The effect of optimising clinical performance measures on outcomes in haemodialysis patients

Background: Chronic kidney disease is a worldwide public health problem that is increasing in incidence and prevalence. In 1997, the Dialysis Outcomes Quality Initiative (DOQI) of the National Kidney Foundation (NKF) advised that certain performance measures be met to improve end stage renal failure patient survival. Aims: To examine whether attainment of the performance measures was associated with decreased mortality and hospitalisation in an Irish setting. The effect of comorbidities on survival and target attainment was also analysed. Methods: A one-year retrospective analysis of 304 haemodialysis patients attending Beaumont Hospital. The Charlson Comorbidity Index (CCI) was calculated to determine the effect of comorbidity on survival and attainment of the targets. Results: The number of targets met was positively correlated with survival rates (P=0.0028), and negatively correlated with both the percentage of patients hospitalised (P=0.0036) and the number of comorbidities (P=0.020). Conclusions: Our findings highlight the importance of quality of care in haemodialysis patients, and the need to implement strategies to ensure attainment of NKF-DOQI guidelines targets.</p