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2017 ; 18
(1
): 212
Nephropedia Template TP
gab.com Text
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Challenges and outcomes of haemodialysis among patients presenting with kidney
diseases in Dodoma, Tanzania
#MMPMID28676037
Meremo AJ
; Ngilangwa DP
; Mwashambwa MY
; Masalu MB
; Kapinga J
; Tagalile R
; Sabi I
BMC Nephrol
2017[Jul]; 18
(1
): 212
PMID28676037
show ga
BACKGROUND: Kidney Diseases contribute a significant proportion to the global
burden of non-communicable diseases. Haemodialysis services as the main modality
of renal replacement therapy in most resource limited countries is only available
in few cities and at higher costs. The aim of this study was to determine the
challenges and outcomes of patients who were on haemodialysis at the University
of Dodoma (UDOM) haemodialysis unit in Tanzania. METHODS: In this retrospective
study; we reviewed haemodialysis registers and charts of 116 patients dialyzed
from January 2013 to June 2015 at The UDOM haemodialysis unit. Data were
descriptively and inferentially analysed using Stata version 11 software.
RESULTS: Of the 116 patients, 52 (44.9%) were male, and 38(32.8%) were married.
Their median age was 45 years. Thirty-two (27.6%) had acute kidney injury, of
them 26 (81.3%) patients had recovery of renal function after haemodialysis.
Indications for hemodialysis were anuria (18), intoxications (14), electrolyte
imbalance (9), uraemia (7) infections (6) and fluid overload (4). Eighty-four
(72.4%) patients had End Stage Renal Diseases (ESRD), of which 37 (44.1%)
absconded/lost to follow up, 15 (17.9%) died, 22 (26.2%) were referred to
Muhimbili National Hospital (MNH), 12 for possible kidney transplant abroad after
haemodialysis, and 10 (11.9%) were still attending our unit for haemodialysis.
Residing outside Dodoma was predictive for poor outcomes while on haemodialysis
(OR 5.2, 95% CI 3.2-8.6, p < 0.001). In addition the odds ratio for poor outcomes
was 7.3 times for a patient ESRD (OR7.34, 95% CI 3.26-18.17, p < 0.001). Patients
who had no National Health Insurance Fund (NHIF) coverage (OR 6.6, 95% CI
5.4-12.7, p < 0.001) also had higher odds of poor outcomes after starting
haemodialysis. CONCLUSION: Unavailability and high costs related to utilization
of haemodialysis services among patients needing dialysis are the challenges for
better outcomes. Therefore, haemodialysis and renal transplants services should
be made easily available in regional referral hospitals at reasonable costs. In
addition, members of the public should be educated on joining health insurance
schemes and on making healthy life style choices for preventing chronic kidney
disease and its progression.