Abstract
Objective: To determine the effect of missed haemodialysis sessions. Methods: This cohort study was carried out from July to October 2019. Patients on maintenance haemodialysis were selected by consecutive sampling technique. Exclusion criteria included patients admitted to hospital during first month of study, haemodialysis for acute kidney injury, haemodialysis from multiple dialysis units, haemodialysis less than two times a week and unwilling patients. Data on haemodialysis sessions carried out during July 2019 was recorded to document attendance patterns. Patients were followed up for all-cause mortality, hospital admissions and need for haemodialysis in emergency over next three months. Results: Appointments were given to 84 patients, aged 59.27± 14.09 years, for 700 sessions during July. Amongst them, 24 (28.57%) missed 34 (4.86%) haemodialysis sessions. At least one haemodialysis session was missed by 14 (26.92%) males as compared to 10 (31.25%) females (p=0.670). During follow up period, 12 (14.29%) patients died. Five of 24 patients missing dialysis died, as compared to seven out of 60 patients with good compliance (p=0.310; relative risk: 1.992). Eight out of 24 patients missing dialysis required hospital admissions, as compared to 19 out of 60 patients with good compliance (p=0.883; relative risk: 1.079). Seven out of 24 patients missing dialysis required emergency haemodialysis, as compared to 12 out of 60 patients with good compliance (p=0.364; relative risk: 1.647). Conclusion: There was a statistically insignificant greater trend towards mortality and need for emergency haemodialysis amongst poorly compliant patients.
Highlights
End stage renal disease (ESRD) is associated with significant morbidity and mortality[1]
In the Dialysis Outcomes and Practice Patterns Study, a wide variation was noted in the incidence of missed HD sessions, ranging from
This problem could be more marked in Pakistan, where dialysis centers may not be at approachable distances for many patients and universally free of cost/ state sponsored healthcare is not the rule[4]
Summary
End stage renal disease (ESRD) is associated with significant morbidity and mortality[1]. Out of the three treatment modalities available for such patients, haemodialysis (HD) is the most widely practiced option in Pakistan. Problems with adherence are a significant issue the world over. In the Dialysis Outcomes and Practice Patterns Study, a wide variation was noted in the incidence of missed HD sessions, ranging from
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