Abstract
The aim of this study was to assess the factors associated with dialysis adequacy in ESRD patients on maintenance hemodialysis in Rwanda. A descriptive cross-sectional study was conducted. A sample size of 66 hemodialysis patients was selected using purposive sampling strategy. An interview scheduled guide was used to collect data. Dialysis adequacy was calculated using kt/v Daugirdas & Schneditz formula. The mean hemodialysis adequacy was 1.26± 0.34. Most participants [41(62%)] had optimal hemodialysis adequacy of equal or greater than to 1.2, 19 (29%) had near optimal hemodialysis adequacy (0.8 - 1.2 kt/v) and only 6 (9%) had less than optimal hemodialysis adequacy (kt/v <0.8). Factors associated with hemodialysis adequacy were hospital settings (p = .010), age (p = .007), BMI (p =.004) and blood pressure level ((p = .018). Moreover, mode of transport and type of drinking water was significantly associated with hemodialysis adequacy (p = 0.032 and 0.030 respectively). In conclusion, the level of hemodialysis adequacy was low in 38% of ESRD patients with associated factors predominantly demographics. Therefore, further research inquiry is needed on additional factors which include technical aspects to establish their association with hemodialysis adequacy. Â
Highlights
The term End Stage Renal Disease (ESRD) refers to chronic kidney disease treated with either dialysis or kidney transplantation (Shibiru et al 2013)
Almost 70% were in normal range of weight based on Body Mass Index (BMI) calculation, 19% were in over weight range while only 12 % were in underweight range even as none was obese
23 (35%) traveled more than 40 kms to reach to the hemodialysis facility at the beginning of their renal replacement therapy modality but 18 (27%) of them shifted from their home to rent a nearby HD facility
Summary
The term End Stage Renal Disease (ESRD) refers to chronic kidney disease treated with either dialysis or kidney transplantation (Shibiru et al 2013). A URR of less than 65% is associated with increased morbidity and mortality among patients (Nahid et al 2016). Inadequate HD is common and is associated in poor patient survival, and leads to anemia, malnutrition, functional impairment and frequent hospitalization that culminate in an increased health care cost and increased mortality rate (Chijiokee et al 2016). HD remains the renal replacement modality for the majority in Rwanda as a SSA country (Naicker 2015) This modality is mainly offered in four referral hospitals and in two small stand-alone private clinics. No study has been done to establish the level of dialysis adequacy and its associated factors in all centers providing hemodialysis in Rwanda.
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