Current Status of the Implication of the Clinical Practice Pattern in Hemodialysis Prescription in Regular Hemodialysis Patients in Egypt (Qena “Sector B”)

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 lead by the MOH. This work is a part of project aiming at assesment 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 May 2013. Our study sample consisted of 515 clinically stable chronic patients on regular thrice- weekly HD. Patients were collected from Qena`s General Hospital, Qena`s New General Hospital, Helal Hospital, Qena`s Homiat Hospital, Qena`s Insurance Hospital, ElBarahma Central Hospital, Quos Central Hospital, and Nikkada Central Hospital all of which are located in Qena Governate.. 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 . Results of this study demonstrated that there were many causes for ESRD in the study population .HTN was responsible for 19% of these cases , DM was responsible for 18% of these cases ,and in 7% the cause was unknown. Different comorbidities in the study population were HTN in (30.3%), DM in (5%), ISHD in (4.9 %), peripheral vascular disease in (1%) of patients. In our study we found that most of the patients 75% were recieving 3 HD sessions /week each lasting 4 hours . The mean value of patients dry weight was 71.17 (±6.43) Kg.. In our study population (91%) were not working , while (9%) were working . Dependency status in the study population showed that (9%) of the patients were dependant, (91%) were not dependant , while all of the dependent patients were wheelchair bound . As regard Sponsoring status in the study population (56%) of them were sponsored by Governorate , while (42%) of them had insurance . In our study we found that 97% of patients were using AVF , 1.5 % were using AVG while 1.5% were using venous catheter .