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Clinical outcomes of end stage renal disease and adequacy of adult maintenance hemodialysis patients

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Int J Med Res Health Sci. |

Authors: Ismail Mahmud Ali, Amirthalingam R
Int J Med Res Health Sci. 2014;3(3):660-668 |  | DOI:10.5958/2319-5886.2014.00414.7

ABSTRACT

Background & Aim: End stage renal disease (ESRD) is an irreversible loss of kidney function caused by various risk factors and affected persons of lives mainly depending on the technology of renal replacement therapy (RRT) or renal transplantation (RT) to sustain the life. Aim of this study is to overview the clinical outcomes of ESRD and adequacy of maintenance hemodialysis among the patients. Materials & Methods: Currently, there are sixty two end stage renal disease patient’s clinical data’s were collected and included in the study. For all patients, pre and post hemodialysis samples were collected and processed through biochemical and hematology auto analyzer. The hemodialysis modalities 4008 H/S and high-flux & low flux ultra filter dialyzers had utilized to three dialysis sessions per week, 4 hrs per session for each individuals. Blood flow rates differed from 150 to 350ml min-1 dependingon conditions and standard dialysate flow was 500ml/ min-1. Results: Of total sixty two patients, 51.62% females and 48.38% males with mean age of 47.76 (18-72) years; gradually increased at the ages of 55 to 72 years then adult age. Concerning overall risk factors in ESRD, 61.30% of hypertension as a leading risk factor followed by 21% NIDDM, 11.30% other kidney diseases and 6.40% cardiac related diseases. Although, there are others clinical signs such as hypothyroidisms; extra-pulmonary infection, retinitis pigmentosa and infertility have been diagnosed. In addition, nearly 33.87%% of HCV, 6.45% HBV and 3.22% of co-infection have been prevalence in ESRD hemodialysis population. Relating to hepatitis C, B and co-infection during dialysis exposure were 29.41%, 2.94% and 2.94% in that order. In relation to overall adequacy of maintenance hemodialysis in this study nearly 75.80% (≥ 1.3 to 2.5 Kt/V) and 24.20% (1.05 to 1.3 Kt/V) were been analyzed through Kt/V formula for wastage clearance. Conclusion: The present study highlighted that the co morbidity of ESRD, current adequacy of adult maintenance hemodialysis, and suggesting to boost better by 90% (≥1.2Kt/V) of adequacy in all dialysis patients. In addition to that, exposure of hepatitis B and C virus during dialysis and advocating to implement current medical strategic to prevent ongoing clinical phenomenon within the patients.

Key words: Maintenance hemodialysis, End Stage Renal Disease, Co-morbidity, GFR

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