Age and Dialysis Adequacy in Maintenance Hemodialysis Patients

Nasri, Hamid

doi:10.4328/jcam.1151

Cited by 2 publications

(1 citation statement)

References 29 publications

(53 reference statements)

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“…In the index study, we have found that the elderly population had more than two times higher risk of having inadequate HD. These findings complement previous reports from Iran [19] and Rwanda [10] where there was a significant negative correlation between age and inadequate HD. Also, in Tanzania the same findings were previously reported where the older population of 40 years or older comprised the majority of patients with inadequate HD [12].…”

Section: Discussionsupporting

confidence: 91%

Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Kilonzo,

Rudovick,

Makambay

et al. 2023

OJNeph

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Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen's kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 -68) years. The median hemoglobin level was 10 (8.9 -11.2) g/dl, and the pre-dialytic urea was 15 (10.6 -21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 -12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 -14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 -9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients How to cite this paper:

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Section: Discussionsupporting

confidence: 91%

Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Kilonzo,

Rudovick,

Makambay

et al. 2023

OJNeph

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Adequacy of Dialysis in Iranian Patients Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

et al. 2018

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Context: Preforming an adequate and effective dialysis is essential to improve patients' quality-of-life and decrease the complications of kidney failure. However, evidence regarding the effectiveness of dialysis among Iranian patients undergoing hemodialysis is inconclusive. The current study aimed at evaluating the effectiveness of dialysis in Iranian patients undergoing hemodialysis using a systematic approach. Evidence Acquisition: In the current meta-analysis, the search was performed using the keywords "Adequacy of Dialysis" and "Hemodialysis Adequacy" in SID, MagIran, ISI/Web of Science, PubMed, and Scopus databases from inception to July 2018. According to the heterogeneity of the studies, the data were analyzed using the random effects model with STATA version 14. Results: The mean urea kinetic modeling (Kt/V) and urea reduction ratio (URR) in Iranian patients undergoing hemodialysis were 1.11% (95% confidence interval (CI): 1.03-1.81) and 59.94% (95% CI: 58.33-61.54), respectively. There was no correlation between indices of dialysis adequacy, sample size, mean age of samples, and year of the paper publication. However, Kt/V and URR in articles with high methodological quality were higher than the ones with moderate methodological quality. Conclusions: The mean adequacy of dialysis indices among Iranian patients was below the standard levels and it is necessary to consider measures to improve dialysis efficacy.

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Age and Dialysis Adequacy in Maintenance Hemodialysis Patients

Cited by 2 publications

References 29 publications

Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Adequacy of Dialysis in Iranian Patients Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

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