Epidemiological profile and perception of patients on chronic hemodialysis through a Moroccan prospective cohort study

Abstract

Introduction: End-stage kidney disease (ESKD) is a major global public health problem. Knowledge of its epidemiology is crucial for its prevention and the optimal care. Objectives: The objective was to study the epidemiological characteristics of patients on chronic hemodialysis, their outcomes and explore their perceptions of therapeutic modalities, through a prospective cohort. Patients and Methods: A prospective study conducted between February 2019 and January 2020, at two public hemodialysis centers in Oujda, Morocco. Results: Around 183 patients were enrolled. The mean age was 53±17 years. The initial nephropathy was undetermined in 37% of cases and dominated by diabetes in 25.7%. About 43% of patients had pre-dialytic nephrology follow-up. Only 32% patients initiated their hemodialysis by an arterialvenous fistula (AVF). The mean hemoglobin rate was 10.3±1.8 g/dL. Moreover, 74 % of patients were under erythropoietin. Serum calcium, phosphorus, vitamin D, and parathormone were within target ranges in 67%, 52%, 61%, and 51% of cases, respectively. Since, 80% of patients were not clearly informed about therapeutic modalities. The majority of patients opted for kidney transplantation (KT), with two major constraints preventing its realization, consisting the lack of related living donors and financial resources. Besides, 29% of patients were hospitalized for cardiovascular and infectious causes during the study year. The survival rate at 1 and 5 years after the start of dialysis was 97.2% and 95% respectively. Conclusion: Early detection of chronic kidney diseases in high-risk people, their rigorous follow-up and early referral to the nephrologist would improve the quality of care. The promotion of KT and PD would better meet the hemodialysis patients’ needs with better outcomes and lower costs.