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

Abstract

Dialysis-dependent CKD (CKD 5D) is one of the main health problems in Egypt. Hemodialysis represents the main mode for treatment of chronic kidney disease stage 5 (CKD5). Although hemodialysis is often used for treatment of (CKD5), 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 done 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 2015. Our study sample consisted of 311 clinically stable chronic patients on regular three- weekly HD. Patients were collected from Alexandria sector B (East area-Almontazah area) 1-Abu Qir General hospital 2- Shark Almedina hospital 3-Alhalal hospital (Backus) 4-Al-Mabarrah hosital (Fleming) 5-New Medical center Hospital smoha 6- Alsagar center (victoria) 7- Almedina Almnora center (Backus) 8-international nephrology center (Fleming) 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).Results of this study demonstrated that there were many causes for (CKD5) in the study population, where HTN 37%, DM 21.5%, and in 14.1% 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 (73.3%), DM in (23.6%), IHD in (22.8 %), and CLD in (4.8%) of patients. In our study we found that most of the patients 97.5% receive 3 HD sessions/week. This was with KDOQI guidelines recommendations for HD adequacy. In our study population (85.2%) was not working, while (14.8%) were working. Dependency status in the study population showed that (37.9%) of the patients were dependent, while (62.1%) of them were independent. As regard Sponsoring status in the study population (86.2%) of them were sponsored by Governorate, while (13.8%) of them were health insurance. In our study we found that 97.7% of patients were using AVF, 1 % were using AVG while 1.3 % were using long term catheter. This was in agreement with KDOQI guidelines for venous access placement.