UK Renal Registry, Southmead Hospital, Bristol, UK.
Nephron Clin Pract. 2011;119 Suppl 2:c255-67. doi: 10.1159/000331783. Epub 2011 Aug 26.
RRT incidence rates and the proportion of patients using a home dialysis modality (peritoneal or home haemodialysis) varies widely between centres and persists even after area differences in age, ethnicity and social deprivation structure are taken into account. A nationwide survey was undertaken to identify possible drivers of this variation.
A systematic literature review followed by a two-stage Delphi consensus technique was employed to identify renal centre characteristics and practice patterns that may be important in determining either RRT incidence or home modality usage.
All 72 (100%) of UK adult renal centres responded. Questions about staffing numbers, interface with primary care, interface with other secondary care sites, capacity within the HD programme, constituents of pre-dialysis education programmes, conservative management programmes, range of treatments available, dialysis access and training and physician attitudes to home modalities were included.
There was wide variation in practice patterns and centre characteristics across the UK. Overall, physician enthusiasm for home dialysis modalities was greater than the actual usage of home dialysis.
RRT 发病率以及使用家庭透析方式（腹膜或家庭血液透析）的患者比例在各中心之间差异很大，即使在考虑了地区间在年龄、种族和社会贫困结构方面的差异后，这种差异仍然存在。进行了一项全国性调查，以确定这种差异的可能驱动因素。
采用系统文献综述和两阶段 Delphi 共识技术，确定可能对确定 RRT 发病率或家庭治疗模式使用有重要影响的肾中心特征和实践模式。
英国所有 72 个（100%）成人肾中心都做出了回应。问题包括人员配备数量、与初级保健的接口、与其他二级保健场所的接口、HD 计划内的能力、透析前教育计划的组成部分、保守管理计划、可提供的治疗范围、透析通路和培训以及医生对家庭治疗模式的态度。
英国各地的实践模式和中心特征存在广泛差异。总体而言，医生对家庭透析模式的热情大于家庭透析的实际使用。
