Assessment of management and treatment responses in haemodialysis patients from Tehran province, Iran

Background. Chronic kidney disease (CKD) and endstage renal disease (ESRD) are emerging as globally important public health problems, and will necessitate improvements in health-care policy. ESRD incidence/ prevalence data are not available from large parts of the developing world. The main objective of this study is to describe and assess the current clinical practices for patients on maintenance haemodialysis (HD) living in the province of Tehran. Methods. In December 2005, an observational study was performed with 2630 patients (1505 males and 1125 females) from 56 different centres in the province of Tehran (the entire HD population), which has a population of 13.5 million inhabitants. Results. The prevalence/incidence of HD was 194.8/ 77.3 p.m.p. The leading causes of ESRD were diabetes and hypertension. Population of 90.3 and 9% received three and two sessions per week, respectively, with a KT/V mean value of 0.97 0.25. All centres used synthetic membranes, and 68% of the sessions were performed using bicarbonate as a buffer. The type of vascular access was autogenous arteriovenous fistula in 91% of patients. Our findings indicated that compliance with the K/DOQI recommendations for calcium–phosphorus management is difficult to achieve. Only 1.8% of patients achieved all four target laboratory tests. For the management of anaemia, ferritin was the most commonly performed measure of iron status (76.7%). Iron deficiency was seen in