Comparison between Two Different Methods of Measuring Dialysis Adequacy and its Relation to Health Related Quality of Life in Prevalent Hemodialysis Patients

Abstract

Summary and Conclusions E nd-stage renal disease (ESRD) is one of the main health problems in Egypt. Currently, hemodialysis represents the main mode for treatment of end stage renal disease in Egypt. Yet, no practice guidelines for hemodialysis practice are available in Egypt. Healthcare facilities are seeking to develop practice guidelines for the sake of improving healthcare services. In the healthcare sector in Egypt, trials for establishing guidelines have been led by the Ministry of Health (MOH). This work is a project aiming at assessment of the current adequacy of dialysis patient in Egypt using a kidney disease quality of life questionnaire. This study is modulated by Ain Shams university Nephrology department. The study included 100 clinically stable patients with ESRD on regular hemodialysis in Port Said Governorate. Patient information was collected from Port Said General Hospital, Hemodialysis Unit. Data was collected in June and July 2015. In all patients, we recorded full history and clinical examination stressing on etiology of renal disease and associated complications. Only 1 hemodialysis units were included in the study. Port Said General Hospital Unit is owned by the Ministry of Health. The mean age of the study population was 55±13 years. Male patients constituted 71% of the study sample, while females constituted 29%. Smoking status in our study population showed that 49 patients (49%) were smokers, while 51 patients (51%) were nonsmokers. Smoking is a hazardous habit and predicts cardiovascular co-morbidities. Regarding the etiology of end stage renal disease in the patients included in the study, hypertension was the most common, present in 67 patients (67%). 48 patients (48%) had a past history of diabetes mellitus (DM). It is followed by 10 patients (10%) have past history of obstructive uropathy. 9 patients (9%) patients had a past history of glomerulonephritis (GN). 5 patients (5%) suffered from adult polycystic kidney disease (APCKD),followed by 3 patients suffered from Gout (3%). and 2 finally patients (2%) have past history of autoimmune disease(SLE). 20 patients were hepatitis C Virus-positive (20% of the study sample), 1 patient (1%) were HBV-positive, while 79 patients were negative for HCV and HBV. All HCV-positive patients were routinely isolated in separate rooms in all the hemodialysis units included in the study which is in accordance to the recommendations that suggest isolation in order to reduce the risk of seroconversion among hemodialysis patients, and so HBV patients. None of the patients included in the study was HIV-positive. Hypertension is the most common cause of end-stage renal disease (ESRD) among patients included in the study (67% of valid data), followed by diabetes mellitus (48%). These results are similar to those of the latest Egyptian Renal Registry where HTN and DM were the main causes of end-stage renal failure.