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Improving Outcomes for Dialysis Patients in the International Dialysis Outcomes and Practice Patterns Study

Friedrich K. Port^*, Ronald L. Pisoni^*, Jürgen Bommer, Francesco Locatelli, Michel Jadoul, Garabed Eknoyan^||, Kiyoshi Kurokawa^¶, Bernard J. Canaud^**, Miles P. Finley^*, and Eric W. Young

^* University Renal Research and Education Association, Ann Arbor, Michigan; University of Heidelberg, Heidelberg, Germany; Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy; Université Catholique de Louvain, Cliniques Universitaires St-Luc, Bruxelles, Belgium; ^|| Renal Section, Department of Medicine, Baylor College of Medicine, Houston, Texas; ^¶ Tokai University, Kanagawa, Japan; ^** Lapeyronie University Hospital, Montpellier, France; and University of Michigan/Veterans Administration Medical Center, Ann Arbor, Michigan

Address correspondence to: Dr. Friedrich K. Port, University Renal Research and Education Association, 315 W. Huron Street, Suite 360, Ann Arbor, MI 48103. Phone: 734-665-4108; Fax: 734-665-2103; E-mail: fport{at}urrea.org

The international Dialysis Outcomes and Practice Patterns Study (DOPPS) is well suited to evaluate levels of deviation from emerging and established guidelines to clinical practice of hemodialysis, over time and by country. The DOPPS can also evaluate whether the target levels that are chosen in the guidelines are in agreement with outcomes such as elevated risk for mortality, hospitalization, and vascular access failure. At a special DOPPS symposium during the 2004 congress of the American Society of Nephrology, the authors presented such findings; key points from that symposium are presented in this article, focusing on vascular access, mineral metabolism, dialysis dose, and anemia management. Although an observational study cannot prove causality, DOPPS suggests large opportunities to improve care and outcomes of dialysis patients. The international perspective of DOPPS assists in the new efforts for international guidelines. Some encouraging trends in recent years are documented in these areas.

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