Adequacy of hemodialysis At Moi teaching and Referral Hospital
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Medical research
![ARE WE ADEQUATELY DIALYSING OUR PATIENTS?
A study assessing the adequacy of hemodialysis among patients with end stage renal disease (ESRD) at a tertiary hospital in Kenya
[E. Essajee , F. Some , L. Diero , J . Odunga – All of School of Medicine, Moi University, Eldoret, Kenya]
Background
End-stage renal disease (ESRD) is of world-wide public
health concern.
The only available therapeutic option for ESRD is renal
replacement therapy (RRT) ; with hemodialysis (HD)
being the most widely available option.
Clinical outcomes are associated with adequacy of HD,
yet assessment of HD adequacy at the Moi Teaching and
Referral Hospital (MTRH) is not routinely conducted.
Objective
To determine the adequacy of HD among ESRD patients
at MTRH.
Methodology
This cross-sectional study of 60 ESRD patients at the
MTRH renal unit assessed adequacy of HD using Kt/V
(fractional clearance of urea as a function of its
distribution volume) and URR (urea reduction ratio)
between February and March 2016. Adequacy was taken
as Kt/V of > 1.8 and URR > 80 % for less than three
times weekly HD.
Peri-dialysis anthropometric measurements, dialysis
ultrafiltration volume and laboratory renal function tests
were among the data collected for analysis.
Data was fed into Microsoft Excel database and analyzed
using STATA version 13.
Results
Gender Distribution
Variable Frequency %
Male
Female
Total
45
15
60
75
25
100.0
Frequency of hemodialysis
35%
65%
once a week dialysis
twice a week dialysis
Kt/V n %
< 1.20
1.20 - 1.79
> or = 1.80
Total
27
28
5
60
45.0
46.7
8.3
100.0
URR
<65
65 - <80
> or = 80
Total
29
28
3
60
48.3
46.7
5.0
100.0
Adequacy results
Conclusion
HD adequacy levels at MTRH are low; with majority of the
participants having temporary vascular access and
dialysing for less than three times weekly.
Recommendations
Adoption of objective tools to assess HD adequacy levels
at the renal unit to improve HD outcomes.
0 20 40 60
Bladder Obstruction
Diabetes
Diabetes,Hypertension
Drug Induced
Hypertension
Systemiclupuserythromat…
%
Co-morbidities](https://image.slidesharecdn.com/dialysisadequacyposter-180904083111/85/Adequacy-of-hemodialysis-At-Moi-teaching-and-Referral-Hospital-1-320.jpg)
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Adequacy of hemodialysis At Moi teaching and Referral Hospital
- 1. ARE WE ADEQUATELY DIALYSING OUR PATIENTS? A study assessing the adequacy of hemodialysis among patients with end stage renal disease (ESRD) at a tertiary hospital in Kenya [E. Essajee , F. Some , L. Diero , J . Odunga – All of School of Medicine, Moi University, Eldoret, Kenya] Background End-stage renal disease (ESRD) is of world-wide public health concern. The only available therapeutic option for ESRD is renal replacement therapy (RRT) ; with hemodialysis (HD) being the most widely available option. Clinical outcomes are associated with adequacy of HD, yet assessment of HD adequacy at the Moi Teaching and Referral Hospital (MTRH) is not routinely conducted. Objective To determine the adequacy of HD among ESRD patients at MTRH. Methodology This cross-sectional study of 60 ESRD patients at the MTRH renal unit assessed adequacy of HD using Kt/V (fractional clearance of urea as a function of its distribution volume) and URR (urea reduction ratio) between February and March 2016. Adequacy was taken as Kt/V of > 1.8 and URR > 80 % for less than three times weekly HD. Peri-dialysis anthropometric measurements, dialysis ultrafiltration volume and laboratory renal function tests were among the data collected for analysis. Data was fed into Microsoft Excel database and analyzed using STATA version 13. Results Gender Distribution Variable Frequency % Male Female Total 45 15 60 75 25 100.0 Frequency of hemodialysis 35% 65% once a week dialysis twice a week dialysis Kt/V n % < 1.20 1.20 - 1.79 > or = 1.80 Total 27 28 5 60 45.0 46.7 8.3 100.0 URR <65 65 - <80 > or = 80 Total 29 28 3 60 48.3 46.7 5.0 100.0 Adequacy results Conclusion HD adequacy levels at MTRH are low; with majority of the participants having temporary vascular access and dialysing for less than three times weekly. Recommendations Adoption of objective tools to assess HD adequacy levels at the renal unit to improve HD outcomes. 0 20 40 60 Bladder Obstruction Diabetes Diabetes,Hypertension Drug Induced Hypertension Systemiclupuserythromat… % Co-morbidities