Current status of the Implication of the Clinical practice pattern in Hemodialysis Prescription in Regular Hemodialysis Patients in Egypt (El-Gharbeya governorate) (Sector D)

Abstract

End-stage renal disease (ESRD) is one of the main health problems in Egypt. Currently, hemodialysis represents the main mode for treatment of chronic kidney disease stage 5 (CKD5), previously called ESRD or chronic renal failure. Although hemodialysis is often used for treatment of ESRD, no practice guidelines are available in Egypt. Healthcare facilities are seeking nowadays 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 MOH. This work is a part of project aiming at Statement of the current status of dialysis patient in Egypt using a questionnaire. This project is modulated by Nephrology department, Ain Shams University. This study was done in April & May 2013. Our study sample consisted of 331 clinically stable chronic patients on regular thrice- weekly HD. Patients were collected from EL Gharbiah governorate sector D (EL Santa, Kotour, Samanoud). In all patients we recorded full history and clinical examination stressing on etiology of renal disease and associated complications, Full review of all medical records over the last 6 months and details of HD prescription (Doctors, nurses, administration orders). Summary 113 Results of this study demonstrated that there were many causes for ESRD in the study population, where HTN 41.1%, DM 21.1% and in 16.3% the cause was unknown, this results agrees with most of the studies where HTN & DM were the main causes of renal failure. Different comorbidities in the study population were HTN in (62.2%), DM in (21.8%), CLD in (13.6 %), chronic arthropathy in (11.8%), CVS in (2.7%), PVD in (2.7%), ISHD in (5.7%) of patients and COPD in (1.8%). In our study we found that most of the patients 98.5% recieve 3 HD sessions /week and most of them (87.6%) lasting 4 hours/session, this was with KDOQI guidelines recommendations for HD adequacy. The median value of HD period is 6.6 (± 4.7) years. The mean value of patients dry weight was 71.08 (± 15.94) Kg. In our study population (84.6%) were not working, while (15.4%) were working. Dependency status in the study population showed that (13.3%) of the patients were dependant, (86.7%) were not dependant, while (1.5%) of them were wheelchair bound. As regard Sponsoring status in the study population (62.2%) of them were sponsored by Government, (37.2%) of them were sponsored by insurance and (0.6%) were sponsored by military.