P130
COMPLIANCE WITH RENAL ASSOCIATION PHOSPHATE AUDIT STANDARDS:
COMPARING PREVALENT DIALYSIS PATIENTS WITH 4,054 PRE-DIALYSIS
PATIENTS ON THE UK RENAL REGISTRY DATABASE
Ford, D¹², Steenkamp, M¹, Ansell, D¹, Tomson, C¹, Ben-Shlomo, Y², Fogarty, D³
¹UK Renal Registry, Bristol, ²University of Bristol, ³Queens University, Belfast
INTRODUCTION: The UK Renal Registry (UKRR) has shown that compliance with Renal
Association (RA) serum phosphate audit standards has been improving during the last decade.
However, it is unclear whether the fall in median serum phosphate over time in pre-dialysis
patients is due to a reduction in patients with phosphate >1.8mmol/L or an increase in patients
with phosphate <1.1mmol/L. The aim of this study was to evaluate the range of serum
phosphate results at different pre-dialysis time points.
METHODS: All incident dialysis patients from 7 renal centres between 2001 and 2006 were
included. Pre-dialysis laboratory results were extracted where available on a monthly basis for
the final 6 months pre-dialysis. The proportion of patients complying with RA audit standards
was calculated at each pre-dialysis time point by first treatment modality and by year of start.
These results were compared with existing UKRR analyses of the prevalent dialysis
population from the same time period.
RESULTS: Figure 1 shows the proportion of patients above, within and below the RA
phosphate guidelines (1.1-1.8 mmol/L) by first dialysis modality for each year during 20012006. Figures 1a-c show results for pre-dialysis patients at 0 months, 3 months and 6 months
pre-dialysis respectively. Figure 1d shows the results for prevalent dialysis patients,
DISCUSSION: These results show that the reason for the reduction in median serum
phosphate in pre-dialysis patients in recent years is largely due to a reduction in patients with
results above the upper limit of the guideline range. There are relatively few pre-dialysis
patients with phosphate <1.1mmol/L when compared with the prevalent dialysis population.