Current Status of the Implication of the Clinical Practice Pattern in Hemodialysis Prescription in Regular Hemodialysis Patients in Egypt (Cairo) sector B3

Suzan Adel Mina;

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 Statement of the current status of hemodialysis patient in Egypt using a questionnaire under supervision of nephrology department Ain Shams University.
Our study sample consisted of 265 clinically stable chronic patients on regular HD. Cases were collected from Dar El Shefa Hospital, El Nozha International Hospital , El Farook Hemodialysis center & Om El Noor Hemodialysis center.
In all patients we recorded full history 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).
As regard Sponsoring status in the study population (69.8%) of them were sponsored by Governorate, (20.5%) of them were sponsored by companies, (8.3%) sponsored by health insurance & only (1.5%) are private cases.
Results of this study demonstrated that there were many causes for ESRD in the study population, where HTN 35.1%, DM 21.1% and in 8.7% 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 (39.6%), CLD in (31.3%), ISHD in (26 %) & DM in (6%) of patients.
In our study we found that most of the patients 85.3% recieve 3 HD sessions /week & (91.7% )of sessions lasting 4 hours, this was with (KDOQI 2006 guidelines) recommendations for HD adequacy .
Dependency status in the study population showed that (86.8%) were independent only (24.9%) of them are working, while (4.9%) of the patients were dependant & (8.3%) of them were wheelchair bound.
In our study we found that 77% of patients were using AVF, 16.2 % were using AVG while 6.8 % were using venous catheter. This was in agreement with (KDOQI 2006 guidelines) for venous access placement.
In our study the mean hemoglobin level was 10.52±1.62 gm/dl and this level was lower than the recommended level in about (41.5%) of patients. the optimum hemoglobin level in (CKD) patients should be 11-12 gm/dl and there is no apparent benefit above that level.


Other data

Title Current Status of the Implication of the Clinical Practice Pattern in Hemodialysis Prescription in Regular Hemodialysis Patients in Egypt (Cairo) sector B3
Other Titles الوضع الحالى لأشكال الممارسة الاكلينكية المتبعة لوصفات الاستصفاء الدموى لدى مرضى الاستصفاء الدموى فى مصر (القاهرة) قطاع ب٣
Authors Suzan Adel Mina
Issue Date 2013

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