Adequacy of dialysis among patients with end-stage renal disease undergoing maintenance haemodialysis in South-West Nigeria

Abstract

Background: Globally, Dialysis remains the most common form of Renal Replacement Therapy (78%) with HD being the preferred mode of Dialysis (89%). An Adequate dialysis is the dose that ameliorates the uraemic symptoms, prolongs life, and provides a quality of life close to normal and reduces the associated morbidity and mortality. Objective: This study assessed the adequacy of dialysis prescribed and delivered to patients on maintenance HD in South-West Nigeria. Methods: An observational cross-sectional study involving Adult ESRD Patients on Maintenance HD at four different units in South Western part of Nigeria. Results: Forty-one (41) patients with ESRD undergoing maintenance HD for ≥3months participated in the study. Their ages ranged between 19 and 84 years (mean ± SD: 49.6 ± 16.5) Males constituted 58.5% with a M:F of 1.4:1. The measures of adequacy of dialysis calculated from Pre- and Post- dialysis urea levels were Percent Reduction of Urea (PRU), Equilibrated Kt/V (eKt/v) and Standard Kt/V (stdKt/V) with mean (± SD) of 54.7 (± 10.8)%, 0.89 (± 0.21)and 1.31 (± 0.37) respectively. Of the 41 patients, 7 (17.1%) had PRU ≥65%, 10 (24.4%) had eKt/v ≥1.05 and 3 (7.3%) had stdKt/V ≥2.0 per week. Conclusion: Adequacy of dialysis using clinical and laboratory parameters in our ESRD patients were poor and did not attain levels recommended by available Clinical Practice Guideline and Recommendations. However, the two measures of adequacy, PRU and stdKt/V, correlated significantly.