A. J. Wing

Negative selection of patients for dialysis and transplantation in the United Kingdom.

In order to understand why the United Kingdom ranks low in the treatment of end stage renal failure a questionnaire investigating knowledge of current acceptance practice for dialysis and transplantation was sent to various groups of doctors throughout the country. The questionnaire comprised 16 case histories of patients with established end stage renal failure and associated social and medical problems. In each case the responding doctor was asked to indicate whether the patient would be suitable for treatment by dialysis or transplantation or both. The questionnaire was sent to a randomly selected sample of general practitioners and non-renal consultant physicians and their responses compared with those of all the nephrologists identified in the United Kingdom. The mean number of cases rejected by both general practitioners and non-renal consultant physicians was significantly higher than the number rejected by nephrologists. The findings suggest that underreferral of patients to dialysis and transplant units contributes to the current low acceptance rate of new patients into treatment programmes in the United Kingdom.

EDTA Registry Centre Survey, 1986 Report from the European Dialysis and Transplant Association Registry

This paper summarises the information given on the 1986 EDTA Registry centre questionnaire which was returned by 82% of the 2,065 known dialysis and transplant centres in 33 European countries. Information is given on the number of patients alive on haemodialysis according to the type of dialysis facilities available where the patient was receiving dialysis and the number of patients receiving special types of dialysis. The centre questionnaire also included questions on testing for HIV infection, serological evidence or symptoms of AIDS and the diagnosis of hepatitis B in patients and staff. The data given in response to these questions are presented together with data on the involvement of dietitians and social workers in the treatment of patients with end stage renal failure. Finally, information on transplant activity in Europe and the treatment policies of transplanting centres is provided.