gs

0 C

arlis

27 C

amb

24 B

right

n

6 B

Hea

rt

16 B

QE

H

0 L

eic

18 D

erby

5 D

udle

y

8 P

rest

n

7 B

asld

n

8 E

ngla

nd

20 N

Irel

and

7 W

ales

9 E

,W&

NI

Centre

Hae

mog

lobi

n g/

dl

Upper quartile

Median HbLower quartile

N = 4,643


Fig 8.2 Percentage of incident dialysis patients with Hb ≥10g/dl at start of dialysis treatment

10

20

30

40

50

60

70

80

90

100

0 T

ruro

1 L

Wes

t

29 P

lym

th

1 O

xfor

d

7 B

ango

r

0 S

hrew

4 L

iv R

I

9 C

helm

s

2 Y

ork

5 Ip

swi

2 M

anW

st

1 L

eeds

0 S

und

28 L

Guy

s

2 C

ardf

f

4 L

Rfr

ee

0 R

edng

3 H

ull

0 G

louc

0 D

orse

t

2 N

ewc

0 B

risto

l

0 P

orts

13 T

yron

e

4 C

arsh

1 N

ottm

6 N

orw

ch

1 W

olve

6 C

ovnt

37 W

irral

2 B

radf

d

12 L

iv A

in

0 S

heff

1 M

iddl

br

0 C

arlis

1 S

wan

se

0 E

xete

r

3 L

Kin

gs

27 C

amb

17 B

elfa

st

6 B

Hea

rt

6 S

tevn

g

0 S

then

d

24 B

right

n

16 B

QE

H

0 L

eic

5 D

udle

y

8 P

rest

n

18 D

erby

7 B

asld

n

8 E

ngla

nd

20 N

Irel

and

7 W

ales

9 E

,W&

NI

Centre

Per

cent

age

with

Hb

≥10

g/dl

Upper 95% CI

% with Hb ≥10

Lower 95% CI

N = 4,643


Fig 8.3 Distribution of haemoglobin in incident dialysis patients Fig 8.3 Distribution of haemoglobin in incident dialysis patients at start of dialysis treatmentat start of dialysis treatment

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0 Truro 1 L West

29 Plymth 1 Oxford

7 Bangor 0 Shrew 4 Liv RI

9 Chelms 2 York 5 Ipswi

2 ManWst 1 Leeds 0 Sund

28 L Guys 2 Cardff

4 L Rfree 0 Redng

3 Hull 0 Glouc

0 Dorset 2 Newc

0 Bristol 0 Ports

13 Tyrone 4 Carsh 1 Nottm

6 Norwch 1 Wolve 6 Covnt37 Wirral 2 Bradfd12 Liv Ain

0 Sheff 1 Middlbr 0 Carlis

1 Swanse 0 Exeter

3 L Kings27 Camb17 Belfast 6 B Heart 6 Stevng 0 Sthend

24 Brightn16 B QEH

0 Leic 5 Dudley 8 Prestn18 Derby

7 Basldn 8 England

20 N Ireland 7 Wales

9 E,W&NI

Ce

ntr

e

Percentage of patients

< 9.0

9.0 - 9.9

10.0 - 10.9

11.0 - 11.9

≥ 12.0


Fig 8.4 Median haemoglobin, by time on dialysis, Fig 8.4 Median haemoglobin, by time on dialysis, for incident dialysis patients in 2005for incident dialysis patients in 2005

9.0

9.5

10.0

10.5

11.0

11.5

12.0

12.5

13.0

Start 3 months 6 months 12 months

Time since commencing dialysis

Ha

em

og

lob

in g

/dl

Upper quartile

Median

Low er quartile


Fig 8.5 Percentage of incident dialysis patients in 2005 Fig 8.5 Percentage of incident dialysis patients in 2005 with Hb ≥10g/dl, by time on dialysiswith Hb ≥10g/dl, by time on dialysis

50

55

60

65

70

75

80

85

90

95

100

Start 3 months 6 months 12 months

Time since commencing dialysis

Per

cent

age

of p

atie

nts

Upper 95% CI% w ith Hb ≥ 10Low er 95% CI


Fig 8.6 Haemoglobin in incident patients at the start of RRT Fig 8.6 Haemoglobin in incident patients at the start of RRT by year of startby year of start

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of start

Per

cent

age

of in

cide

nt p

atie

nts

≥12.0%

11.0-11.9%

10.0-10.9%

9.0-9.9%

<9.0%


Fig 8.7 Median haemoglobin: HDFig 8.7 Median haemoglobin: HD

9.0

9.5

10.0

10.5

11.0

11.5

12.0

12.5

13.0

13.5

14.0

19 C

hest

r 3

Liv

RI

1 Y

ork

1 W

olve

1 A

irdrie

2 E

dinb

1 L

eeds

0 N

ewc

4 D

&Gal

l 0

Bra

dfd

13 L

Rfre

e 1

L W

est

8 C

lwyd

3 A

ntrim

4 T

yron

e 1

Lei

c 1

Oxf

ord

3 B

QEH

2 D

unfn

0 In

vern

s 5

Car

lis 2

Car

dff

2 D

unde

e 0

Shr

ew 5

Wirr

al 1

Mid

dlbr

2 A

brdn

5 B

elfa

st 0

Glo

uc 0

Red

ng 1

Sw

anse

2 G

lasg

w 1

Klm

arnk

1 N

ottm

0 B

risto

l12

L G

uys

0 L

Kin

gs 1

She

ff 3

Sun

d 4

Nor

wch

19 M

anW

st 2

Che

lms

3 L

iv A

in 8

B H

eart

3 B

ango

r 1

New

ry 1

Tru

ro 1

Hul

l 1

Por

ts 3

Pre

stn

2 D

orse

t16

Car

sh 0

Ipsw

i 7

Ply

mth

0 U

lste

r17

Ste

vng

34 C

amb

2 B

asld

n 1

Der

by 1

Exe

ter

2 C

ovnt

1 S

then

d15

Dud

ley

0 L

Bar

ts27

Brig

htn

5 E

ngla

nd 6

N Ir

elan

d 2

Sco

tland

12 W

ales

5 U

K

Centre

Hae

mog

lobi

n g/

dL

Upper quartileMedianLower quartile

N = 15,386


Fig 8.8 Percentage of HD patients with Hb ≥10g/dlFig 8.8 Percentage of HD patients with Hb ≥10g/dl

60

65

70

75

80

85

90

95

100

Centre

Per

cent

age

of p

atie

nts

Upper 95% Cl% with Hb ≥10Lower 95% Cl

N = 15,386


Fig 8.9 Percentage of HD patients with Hb ≥11g/dlFig 8.9 Percentage of HD patients with Hb ≥11g/dl

40

50

60

70

80

90

100

Centre

Pe

rce

nta

ge

of p

atie

nts

Upper 95% Cl% with Hb ≥ 11Lower 95% Cl


Fig 8.10 Distribution of haemoglobin in patients on HDFig 8.10 Distribution of haemoglobin in patients on HD

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

3 Antrim 0 Shrew

4 D&Gall 8 Clwyd 2 Edinb

19 Chestr 1 York

0 Inverns 1 L West 1 Truro

1 Swanse 3 Liv RI 1 Wolve 0 Newc 1 Airdrie

3 Bangor 2 Chelms

1 Leeds 2 Cardff 0 Redng

1 Klmarnk 0 Bradfd

4 Norwch 5 Belfast

3 Sund13 L Rfree

1 Sheff 1 Nottm 2 Abrdn

3 Liv Ain 1 Newry

1 Oxford 5 Carlis

2 Dundee 0 Glouc

1 Leic 0 Bristol 4 Tyrone

1 Hull 0 Ipswi

2 Dorset 2 Dunfn

3 P restn12 L Guys 2 Glasgw 1 Middlbr 0 L Kings

5 Wirral 1 P orts 0 Ulster

17 Stevng 7 P lymth 1 Exeter

3 B QEH 1 Sthend16 Carsh 2 Covnt

19 ManWst 8 B Heart

1 Derby34 Camb15 Dudley 2 Basldn 0 L Barts

27 Brightn 5 England

6 N Ireland 2

12 Wales 5 UK

Ce

ntr

e


<9.0

9-9.9

10-10.9

11-11.9

≥12


Fig 8.11 Percentage of HD patients with Hb ≥10.5 and ≤12.5g/dlFig 8.11 Percentage of HD patients with Hb ≥10.5 and ≤12.5g/dl

10

20

30

40

50

60

70

80

Centre

Per

cent

age

of p

atie

nts

Upper 95% Cl

% with Hb 10.5-12.5

Lower 95% Cl N = 15,386


Fig 8.12 Funnel plot for percentage of HD patients with Fig 8.12 Funnel plot for percentage of HD patients with Hb ≥10.5 and ≤12.5g/dlHb ≥10.5 and ≤12.5g/dl

20

30

40

50

60

70

0 100 200 300 400 500 600 700 800 900 1,000 1,100

Number of patients w ith haemoglobin measurement in each centre

Pe

rce

nta

ge

with

Hb

≥1

0 a

nd

≤1

2.5

g/d

l

% with Hb ≥10 and ≤12.5g/dL+3 SD+2 SDMean-2 SD-3 SD


Fig 8.13 Funnel plot for percentage of HD patients Fig 8.13 Funnel plot for percentage of HD patients with Hb ≥10g/dlwith Hb ≥10g/dl

65

70

75

80

85

90

95

100

0 100 200 300 400 500 600 700 800 900 1,000 1,100

Number of patients w ith haemoglobin measurement in each centre

Per

cent

age

with

Hb

≥10

g/dl

% with Hb ≥10g/dL

+3 SD

+2 SD

Mean

-2 SD

-3 SD


Fig 8.14 Median haemoglobin: PDFig 8.14 Median haemoglobin: PD

10.0

10.5

11.0

11.5

12.0

12.5

13.0

13.5

14.0

8 A

ntrim

1 L

Kin

gs

0 D

orse

t

2 W

olve

4 M

iddl

br

0 R

edng

14 L

Bar

ts

8 L

iv R

I

5 Y

ork

2 N

orw

ch

0 D

udle

y

0 B

ango

r

3 A

brdn

0 S

hrew

0 C

ardf

f

4 Ip

swi

0 B

risto

l

0 C

amb

0 P

orts

0 O

xfor

d

2 L

eeds

0 C

helm

s

2 S

tevn

g

0 D

unde

e

5 B

Hea

rt

11 M

anW

st

2 N

ewc

5 K

lmar

nk

0 A

irdrie

5 B

elfa

st

0 T

ruro

1 B

right

n

1 L

Guy

s

0 S

heff

8 P

lym

th

0 D

unfn

2 E

dinb

0 C

ovnt

3 D

erby

0 E

xete

r

2 C

arsh

3 L

eic

0 G

louc

1 P

rest

n

3 S

wan

se

2 G

lasg

w

0 B

radf

d

7 H

ull

0 B

asld

n

0 N

ottm

3 L

Wes

t

6 L

Rfr

ee

6 B

QE

H

4 E

ngla

nd

8 N

Irel

and

9 S

cotla

nd

13 W

ales

5 U

K

Centre

Hae

mog

lobi

n g/

dl

Upper quartile

Median

Lower quartileN = 3,703


Fig 8.15 Percentage of PD patients with Hb ≥10g/dllFig 8.15 Percentage of PD patients with Hb ≥10g/dll

65

70

75

80

85

90

95

100

8 A

ntrim

4 Ip

swi

2 N

orw

ch 0

Shr

ew 5

B H

eart

0 C

amb

2 W

olve

0 D

unde

e 8

Liv

RI

0 R

edng

0 B

risto

l 1

L K

ings

2 L

eeds

0 T

ruro

0 C

helm

s 5

Bel

fast

4 M

iddl

br 2

Ste

vng

0 P

orts

0 C

ovnt

0 C

ardf

f 2

Gla

sgw

2 E

dinb

0 G

louc

5 Y

ork

0 O

xfor

d 3

Der

by 3

L W

est

5 K

lmar

nk 2

Car

sh 3

Abr

dn 3

Sw

anse

1 L

Guy

s 0

Not

tm 1

Pre

stn

14 L

Bar

ts 0

Dud

ley

0 D

unfn

0 B

ango

r 0

Dor

set

0 A

irdrie

2 N

ewc

1 B

right

n11

Man

Wst

7 H

ull

0 B

radf

d 0

She

ff 0

Bas

ldn

3 L

eic

0 E

xete

r 8

Ply

mth

6 B

QE

H 6

L R

free

4 E

ngla

nd 8

N Ir

elan

d 9

Sco

tland

13 W

ales

5 U

K

Centre

Per

cent

age

of p

atie

nts

Upper 95% Cl

% with Hb ≥10g/dL

Lower 95% Cl N = 3,703


Fig 8.16 Percentage of PD patients with Hb ≥11g/dlFig 8.16 Percentage of PD patients with Hb ≥11g/dl

50

60

70

80

90

100

2 N

orw

ch

4 Ip

swi

8 A

ntrim

1 L

Kin

gs

0 C

helm

s 8

Liv

RI

3 A

brdn

5 Y

ork

0 D

unde

e 0

Red

ng

0 S

hrew

2 L

eeds

0 D

unfn

0 T

ruro

5 B

Hea

rt

0 B

ango

r 4

Mid

dlbr

2 W

olve

0 C

amb

0 D

orse

t 0

Bas

ldn

14 L

Bar

ts 0

Dud

ley

1 L

Guy

s 0

Car

dff

3 D

erby

3 L

Wes

t 5

Bel

fast

8 P

lym

th

0 B

risto

l 2

New

c 2

Ste

vng

0 A

irdrie

0 O

xfor

d 7

Hul

l

0 B

radf

d 2

Car

sh

0 E

xete

r 2

Edi

nb 1

Brig

htn

0 P

orts

0 C

ovnt

0 S

heff

0 G

louc

2 G

lasg

w 3

Sw

anse

1 P

rest

n 0

Not

tm

3 L

eic

5 K

lmar

nk11

Man

Wst

6 B

QE

H 6

L R

free

4 E

ngla

nd

8 N

Irel

and

9 S

cotla

nd13

Wal

es

5 U

K

Centre

Per

cent

age

of p

atie

nts

Upper 95% Cl

% with Hb ≥11g/dL

Lower 95% ClN = 3,703


Fig 8.17 Percentage of PD patients with Hb ≥10.5 and ≤12.5 g/dlFig 8.17 Percentage of PD patients with Hb ≥10.5 and ≤12.5 g/dl

10

20

30

40

50

60

70

80

1 S

wan

se

2 C

helm

s

2 D

unde

e

1 T

ruro

3 B

QE

H

1 D

erby

0 G

louc

2 E

dinb

2 G

lasg

w

17 S

tevn

g

2 B

asld

n

2 C

ovnt

1 L

Wes

t

4 N

orw

ch

0 Ip

swi

2 D

unfn

1 N

ottm

8 B

Hea

rt

12 L

Guy

s

13 L

Rfr

ee

34 C

amb

1 A

irdrie

16 C

arsh

0 B

radf

d

1 E

xete

r

1 H

ull

1 L

eeds

0 B

risto

l

3 P

rest

n

1 L

eic

1 O

xfor

d

7 P

lym

th

3 B

ango

r

2 A

brdn

1 M

iddl

br

1 P

orts

0 S

hrew

15 D

udle

y

2 C

ardf

f

5 B

elfa

st

3 L

iv R

I

0 R

edng

27 B

right

n

19 M

anW

st

1 S

heff

1 W

olve

1 K

lmar

nk

0 N

ewc

0 L

Bar

ts

1 Y

ork

3 A

ntrim

0 L

Kin

gs

2 D

orse

t

5 E

ngla

nd

6 N

Irel

and

2 S

cotla

nd

12 W

ales

5 U

K

Centre

Per

cent

age

of p

atie

nts

Upper 95% Cl

% with Hb 10.5-12.5

Lower 95% Cl N = 3,703


Fig 8.18 Distribution of haemoglobin in patients on PD Fig 8.18 Distribution of haemoglobin in patients on PD

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

8 Antrim 4 Ipswi

2 Norwch 0 Shrew

5 B Heart 0 Camb 2 Wolve

0 Dundee 8 Liv R I

0 Redng 0 B ristol 1 L Kings 2 Leeds 0 Truro

0 Chelms 5 Belfast

4 M iddlbr 2 Stevng

0 Ports 0 Covnt 0 Cardff

2 Glasgw 2 Edinb 0 Glouc 5 Y ork

0 Oxford 3 Derby

3 L West 5 Klmarnk

2 Carsh 3 Abrdn

3 Swanse 1 L Guys 0 Nottm 1 Prestn

14 L Barts 0 Dudley 0 Dunfn

0 Bangor 0 Dorset 0 A irdrie

2 Newc 1 B rightn

11 M anWst 7 Hull

0 B radfd 0 Sheff

0 Basldn 3 Leic

0 Exeter 8 Plymth 6 B QEH 6 L R free

4 England 8 N Ireland

9 Sctland13 Wales

5 UK

Ce

ntr

e


<9.0

9.0-9.9

10.0-10.9

11.0-11.9

≥12


Fig 8.19 Funnel plot for percentage of PD patients Fig 8.19 Funnel plot for percentage of PD patients with Hb ≥10g/dlwith Hb ≥10g/dl

75

80

85

90

95

100

0 25 50 75 100 125 150 175 200

Number of patients with haemoglobin measurement in each centre

Per

cent

age

with

Hb

≥10g

/dl

% with Hb ≥10g/dL+3 SD+2 SDMean-2 SD-3 SD


Fig 8.20 Percentage of new and prevalent dialysis Fig 8.20 Percentage of new and prevalent dialysis patients with Hb ≥10g/dlpatients with Hb ≥10g/dl

0

10

20

30

40

50

60

70

80

90

100

Ba

sld

nG

lasg

w

De

rby

Pre

stn

Du

dle

yL

eic

B Q

EH

Bri

gh

tnS

the

nd

Ste

vng

B H

ea

rt

Be

lfast

Ca

mb

L K

ing

sE

xete

r

Sw

an

seC

arl

isM

idd

lbr

Sh

eff

Liv

Ain

Bra

dfd

Wir

ral

Co

vnt

Wo

lve

No

rwch

No

ttmC

ars

hT

yro

ne

Po

rts

Bri

sto

lN

ew

c

Do

rse

tG

lou

cH

ull

Re

dn

g

L R

fre

eC

ard

ff

L G

uys

Su

nd

Le

ed

sIp

swi

Ma

nW

st

Yo

rkC

he

lms

Liv

RI

Sh

rew

Ba

ng

or

Oxf

ord

Ply

mth

L W

est

Tru

ro

En

gla

nd

N Ir

ela

nd

Sco

tlan

dW

ale

s

UK

Centre

Per

cen

tag

e o

f p

atie

nts

New dialysis patientsPrevalent dialysis patients


Fig 8.21 Percentage of patients with Hb ≥10g/dl plotted Fig 8.21 Percentage of patients with Hb ≥10g/dl plotted against median haemoglobin: HDagainst median haemoglobin: HD

50

60

70

80

90

100

10.5 11.0 11.5 12.0 12.5 13.0

Median Hb g/dl

Per

cent

age

Hb

≥10g

/dl


Fig 8.22 Percentage of patients with Hb ≥11g/dl plotted Fig 8.22 Percentage of patients with Hb ≥11g/dl plotted against median haemoglobin: HDagainst median haemoglobin: HD

50

60

70

80

90

100

10.5 11.0 11.5 12.0 12.5 13.0

Median Hb g/dl

Per

cent

age

Hb

≥11g

/dl


Fig 8.23 Percentage of patients with Hb ≥10g/dl plotted Fig 8.23 Percentage of patients with Hb ≥10g/dl plotted against median haemoglobin: PDagainst median haemoglobin: PD

50

60

70

80

90

100

10.5 11.0 11.5 12.0 12.5 13.0

Median Hb g/dl

Pe

rce

nta

ge

Hb

≥1

0g

/dl


Fig 8.24 Percentage of patients with Hb ≥11g/dl plotted Fig 8.24 Percentage of patients with Hb ≥11g/dl plotted against median haemoglobin: PDagainst median haemoglobin: PD

50

60

70

80

90

100

10.5 11.0 11.5 12.0 12.5 13.0

Median Hb g/dl

Pe

rce

nta

ge

Hb

≥1

1g

/dl


Fig 8.25 Percentage of prevalent HD and PD patients with Fig 8.25 Percentage of prevalent HD and PD patients with Hb ≥10g/dl: 1997-2006Hb ≥10g/dl: 1997-2006

50

55

60

65

70

75

80

85

90

95

100

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Per

cent

age

Hb

≥10

g/dl

Upper 95% CI

% with Hb ≥10g/dL

Lower 95% CI

Haemodialysis Peritoneal dialysis


Fig 8.26 Percentage of incident and prevalent dialysis patients Fig 8.26 Percentage of incident and prevalent dialysis patients with Hb ≥10g/dl: 1998-2006with Hb ≥10g/dl: 1998-2006

30

40

50

60

70

80

90

100

1998

1999

2000

2001

2002

2003

2004

2005

2006

1998

1999

2000

2001

2002

2003

2004

2005

2006

Pe

rce

nta

ge

Hb

≥1

0 g

/dl Upper 95% CI

% with Hb ≥10g/dL

Lower 95% CI

Incident patients Prevalent patients


Fig 8.27 Median haemoglobin by length Fig 8.27 Median haemoglobin by length of time on RRT: HDof time on RRT: HD

9.5

10.0

10.5

11.0

11.5

12.0

12.5

<6 months 6m-1year 1-2 years >2 years All

Time on RRT

Hb

g/d

l

HD 1999

HD 2000

HD 2001

HD 2002

HD 2003

HD 2004

HD 2005

HD 2006


Fig 8.28 Median haemoglobin by length Fig 8.28 Median haemoglobin by length of time on RRT: PDof time on RRT: PD

9.5

10.0

10.5

11.0

11.5

12.0

12.5


Time on RRT

Hb

g/d

l

PD 1999

PD 2000

PD 2001

PD 2002

PD 2003

PD 2004

PD 2005

PD 2006


Fig 8.29 Median serum ferritin: HDFig 8.29 Median serum ferritin: HD

0

100

200

300

400

500

600

700

800

900

1000

Centre

Fer

ritin

µg/

L

Upper quartile

Median ferritin

Lower quartile

N = 13,612


Fig 8.30 Median serum ferritin: PDFig 8.30 Median serum ferritin: PD

0

100

200

300

400

500

600

700

800

2 N

orw

ch

12 R

edng

3 B

ango

r

8 B

right

n

0 B

radf

d

0 Y

ork

2 L

Rfr

ee

13 H

ull

0 N

ewc

0 N

ottm

11 M

iddl

br

49 L

Bar

ts

2 L

eeds

0 S

heff

39 D

erby

12 M

anW

st

3 S

hrew

8 P

lym

th

5 B

elfa

st

2 D

orse

t

3 S

wan

se

7 L

eic

3 C

helm

s

4 L

Wes

t

0 B

risto

l

2 L

iv R

I

0 P

rest

n

12 Ip

swi

12 P

orts

1 L

Guy

s

0 C

amb

3 G

louc

3 C

ovnt

2 C

ardf

f

0 W

olve

8 B

QE

H

5 B

Hea

rt

0 T

ruro

0 B

asld

n

0 L

Kin

gs

4 D

udle

y

0 A

ntrim

2 O

xfor

d

0 E

xete

r

4 C

arsh

12 S

tevn

g

8 E

ngla

nd

5 N

Irel

and

14 W

ales

17 E

,W&

NI

Centre

Fer

ritin

µg/

L

Upper quartileMedian ferritinLower quartile

N = 3,214


Fig 8.31 Percentage of HD patients with serum ferritin ≥100µg/LFig 8.31 Percentage of HD patients with serum ferritin ≥100µg/L

65

70

75

80

85

90

95

100

1 N

ewry

0 U

lste

r 5

Wirr

al 8

Clw

yd 1

Che

lms

3 B

ango

r 3

Sun

d 6

Bel

fast

1 N

ottm

6 R

edng

5 C

arlis

1 W

olve

0 N

ewc

1 H

ull

0 L

Wes

t 3

Nor

wch

1 Y

ork

2 T

ruro

3 B

QE

H49

Tyr

one

3 A

ntrim

1 B

radf

d 1

Sw

anse

6 L

Bar

ts 4

Car

dff

1 L

eeds

0 S

tevn

g 3

Ply

mth

0 P

rest

n37

Brig

htn

43 M

anW

st 0

L K

ings

5 L

iv R

I 1

She

ff 0

Bris

tol

10 L

Guy

s 2

Exe

ter

9 L

iv A

in 0

Dor

set

23 C

amb

2 S

then

d 3

Oxf

ord

16 C

arsh

3 C

ovnt

1 Ip

swi

0 D

erry

3 P

orts

14 L

Rfr

ee 1

Glo

uc10

Der

by13

Lei

c 1

Bas

ldn

4 M

iddl

br 2

Shr

ew26

Dud

ley

8 B

Hea

rt 7

Eng

land

10 N

12 W

ales

16 U

K

Centre

Per

cent

age

ferr

itin

≥100

µg/

L

Upper 95% CI

% with ferritin ≥ 100

Lower 95% CI N = 13,612


Fig 8.32 Percentage of HD patients with serum ferritin ≥200µg/LFig 8.32 Percentage of HD patients with serum ferritin ≥200µg/L

40

50

60

70

80

90

100

5 W

irral

1 C

helm

s 1

Not

tm 3

Sun

d 1

Yor

k 6

Red

ng 0

L W

est

0 N

ewc

0 U

lster

1 W

olve

2 T

ruro

5 C

arlis

43 M

anW

st 0

Pre

stn

3 N

orwc

h 1

Lee

ds 1

Bra

dfd

4 C

ardf

f 8

Clw

yd 3

B Q

EH 6

Belf

ast

1 H

ull37

Brig

htn

3 A

ntrim

1 N

ewry

3 B

ango

r 6

L B

arts

49 T

yron

e 0

Dor

set

0 L

King

s 3

Plym

th 1

She

ff 5

Liv

RI 0

Bris

tol

1 S

wans

e 0

Ste

vng

10 L

Guy

s 0

Der

ry 2

Sth

end

16 C

arsh

23 C

amb

1 Ip

swi

1 G

louc

3 O

xfor

d 2

Exe

ter

14 L

Rfre

e13

Leic

4 M

iddlbr

1 B

asldn

3 C

ovnt

9 L

iv Ai

n26

Dud

ley 3

Por

ts10

Der

by 2

Shr

ew 8

B H

eart

7 E

nglan

d10

N Ir

eland

12 W

ales

16 E

,W&N

I

Centre

Per

cent

age

ferr

itin

≥200

µg/

L

Upper 95% CI

% with ferritin ≥ 200Lower 95% CI

N = 13,612


Fig 8.33 Percentage of HD patients with Fig 8.33 Percentage of HD patients with serum ferritin ≥800µg/Lserum ferritin ≥800µg/L

0

10

20

30

40

50

60

8 C

lwyd

1 B

asld

n 8

B H

eart

3 B

QEH

2 E

xete

r 2

Shr

ew23

Cam

b 2

Tru

ro 2

Sth

end

3 O

xfor

d 5

Car

lis 3

Por

ts 1

Hul

l 1

Sw

anse

26 D

udle

y 6

L B

arts

0 D

orse

t16

Car

sh10

Der

by 0

Bris

tol

3 C

ovnt

0 S

tevn

g37

Brig

htn

1 L

eeds

10 L

Guy

s13

Lei

c 1

Glo

uc 1

Ipsw

i 1

Wol

ve 3

Ant

rim 0

New

c 1

Bra

dfd

1 S

heff

3 B

ango

r14

L R

free

0 U

lste

r 1

Yor

k 0

L K

ings

6 R

edng

1 N

ottm

3 S

und

4 C

ardf

f 9

Liv

Ain

3 P

lym

th 6

Bel

fast

1 N

ewry

3 N

orw

ch 4

Mid

dlbr

1 C

helm

s 0

L W

est

5 W

irral

49 T

yron

e 5

Liv

RI

43 M

anW

st 0

Der

ry 0

Pre

stn

7 E

ngla

nd10

N Ir

elan

d12

Wal

es16

E,W

&NI

Centre

Pe

rce

nta

ge

fe

rriti

n ≥

80

0µ

g/L

Upper 95% CI% with ferritin ≥ 800

Lower 95% CI

N = 13,612


Fig 8.34 Percentage of PD patients with Fig 8.34 Percentage of PD patients with serum ferritin ≥100µg/Lserum ferritin ≥100µg/L

50

55

60

65

70

75

80

85

90

95

100

2 T

ruro

0 L

Wes

t

3 N

orw

ch

1 N

ottm

6 R

edng

1 H

ull

5 L

iv R

I

6 L

Bar

ts

3 B

ango

r

14 L

Rfr

ee

23 C

amb

37 B

right

n

10 D

erby

4 C

ardf

f

1 L

eeds

1 S

heff

4 M

iddl

br

0 D

orse

t

0 N

ewc

2 S

hrew

1 Y

ork

10 L

Guy

s

1 S

wan

se

3 P

lym

th

43 M

anW

st

13 L

eic

1 G

louc

3 A

ntrim

1 C

helm

s

1 B

asld

n

3 P

orts

0 L

Kin

gs

1 B

radf

d

26 D

udle

y

2 E

xete

r

0 S

tevn

g

3 C

ovnt

0 B

risto

l

3 B

QE

H

1 W

olve

6 B

elfa

st

0 P

rest

n

3 O

xfor

d

1 Ip

swi

16 C

arsh

8 B

Hea

rt

7 E

ngla

nd

10 N

Irel

and

12 W

ales

16 E

,W&

NI

Centre

Per

cent

age

ferr

itin

≥100

µg/

L

Upper 95% CI


Lower 95% CIN = 3,214


Fig 8.35 Percentage of PD patients Fig 8.35 Percentage of PD patients with serum ferritin ≥200µg/Lwith serum ferritin ≥200µg/L

10

20

30

40

50

60

70

80

90

100

6 R

edng

3 B

ango

r

3 N

orw

ch

1 N

ottm

1 H

ull

0 D

orse

t

10 D

erby

37 B

right

n

1 Y

ork

14 L

Rfr

ee

6 L

Bar

ts

0 N

ewc

0 L

Wes

t

1 L

eeds

1 S

heff

4 M

iddl

br

43 M

anW

st

1 B

radf

d

1 S

wan

se

5 L

iv R

I

2 S

hrew

13 L

eic

1 C

helm

s

4 C

ardf

f

1 G

louc

23 C

amb

10 L

Guy

s

0 B

risto

l

1 W

olve

6 B

elfa

st

3 P

orts

3 P

lym

th

0 P

rest

n

3 C

ovnt

1 Ip

swi

8 B

Hea

rt

3 B

QE

H

2 T

ruro

1 B

asld

n

0 L

Kin

gs

3 O

xfor

d

2 E

xete

r

3 A

ntrim

16 C

arsh

0 S

tevn

g

26 D

udle

y

7 E

ngla

nd

10 N

Irel

and

12 W

ales

16 E

,W&

NI

Centre

Per

cent

age

ferr

itin

≥200

µg/

L

Upper 95% CI


Lower 95% CI

N = 3,214


Fig 8.36 Percentage of PD patients with Fig 8.36 Percentage of PD patients with serum ferritin ≥800µg/Lserum ferritin ≥800µg/L

0

5

10

15

20

25

30

35

40

3 A

ntrim

2 T

ruro

1 Ip

swi

1 G

louc

2 E

xete

r

16 C

arsh

0 B

risto

l

0 L

Kin

gs

23 C

amb

1 L

eeds

1 H

ull

0 D

orse

t

10 D

erby

2 S

hrew

1 S

wan

se

0 S

tevn

g

10 L

Guy

s

1 C

helm

s

3 B

QE

H

1 B

asld

n

3 C

ovnt

1 S

heff

1 W

olve

26 D

udle

y

1 B

radf

d

1 N

ottm

3 P

orts

43 M

anW

st

8 B

Hea

rt

6 L

Bar

ts

0 N

ewc

5 L

iv R

I

4 C

ardf

f

13 L

eic

3 O

xfor

d

3 B

ango

r

4 M

iddl

br

0 L

Wes

t

0 P

rest

n

1 Y

ork

14 L

Rfr

ee

37 B

right

n

6 R

edng

3 P

lym

th

6 B

elfa

st

3 N

orw

ch

7 E

ngla

nd

10 N

Irel

and

12 W

ales

16 E

,W&

NI

Centre

Per

cent

age

ferr

itin

≥800

µg/L

Upper 95% CI


Lower 95% CI

N = 3,214


Fig 8.37 Change in achievement of serum Fig 8.37 Change in achievement of serum ferritin ≥100µg/L: 1999-2006ferritin ≥100µg/L: 1999-2006

70

75

80

85

90

95

100

1999

2000

2001

2002

2003

2004

2005

2006

1999

2000

2001

2002

2003

2004

2005

2006

Per

cent

age

fer

ritin

≥1

00µ

g/L

Upper 95% CI


Lower 95% CI



Fig 8.38 Change in median serum ferritin: 1999-2006Fig 8.38 Change in median serum ferritin: 1999-2006

0

100

200

300

400

500

600

1999

2000

2001

2002

2003

2004

2005

2006

1999

2000

2001

2002

2003

2004

2005

2006

Me

dia

n f

err

itin

µg

/L

Upper quartile

Median ferritin

Lower quartile



Fig 8.39 Median serum ferritin by Fig 8.39 Median serum ferritin by length of time on RRT: HDlength of time on RRT: HD

0

100

200

300

400

500

600

700


Time

Ser

um fe

rriti

n µg

/L

Upper quartileMedianLow er quartile


Fig 8.40 Median serum ferritin by Fig 8.40 Median serum ferritin by length of time on RRT: PDlength of time on RRT: PD

0

50

100

150

200

250

300

350

400

450

500


Time

Ser

um fe

rriti

n µg

/L

Upper quartileMedianLower quartile


Fig 8.41 Percentage of patients who are not on ESA and Fig 8.41 Percentage of patients who are not on ESA and have Hb ≥10g/dL, by age group and modalityhave Hb ≥10g/dL, by age group and modality

0

5

10

15

20

25

30

18-34 35-44 45-54 55-64 65-74 75+

Age range (years)

Per

cent

age

of p

atie

nts

HDPD


Fig 8.42 Percentage of dialysis patients on ESA, Fig 8.42 Percentage of dialysis patients on ESA, by age group and modality by age group and modality

50

60

70

80

90

100

18-34 35-44 45-54 55-64 65-74 75+

Age range (years)

Per

cent

age

of p

atie

nts

HD

PD


Fig 8.43 Percentage of patients with Hb <10g/dl who Fig 8.43 Percentage of patients with Hb <10g/dl who are on ESA, by age group and modalityare on ESA, by age group and modality

50

60

70

80

90

100

18-34 35-44 45-54 55-64 65-74 75+

Age range (years)

Per

cent

age

of p

atie

nts

HD

PD


Fig 8.44 Provision of ESA by age and gender: HDFig 8.44 Provision of ESA by age and gender: HD

60

70

80

90

100

18-34 35-44 45-54 55-64 65-74 75+

Age range (years)

Per

cent

age

of p

atie

nts

MF


Fig 8.45 Provision of ESA by age and gender: PDFig 8.45 Provision of ESA by age and gender: PD

60

70

80

90

100

18-34 35-44 45-54 55-64 65-74 75+

Age range (years)

Per

cent

age

of p

atie

nts

MF


Fig 8.46 Percentage of patients on ESA by time on RRTFig 8.46 Percentage of patients on ESA by time on RRT

70

75

80

85

90

95

100

<1 year 1-2years

2-3years

3-5years

5-10years

>10years

Time on RRT

Per

cent

age

of p

atie

nts

on E

SA

HDPD


Fig 8.47 Median haemoglobin versus mean ESA Fig 8.47 Median haemoglobin versus mean ESA dose in haemodialysis patientsdose in haemodialysis patients

10.0

10.5

11.0

11.5

12.0

12.5

13.0

6,000 8,000 10,000 12,000 14,000

Mean ESA dose (IU/w eek)

Med

ian

Hb

g/dl


Fig 8.48 Compliance with European Best Practice Guidelines versus Fig 8.48 Compliance with European Best Practice Guidelines versus

mean ESA dose in haemodialysis patientsmean ESA dose in haemodialysis patients

40

50

60

70

80

90

100

6,000 8,000 10,000 12,000 14,000

Mean ESA dose (IU/w eek)

Com

plia

nce

with

Hb

≥11g

/dl

Documents

UK Renal Registry 10th Annual Report 2007