Enabling new research in renal care practice- HSCIC case study

Released data set

In 2011, the National Institute for Health Research (NIHR) Research Capability Programme (RCP) disseminated a linked data set to the UK Renal Registry (UKRR) and the Sheffield Kidney Institute. The linked data set, which contained data on patients over the age of 18 who started renal replacement therapy (RRT) between 2002 and 2006, was based on three ‘base’ data sets:

  • The UK Renal Registry (UKRR) data set
  • HSCIC’s Hospital Episode Statistics (HES) data set
  • Office for National Statistics (ONS) mortality data set.

Linked data set: New findings in renal care practices and outcomes

  • Finding – for patients undergoing haemodialysis dialysis treatment three-times-a-week, there was a 69% increase in admissions and a 22% increase in deaths on the first day after the two-day break (long interdialytic gap), when compared to the rest of the week (e.g. patients undergoing treatment on Tuesdays, Thursdays and Saturdays saw increases on Tuesdays).
  • Associated research study – in December 2015, the NIHR awarded a five year fellowship, led by Dr James Fotheringham, to the Sheffield Kidney Institute and the University of Sheffield. The fellowship, which started in March 2016, aims to understand and reduce the harm associated with two-day dialysis breaks.
  • Finding – haemodialysis and peritoneal dialysis (PD) therapies are used to remove blood waste products and excess water when a patient’s kidneys fail. PD catheters are only inserted in patients undergoing PD therapy, but 7% of patients (438 patients) receiving PD catheters were only ever treated with haemodialysis therapy. A likely explanation for this is that when the patients commenced treatment with PD, the catheters did not function on them properly, so they had to be treated with haemodialysis therapy.
  • Associated research study – in May 2014, the NIHR awarded a £350k grant to the Sheffield Kidney Institute for the UK Catheter Study. The study is exploring the factors associated with successful PD catheter insertion and is taking place between 1 July 2015 and 30 September 2018.

Linked data set: Improved data completeness

  • Previously, 61% of patients in the UKRR data set had missing ethnicity, deprivation and/or comorbidity data; however, with the inclusion of HES data this was reduced to 3.8%.

Linked data set: Adjustment to the survival rate methodology

  • Previously, when three-year survival rate for RRT was adjusted for age and sex only, six renal centres were categorised as ‘outliers’ (i.e. centres with worse-than-expected survival rate). When the same measure was re-calculated with three additional variables – comorbidity, ethnicity and socio-economic status – only one renal centre had a worse-than-expected survival rate.

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