ckd conservative care and preparation for dialysis - uk ：ckd患者保守治疗和准备透析英国

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1、CKDConservativecareandpreparationfordialysisUKRenalRegistry2013AnnualAuditMeetingDrAnirudhRaoRegistrar,UKRenalRegistryScopeofthetalkBackgroundCKMAPPSEQUALMyResearchFutureBackground-AgingPopulationBackground-UKRRdataBackground-UKRRdataSurvivalAgegroup1year2year3year4year5year18-3497.

2、7994.9092.2191.3189.2735-4494.6790.9588.2684.3882.8845-5491.8286.2480.3975.9971.2155-6486.6778.6972.7266.0461.6765-6982.2570.4060.4648.3840.7270-7473.9062.9453.9543.2634.5575-7969.1854.1841.8133.7727.3680-8467.4750.9337.9827.8019.5285+53.3740.0326.6921.2414.71Literaturesurvey:Summarygr

3、aphofsurvivalofelderlypatientswithESRDinpreviousstudies.CarsonRCetal.CJASN2009;4:1611-1619©2009byAmericanSocietyofNephrologyUKevidenceSummaryofpublishedliteratureLimiteddatainUKcomparingCKMvsRRTRelativelysmall(nowithCKM29-77)>singlecentresRetrospective--issuesofstarttime,inclusion(vari

4、ableage,+/-latereferred),limitedoutcomes(>survival),selectionbias,handlinglatereferrersKeySurvivaldependonwhenyoustartclock,survivaldifferencesdependonwhatyouadjustforLimitedevidenceofanydialysisbenefitonceadjustforfunction/comorbidity,nodataoncostsbutsomeevidencelesshospitalisation/tr

5、avel,limiteddataonEoLcaresomeevidencemorehomeorhospicedeathWhyisconservativecaredatadifferent?Conservativecaredata-ChallengesWeneeddataonCKDstage5patientsUn-referredchronickidneydisease.Spectrumofconservativecaremanagement.Whoandwhereiscareprovided?VariationAcrossUKCKMAPPSProfessorPau

6、lRoderick,DrHughRayner,etalTodescribethevariationinconservativekidneymanagement,itsscalecomparedtodialysis,servicedevelopmentsandfutureplans.Toexplorehowandwhendecisionsaremadeabouttreatmentoptionsforolderpatients(75+)withCKD5andfactorsthatinfluencedecisionstooptforCKM.Todescribetheint

7、erfacebetweenrenalunitsandprimarycareinmanagingCKD5patients.ToexplorefeasibilityofRCTorobservationalstudyofCKMvsdialysisStudycomponentsPhase1Qualitativestudyofcliniciansandpatientsin9unitsPhase2NationalsurveyofpracticepatternsinallrenalunitsSubcomponentsGPReferralpatternsin9units,exp