The Spectrum of Intradialysis Complications in Renal Patients Accessing Care in A Tertiary Hospital in South East Nigeria

Abstract

Background: Haemodialysis (HD) is currently the most common mode of renal replacement therapy (RRT) in the Sub-Saharan Africa. It is however, fraught with many complications which sometimes cause morbidity and mortality outside the primary kidney problems. Hence, there must be concerted effort to identify them early. This would enable the clinician institute preventive measures or treat them efficiently when these adverse effects occur. Materials and Method: A prospective study was carried out among chronic kidney disease (CKD) and acute kidney injury (AKI) patients in failure assessing HD care at the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi dialysis center. Subjects were one hundred and twenty six in number: 84 CKD and 42 AKI. Sixty five (65) were males while sixty one (61) were females. A total of three hundred and sixty nine (369) HD sessions were done. Sociodemographic data and medical history were obtained from each subject and relevant physical examinations and laboratory investigations were carried out prior to and intra dialysis for each subject. Results were analyzed using Statistical Package for Social Sciences (SPSS) software version 17. Results: Intradialytic complications occurred in 86 out of 126 subjects. The commonest intradialytic complication was hypotension (20.6% for patient-based analysis and 21.1% for session-based analysis). This was followed by hypertension (19.8% for patient-based analysis and 16.5% for session-based analysis). Other complications noted were fever (9.95%), chest pain (9.95%), cramps (1.0%) and seizure (1.0%). Conclusion: In this study population, intradialysis hypotension was the most common complication followed by intradialysis hypertension. Patients on HD should be assessed and monitored actively to identify and possibly prevent or treat these complications when they occur.