Current clinical situation of hemodialysis patients in nephrology center, Benghazi, Libya

Abstract

Background Dialysis adequacy is an important and effective factor in reducing mortality and morbidity among patients with end-stage kidney disease. This study aims to assess the current clinical situation of hemodialysis (HD) patients, to monitor the established quality-of-care indicators, and to identify the unachieved quality-of-care goals.Patients and methods This is an observational study in which all patients underwent chronic HD program (>1 year) at the nephrology center in Benghazi, Libya. It was conducted between January and June 2018. Mean levels were collected for the following indicators: hemoglobin, dialysis dose, serum calcium and phosphorus, parathyroid hormone, systolic and diastolic blood pressure, interdialytic hypotension, and vascular access.Results A total of 292 dialysis patients were reviewed and followed over a 6-month period. Overall, 170 (58.2%) were males and 122 (41.8%) were females. Mean age was 51.1±14 years. Hypertension was the most common cause of end-stage kidney disease in 76 (26.0%) patients followed by diabetes mellitus in 32 (11.0%) patients. Our patients failed to achieve adequate HD, as laboratory value results were as follows: mean hemoglobin level less than 10 g/dl in 61% of patients, serum Ca+2 was less than 8.4 mg/dl in 48.6%, serum PhO4 was more than 5.5 mg/dl in 50%, and serum parathyroid hormone was more than 300 ng/dl in 60.3%.Conclusion Dialysis insufficiency was seen in a significant percent of patients in this study. More extensive research studies for finding the causes of low dialysis quality are suggested.