UK Renal Registry 20th Annual Report: Chapter 6 Adequacy of Haemodialysis in UK Adult Patients in 2016: National and Centre-specific Analyses

Data regarding the urea reduction ratio (URR) were available for analysis from 63 renal centres and 74% of the prevalent haemodialysis (HD) population in the UK. - Fifty-one centres provided URR data on more than 90% of prevalent HD patients. - The proportion of patients in the UK who met the Renal Association (RA) clinical practice guideline for URR (.65%) has been stable between 88–89% since 2011. - The median URR has been stable over the same period (75%). - There was persistent variation observed between centres, 15 centres attaining the RA clinical practice guideline in .90% of patients and 42 centres attaining the guideline in 70–90% of patients. . Over 95% of the prevalent HD population received dialysis three times a week but 26% did less than four hours per session. - Median URR was similar between patients irrespective of dialysis session duration

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Chapter 3 demographic and biochemistry profile of kidney transplant recipients in the UK in 2016

There was a 5% increase in overall renal transplant numbers from 2015 to 2016, with an increase in kidney transplants from donors after brainstem death (9%), donors after cardiac death (13%) but a fall from living donors (-3%). In 2016, death-censored renal transplant failure rates in prevalent patients were similar to previous years at 2.4% per annum. Transplant patient death rates were similar at 2.5 per 100 patient years. The median age of incident and prevalent renal transplant patients in the UK was 51.4 and 54.3 years respectively. The median EGFR of prevalent renal transplant recipients was 52.2 ml/min/1.73 m2. The median EGFR of patients one year after transplantation was 57.2 ml/min/1.73 m2 post live transplant, 52.4 ml/min/1.73 m2 post brainstem death transplant and 48.4 ml/min/1.73 m2 post circulatory death transplant. In 2016, 13.1% of prevalent transplant patients had EGFR ,30 ml/min/1.73 m2. The median decline in EGFR slope beyond the first year after transplantation was -0.7 ml/min/1.73 m2/year. In 2016, malignancy (23%) replaced infection (22%) as the commonest cause of death in patients with a functioning renal transplant. Data completeness for attainment of blood pressure targets remained variable between centres

Chapter 3 demographic and biochemistry profile of kidney transplant recipients in the UK in 2016

There was a 5% increase in overall renal transplant numbers from 2015 to 2016, with an increase in kidney transplants from donors after brainstem death (9%), donors after cardiac death (13%) but a fall from living donors (-3%). In 2016, death-censored renal transplant failure rates in prevalent patients were similar to previous years at 2.4% per annum. Transplant patient death rates were similar at 2.5 per 100 patient years. The median age of incident and prevalent renal transplant patients in the UK was 51.4 and 54.3 years respectively. The median EGFR of prevalent renal transplant recipients was 52.2 ml/min/1.73 m2. The median EGFR of patients one year after transplantation was 57.2 ml/min/1.73 m2 post live transplant, 52.4 ml/min/1.73 m2 post brainstem death transplant and 48.4 ml/min/1.73 m2 post circulatory death transplant. In 2016, 13.1% of prevalent transplant patients had EGFR ,30 ml/min/1.73 m2. The median decline in EGFR slope beyond the first year after transplantation was -0.7 ml/min/1.73 m2/year. In 2016, malignancy (23%) replaced infection (22%) as the commonest cause of death in patients with a functioning renal transplant. Data completeness for attainment of blood pressure targets remained variable between centres