Haemodialysis Experience with Chronic Kidney Failure Patients at the University of Port-Harcourt Teaching Hospital: An Analysis of Data of the First Year of Operation

Abstract

The haemodialysis experience with chronic kidney failure patients who needed haemodialysis treatment, during the first year of operations,(January to December,2007) at the haemodialysis unit the of University of port Harcourt Teaching hospital were retrospectively studied.They were 55 patients (35 males,20 females, M/F=1.8:1). Their mean age was 46.16 +17.68(12-78) years with the peak age of occurrence in the 50-59 year age group. At first
presentation, they had a mean e-CLcreat. of 6.22 + 5.8(2.7-34.3) mls/min, a mean blood urea of 32.9 + 10.2(28-49) mmol/l , mean plasma creatinine of 1224.9 + 557.4(245-2505) umol/l and a mean haematocrit of 20.9 + 6.8 ( 10-35)% respectively. Chronic glomerulonephritis,20(36.4%), Hypertensive - nephropathy,13(13.6%) and Diabetic nephropathy,12(21.8%) were the leading disorders underlying chronic kidney disease, collectively 
constituting 81.8% of the patients. Clinical status at first presentation for dialysis was poor. Twenty-two patients(40%) and 14(25.5%) patients presented with advanced uremia with severe haemodynamic instability and uraemic encephalopathy respectively. Exposure to dialysis was very poor. The mean duration on dialysis was 5.2 + 2.6(1-36.7)weeks. The mean total number of dialysis sessions attained was 4.3 +4.2(1-21) sessions. Similarly, measures of dialysis adequacy were poor. The mean URR was 48.75%(8- 88%). The mean Kt/v was 0.94+0.4(0.5-1.9). A total of 15(27.2%)patient complications of dialysis were observed with hypoglycaemia-4(7.2%) being the most frequently observed. As at the end of the one year study period only 6(10.9%) of the patients were surviving and dialyzing, 22(40%) had died, and 23(41.8%) absconded and presumed dead.
Four(7.2%) patients were referred out of the country for kidney transplantation and all returned after a successful transplant. The haemodialysis exposure, performance and outcomes of chronic kidney failure patients receiving haemodialysis treatment at the University of Port Harcourt Teaching Hospital were very poor. Late presentation and financial inability to access regular dialysis treatment were the dominant factors of poor outcome. A call is made for an urgent Government subsidy for haemodialysis treatment in Nigeria.