Challenges of haemodialysis: A single centre experience in South West Nigeria
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Abstract
Background: Haemodialysis is the commonest method of Renal Replacement Therapy in Nigeria. Despite an advancement in the technicality and better understanding of haemodialysis, a number of complications are known to be associated with this procedure..
Objective: We aimed to highlight our experiences and share some of the uncommon complications encountered during haemodialysis and present the outcome of our patients.
Subjects and methods: A retrospective review of 101 patients during the last two years was done. Data extracted include: sociodemographic characteristic, aetiology of kidney disease, type of vascular access, intradialytic complication and outcome of treatment.
Results: The total number of dialysis session during the period was 823. Males constituted a higher proportion (64.4%) and were found to be older than female patients 49.8 vs 42.8 years (P=0.001).
Majority (89.1%) had chronic kidney disease while chronic glomerulonephritis was the main cause of CKD as seen in about 45% of the patient.
Due to the cost implication, only 2(1.98%) were able to undergo 3 sessions of dialysis per week for up to 1 month.
Vascular access was femoral (66.3%), internal jugular vein (25.7%), while only 2% used Artero-venous-fistula and one patient had femoral vessel pseudoaneurysm from frequent cannulation.
The commonest complication was hypotension which was present in 15.8%. Twenty-eight deaths were recorded, 44(43%) were either lost to follow up or absconded while 5% were transplanted at a referral centre.
Conclusion: Challenges of renal replacement therapy is overwhelming in our country due to poor human and financial resources. Early diagnosis and adequate government support are advocated.
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Naicker S. Nephrology in Africa - challenges of practice in resource-limited environment. Clin Nephrol. 2016; 86: 84-89. Ref.: https://goo.gl/WEmk2g
Okafor UH, Ekwem I, Wokoma FS. Challenges of kidney care in a resource poor nation: A study of private kidney care centre in Nigeria. Niger Med J. 2012; 53: 47-50. Ref.: https://goo.gl/GNkpyb
Stanifer JW, Jing B, Tolan S, Helmke N, Mukerjee R, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet. 2014; 2: 174-181. Ref.: https://goo.gl/S8Dqgr
Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int. 2011; 80: 1258-1270. Ref.: https://goo.gl/JS2G3w
Ekrikpo UE, Udo AI, Ikpeme EE, Effa EE. Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality. BMC Nephrol. 2011; 12: 50. Ref.: https://goo.gl/dBX7KB
Okaka EI, Unuigbe EI. Eight year review of hemodialysis: treated patients in a tertiary center in Southern Nigeria. Ann Afri Med. 2014; 13: 221-225. Ref.: https://goo.gl/7yohq6
Oluyombo R, Okunola OO, Olanrewaju TO, Soje MO, Obajolowo OO, et al. Challenges of hemodialysis in a new renal care center: call for sustainability and improved outcome. Int J Nephrol Renovasc Dis 2014; 7: 347-352. Ref.: https://goo.gl/RexUmP
Bello BT, Raji YR, Sanusi I, Braimoh RW, Amira OC, et al. Challenges of providing maintenance hemodialysis in a resource poor country: Experience from a single teaching hospital in Lagos, Southwest Nigeria. Hemodial Int. 2013; 17: 427-433. Ref.: https://goo.gl/xscLWy
Alebiosu CO. Detrimental effects of late referral for dialysis. Afr J Health Sci. 2001; 8: 89-92. Ref.: https://goo.gl/cwAZSz
Kaze FF, Ashuntantang G, Kengne AP, Hassan A, Halle MP, et al. Acute hemodialysis complications in end-stage renal disease patients: the burden and implications for the under-resourced Sub-Saharan African health systems. Hemodial Int. 2012; 16: 526-531. Ref.: https://goo.gl/SUqcQt
Okunola Y, Ayodele O, Akinwusi P, Gbadegesin B, Oluyombo R. Haemodialysis practice in a resource-limited setting in the tropics. Ghana Med J. 2013; 47: 4-9. Ref.: https://goo.gl/hLcbec
Shibiru T, Gudina EK, Habte B, Deribew A, Agonafer T. Survival patterns of patients on maintenance hemodialysis for end stage renal disease in Ethiopia: summary of 91 cases. BMC Nephrol. 2013; 14: 127. Ref.: https://goo.gl/b6AmNH
Mtika V, Muula A, Chipolombwe J, Nyirongo J, Rajabu J. Renal replacement therapy at lilongwe Central Hospital, Malawi. Trop Doc. 2002; 32: 163-165. Ref.: https://goo.gl/gh91S5
Krzanowski M, Janda K, Chowaniec E, Kusnierz-Cabala B, Sulowicz W. [Types of hemodialysis vascular access in patients on renal replacement therapy and its complications during a one year observation period]. Przegl Lek. 2011; 68: 343-347. Ref.: https://goo.gl/c72Cw6
National Kidney Foundation. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update. Am J Kidney Dis. 2015; 66: 884-930. Ref.: https://goo.gl/WAQDXJ
Meremo AJ, Ngilangwa DP, Mwashambwa MY, Masalu MB, Kapinga J, et al. Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma. Tanzania. BMC Nephrol. 2017; 18: 212. Ref.: https://goo.gl/RzRVPA
Acchiardo SR, Hatten KW, Ruvinsky MJ, Dyson B, Fuller J, et al. Inadequate dialysis increases gross mortality rate. ASAIO J. 1992; 38: M282-M285. Ref.: https://goo.gl/o13YPt
Chauhan R, Mendonca S. Adequacy of twice weekly hemodialysis in end stage renal disease patients at a tertiary care dialysis centre. Indian J Nephrol. 2015; 25: 329-333. Ref.: https://goo.gl/cRBnJc
Tentori F, Zhang J, Li Y, Karaboyas A, Kerr P, et al. Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplantant. 2012; 27: 4180-4188. Ref.: https://goo.gl/pz6TVz
Marshall MR, Byrne BG, Kerr PG, McDonald SP. Associations of hemodialysis dose and session length with mortality risk in Australian and New Zealand patients. Kidney Int. 2006; 69: 1229-1236. Ref.: https://goo.gl/bPVQ1x