The SRAU is primarily an epidemiological registry, where the initiating event is any form of chronic RRT and the endpoint is death. Co-morbidity is recorded when patients are entered. Change of treatment modality, as well as change of treatment facility, is recorded consecutively. SRAU has been operational since 1991 and provides annual reports concerning the incidence, prevalence and mortality of RRT in Sweden on national, regional and – for some data – local levels. Except for survival calculations for the different modalities of treatment, SRAU does not provide any data on the quality of the processes of care.

To overcome this limitation the SDDB was created and became operational in 2002. The SDDB records about 40 variables regarding prescription, treatment and laboratory values of each dialysis patient. One set of variables per patient is collected each autumn. Reporting is by a secure Internet application.
 
Growing insight during the last decade concerning the relative futility of many high cost interventions on patients already on RRT has gradually directed more of the interest of the nephrology community towards optimization of the various processes of care in the earlier stages of CKD. The Swedish Society of Nephrology is therefore merging the SRAU and the SDDB, and simultaneously incorporating two regional registries covering CKD stages 4 and 5. Our new national registry will thus cover all patients with severe chronic renal disease, irrespective of whether RRT has begun or not and also irrespective of treatment modality, including transplantation. Cooperation with a software company specialised in Internet health care database solutions has begun.

We aim for automated retrieval of as much data as possible, but are held back by present technical obstacles. We also consider the inverse correlation between the number of desirable variables to collect and the quality of data. One of our high priority goals is to maintain the good coverage of SRAU and SDDB. The somewhat inconsistent organisation of RRT in Sweden makes lack of manpower another limiting factor at many facilities.

The objectives of the new integrated registry are manifold. First we will use the registry to improve the chances of survival and the quality of life for our RRT patients. Second the registry will support our efforts to retard the increasing numbers of patients entering RRT. Third the registry will assist our clinical and research efforts in this patient population.