High incidence of XXXX requiring short-term dialysis: a prospective observational study.

@entity1 @entity177 @entity810
BACKGROUND: Previous estimates of incidence of @entity810 ( @entity810 ) requiring renal replacement therapy have varied from 18 to 75 @entity1 per million per year, but have been beset by problems of definition. AIM: To investigate whether the '90-day rule' provides a more reliable, reproducible and robust estimate of the need for short-term dialysis. SETTING: District general hospital serving a population of 147 000. DESIGN: Prospective observational study. METHODS: @entity1 who received renal replacement therapy in Dumfries and Galloway between 01/01/94 and 31/12/2000 were divided into two groups: long-term dialysis (> or =90 days) and short-term dialysis (<90 days). RESULTS: Of 302 @entity1 , 193 received short-term dialysis, giving an incidence for short-term dialysis of 187 @entity1 episodes per million per year (95%CI 170-203). Use of a more conventional definition for @entity810 (including all @entity810 and @entity810 , but excluding @entity1 with @entity177 who present acutely) produced a similar estimate at 176 @entity1 per million per year (95%CI 160-193). DISCUSSION: The 90-day rule estimated the incidence of short-term dialysis/ @entity810 at nearly twice the incidence of @entity177 requiring dialysis, and more than twice the most recent estimate of the incidence of @entity810 in the UK. The main attraction of the 90-day rule is its simplicity. If the high level of short-term dialysis/ @entity810 found in our study is confirmed by other centres, there are significant resource implications for the provision of renal care.
