Monitoring of hemodialysis quality-of-care indicators: why is it important?

BMC Nephrology

Table 1 Quality-of-care indicators, targets and references

Field	Clinical indicator	Frequency	Clinical performance measures	References
Anemia	Hemoglobin (Hb, g/dl)	M	% of patients with 10 < Hb < 13	*
Dialysis dose	Kt/V_{BCM (single-pool)}	S	% of patients with Kt/V_BCM > 1.4	EPBG 2002
Dialysis dose	Kt (liters)	S	% of patients with Kt > 40l (women), with Kt > 45l (men)	Lowrie et al. [14–16]
Bone metabolism	Phosphorus (mmol/l)	M	% of patients with 1.13 < P < 1.78	KDOQI Bone metabolism 2003
	Calcium (mmol/l)	M	% of patients with 2.10 < Ca < 2.38	KDOQI Bone metabolism 2003
	PTH (pg/ml)	Q	% of patients with 150 < PTH < 300	KDOQI Bone metabolism 2003
	25(OH)vitD (nmol/l)	Q	% of patients with 72 < vitD < 200	*
Nutrition	Albumin (g/l)	M	% of patients with albumin > 35	*
	Serum Bicarbonate (mmol/l)	M	% of patients with 20 < HCO3^- < 24	*
	LDL-cholesterol (mmol/l)	Q	% of patients with LDL < 2.6	*
Vascular access	Arteriovenous fistula		% of patients with catheters < 7%	Dopps [4]
Middle molecule removal	Infusion Volume (Liters)	S	Infusion volume > 15 L	*
Middle molecule removal	β2-microglobulin (mg/l)	Q	% of patients with β2m < 27.5	Cheung et al. [17]
Hemodynamics	Blood pressure	S	% of patients with pre-dialysis BP < 140/90 mmHg	KDOQI 2005 [5]
	Hemodynamics instability		% of dialysis sessions with symptomatic IDH

: Targets different from available clinical practice guidelines.
Frequency : S = Values collected each dialysis session ; M = monthly ; Q = quarterly.

ISSN: 1471-2369