Lagos Renal Registry: An Audit of Renal Replacement Therapy in Five Public Dialysis Units in Lagos Metropolis

Abstract

Introduction: Renal registries are databases containing specific disease and treatment related information about patients with renal diseases. In Nigeria, early attempts at establishing a national renal registry encountered considerable challenges as participation by centres was low and data entry by the participating centres were inconsistent and grossly inadequate. This report presents the findings of a registry data of dialysed patients between 1^st and 7^th of December 2011 in 5 public hospitals in Lagos metropolis.

Method: Lagos Renal Registry was established on the 1^st of December 2011. The Registry aims to collect and document information on patients with renal diseases in Lagos State quarterly. Collected data would be used to identify challenges in nephrology practices in the State, and measures aimed at resolving the identified problems would be implemented. An audit of dialysis care in 5 public hospitals in Lagos during the first week of December 2011 was conducted.

Results: Fifty five patients were dialysed during the audit period. There were 39 (70.9%) males and 16 (29.1%) females with a M:F ratio of 2.4:1. Majority of the patients 48 (87.3%) were "crashlanders" dialysed acutely or within three months of contact with the unit. Hypertension was the commonest aetiology of ESRD accounting for 26 (47.3%) of the dialysed patients. For financial reasons, dialysis was infrequent

with 24 (43.6%) patients dialysing weekly and 17(30.9%) on twice weekly dialysis. Consequently, excessive inter-dialysis weight gain was common, occurring in 38 (69.1%) of the patients. Blood pressure control was also found to be poor in 37(67.22%) of the patients.

Vascular access was via femoral vein cannulation in 45(81.8%), A-V fistula 6(10.9%) and internal jugular cannulation in 4(7.3%).

Conclusion: In conclusion, the pilot study has demonstrated the feasibility of collaborative data collection by dialysis units in Lagos State with generation of useful information on patients' characteristics and treatment outcomes. In developing a renal registry in Nigeria, we propose that State and hospital based Registries be first established. These could gradually be coordinated into a viable National renal registry when experience in large scale data handling and the financial means to coordinate multiple centre information become available