Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality

Ekrikpo, Udeme; Udo, Aniema I. A.; Ikpeme, Enobong Emmanuel; Effa, Emmanuel

doi:10.1186/1471-2369-12-50

Cited by 39 publications

(49 citation statements)

References 12 publications

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“…Similar findings were reported in Nigeria whereby long standing hypertension was seen in 70 (38.8%) patients with ESRD [23]. In contrast, other studies done in Nigeria and sub Saharan Africa reported chronic glomerulonephritis as the leading causes of ESRD [12, 24, 25] . This may reflect lifestyle differences, geographical variability and a greater control of infectious diseases.…”

Section: Discussionsupporting

confidence: 80%

Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania

et al. 2017

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BackgroundKidney Diseases contribute a significant proportion to the global burden of non-communicable diseases. Haemodialysis services as the main modality of renal replacement therapy in most resource limited countries is only available in few cities and at higher costs. The aim of this study was to determine the challenges and outcomes of patients who were on haemodialysis at the University of Dodoma (UDOM) haemodialysis unit in Tanzania.MethodsIn this retrospective study; we reviewed haemodialysis registers and charts of 116 patients dialyzed from January 2013 to June 2015 at The UDOM haemodialysis unit. Data were descriptively and inferentially analysed using Stata version 11 software.ResultsOf the 116 patients, 52 (44.9%) were male, and 38(32.8%) were married. Their median age was 45 years. Thirty-two (27.6%) had acute kidney injury, of them 26 (81.3%) patients had recovery of renal function after haemodialysis. Indications for hemodialysis were anuria (18), intoxications (14), electrolyte imbalance (9), uraemia (7) infections (6) and fluid overload (4). Eighty-four (72.4%) patients had End Stage Renal Diseases (ESRD), of which 37 (44.1%) absconded/lost to follow up, 15 (17.9%) died, 22 (26.2%) were referred to Muhimbili National Hospital (MNH), 12 for possible kidney transplant abroad after haemodialysis, and 10 (11.9%) were still attending our unit for haemodialysis. Residing outside Dodoma was predictive for poor outcomes while on haemodialysis (OR 5.2, 95% CI 3.2–8.6, p < 0.001). In addition the odds ratio for poor outcomes was 7.3 times for a patient ESRD (OR7.34, 95% CI 3.26–18.17, p < 0.001). Patients who had no National Health Insurance Fund (NHIF) coverage (OR 6.6, 95% CI 5.4–12.7, p < 0.001) also had higher odds of poor outcomes after starting haemodialysis.ConclusionUnavailability and high costs related to utilization of haemodialysis services among patients needing dialysis are the challenges for better outcomes. Therefore, haemodialysis and renal transplants services should be made easily available in regional referral hospitals at reasonable costs. In addition, members of the public should be educated on joining health insurance schemes and on making healthy life style choices for preventing chronic kidney disease and its progression.

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Section: Discussionsupporting

confidence: 80%

Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania

et al. 2017

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“…En México, solo el 22% de los pacientes con ERC recibió alguna forma de TRR (HD, diálisis peritoneal o trasplante) en el año 2009, lo que representó un costo aproximado de 559 millones dólares anuales en insumos para los procedimientos. Si se hubiera atendido a todas las personas con ERC, se hubiera requerido más de 2400 millones de dólares anuales (13) .…”

Section: Discussionunclassified

Factores asociados a mortalidad intrahospitalaria de una población en hemodiálisis en el Perú

Herrera‐Añazco

Benítes-Zapata

Hernández

2015

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Determinar los factores asociados a la mortalidad durante la primera hospitalización de una población incidente en hemodiálisis. Materiales y métodos. Estudio observacional y retrospectivo de pacientes que ingresaron al Hospital Nacional Dos de Mayo entre enero de 2012 y diciembre de 2013. Para el análisis de la supervivencia utilizamos el método de Kaplan-Meier. Se realizó un análisis de regresión logístico multivariado para evaluar los factores asociados a mortalidad intrahospitalaria. Resultados. Se estudiaron 216 pacientes con edad promedio de 56,9 ± 15,5 años. El 24% de los paciente (n=51) fallecieron durante la estancia hospitalaria. La tasa de mortalidad fue de 9,3 muertes/100 personas-semanas (IC 95%: 7,0 a 12,3). Se evidenció una tendencia a menor riesgo de fallecer en pacientes que tenían entre uno y seis meses con diagnóstico de enfermedad renal crónica (OR 0,84; IC 95%: 0,32 a 2,26), y en aquellos con más de seis meses comparado con aquellos que lo tenían hace menos de un mes (OR 0,55; IC 95%: 0,19 a 1,57). La atención previa por un nefrólogo no estuvo asociada a diferencias en la mortalidad menor (OR 1,14; IC 95%: 0,39 a 3,31). Conclusiones. Existe una deficiente atención previa entre los pacientes en hemodiálisis que forman parte de una inadecuada estructura de atención de salud y que está asociado a una alta mortalidad intrahospitalaria. Palabras clave: Mortalidad; Hemodiálisis; Sistemas de salud (fuente: DECS/Bireme) FACTORS ASSOCIATED WITH IN HOSPITAL DEATHS IN A HEMODIALYSIS POPULATION IN PERU ABSTRACTObjectives. To determine the factors associated with mortality during the first hospitalization of patients admitted to a hemodialysis unit. Materials and methods. Observational and retrospective study of patients admitted to "Dos de Mayo" National Hospital between January 2012 and December 2013. For the survival analysis we used the Kaplan-Meier method. A multivariate logistic regression was performed to evaluate the factors associated with hospital mortality. Results. 216 patients with a mean age of 56.9 ± 15.5 years were studied. 24% of patients (n = 51) died during their hospital stay. The mortality rate was 9.3 deaths/100 person-weeks (95% CI: 7.0 to 12.3). We found a tendency of less risk of death in patients with between 1 and 6 months from chronic kidney disease diagnosis (OR 0.84, 95% CI: 0.32 to 2.26) and in those with more than six months from chronic kidney disease diagnosis compared with those who had less than a month from chronic kidney disease diagnosis (OR 0.55, 95% CI: 0.19 to 1.57). Previous care by a nephrologist was not associated with differences in lower mortality (OR 1.14, 95% CI: 0.39 to 3.31). Conclusions. There is poor prior care among hemodialysis patients that form part of an inadequate health care structure and this is associated with high inhospital mortality.

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“…Again, due to the high cost of treatment and considering the large prevalence of poverty in most of these countries, most of the patients cannot afford the treatment and therefore lack access to this method of treatment. However, it is the most common form of renal replacement therapy in Sub-Saharan Africa, with other forms such as peritoneal dialysis and kidney transplant being less common largely due to their high costs and lack of facilities and human resources [4]. This prevents many people in African countries from having other treatment choices when they develop ESRD [5].…”

Section: Introductionmentioning

confidence: 99%

Maintenance Haemodialysis in the Edward Francis Small Teaching Hospital in the Gambia

Sanyang

Sambou

2019

Nephron

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Maintenance haemodialysis is the most common form of renal replacement therapy treatment in Sub-Saharan Africa. In spite of this, there is a general inadequacy for patients receiving this form of therapy due to lack of materials, human resources and funding from the governments. This form of treatment is relatively new in the Gambia compared to many West African countries, but there is also an enormous challenge on the part of the government to ensure that the citizens benefit from this form of therapy. Inadequate finances and human resources are making it difficult for the Gambia government to achieve this objective. It is therefore imperative for the state to invest more efforts on preventive strategies, which until today continue to remain inadequate.

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Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality

Cited by 39 publications

References 12 publications

Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania

Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania

Factores asociados a mortalidad intrahospitalaria de una población en hemodiálisis en el Perú

Maintenance Haemodialysis in the Edward Francis Small Teaching Hospital in the Gambia

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