Haemodialysis at a Privately-run, Stand-alone Dialysis Unit: A One-year Retrospective Review of the Clinical and Laboratory Parameters of Incident Patients.
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Abstract
Background
There has been a recent and rapid rise in the number of privately-run dialysis units in Lagos with attendant concerns about the quality of care provided. This study describes patient characteristics and outcomes at one such unit.
Methods
This was a retrospective review of 152 consecutively presenting patients who were dialyzed at a privately dialysis unit in Lagos. Patients’ biodata, the source of the referral, type of kidney disease, co-morbid conditions present, clinical and laboratory parameters prior to the first dialysis session. Continuous and categorical variables are presented respectively as means and percentages. Student’s t-test and chi-square test were used to compare means and percentages respectively.
Results
The mean age of the study population was 48.6 + 6.7years, 65 (42.8%) were females, 117 (77.0%) had CKD while 35 (23.0%) had AKI. 38.8% were referred from general hospitals, 32.2% from private hospitals while 10.5% were walk-in patients. 35.5% had previously been dialyzed. Anaemia (98%), hypertension (65.1%), hyponatremia (63.2%), leukocytosis (39.5%) and hyperkalaemia (36.8%) were the most common abnormalities noted. The 152 patients received a total of 1,278 sessions of dialysis during the period under review. Intradialytic complications requiring intervention occurred during 28(2.2%) of the sessions with hypotension (60.7%), hypertension (28.6%) and hypoglycaemia (10.7%) responsible for all 28 episodes. In six of the cases, the session of dialysis had to be terminated early due to failure of hypotension to respond to fluid resuscitation and/or inotropic support during dialysis.
Conclusion
Privately-run dialysis centers provide services to patients with a wide range of co-morbid conditions and high rates of pre-dialysis clinical and laboratory abnormalities. Intradialytic complications leading to termination of dialysis sessions appear to be relatively infrequent.