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Consensus procedure for the management of children with ESRD. Oct 2011. Aim. Defining consensus-based benchmarks. Hemoglobin Blood pressure Phosphate PTH Calcium CaXP Lipids. Implementation Benchmark. Indicators. Best practice Hb. Nijmegen. i. 12\%. Hb too high Anemia.

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Presentation Transcript
slide2
Aim

Defining consensus-based benchmarks

indicators
Hemoglobin

Blood pressure

Phosphate

PTH

Calcium

CaXP

Lipids

Implementation

Benchmark

Indicators
best practice hb
Best practice Hb

Nijmegen

i

12%

Hb too high

Anemia

50%

7%

71%

38%

72%

22%

M0

N=32

M12

N=14

M24

N= 7

best practice bp
Best Practice BP

Utrecht

Systolic

Diastolic

17%

29%

BP> p95

71%

83%

38%

100%

62%

100%

100%

M0 M12 M24

N=24 N=8 N=6

M0 M12 M24

N=24 N=8 N=6

best practice phosphate
Best Practice phosphate

Nijmegen

32%

Too high

Too low

according to ESPN

58%

43%

29%

57%

71%

10%

M0

N=31

M12

N=14

M24

N=7

slide8
Protocol development

- study group + best practice hospital

- consensus

- applicable in all centres

  • Implementation
  • Qoc improvement?
slide9
Indicators

PTH

Calcium

CAXP

Lipids

best practice ipth
Best Practice (iPTH )

Too high

Too low

Amsterdam

HD

PD

calcium
Too high

Too low

According to ESPN

Calcium

11%

12%

best practice
Best practice

Liege

HD

PD

proposal all lipids
Proposal all lipids

- Cholesterol ( Total, LDL, HDL)

- Triglycerides

definitions
Definitions
  • Exit site infection:

a minimum of 1 clinical sign of inflammation (redness, warm,pain, pus) with or without positive swab and with antibiotic treatment (not cream or profylactic)

  • Rejection:

-Biopsy proven rejection with treatment (high dose steroids or antibody treatment) or

- Clinical suspected rejection with rejection treatment (without biopsy)

to do
To do…
  • Tx Infection:

Clinical symptoms (fever, GI) and / or parameters (crp, increased creatinin) with a positive culture/PCR/…

  • Infection tractus: of clinical symptoms
  • X ray: mild/ severe signs of ROD
  • Other?
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