DIALYSIS PRACTICE PATTERN IN PATIENTS UNDERGOING HEMODIALYSIS IN A TERTIARY AND A PRIVATE HOSPITAL
Objective: To evaluate the dialysis practice pattern in chronic kidney disease patients undergoing hemodialysis in a tertiary and a private hospital
Methods: A prospective observational study of six months duration was carried out in 158 CKD patients on hemodialysis for a minimum period of one month. Data such as socio-demographic, clinical characteristics and dialysis practice details were captured from the patient’s medical records into the pre-designed Patient Proforma. The collected data were analysed.
Results: Majority of respondents were male (67.09%), more than 60 y of age (32.28 %), married (89.24%). Hypertension (26.51%, 17.33%) was found to be the leading cause of CKD in a tertiary and private hospital. In the tertiary hospital, 78.31% of patients were undergoing twice-weekly hemodialysis, whereas in the private hospital thrice weekly (50.67%) hemodialysis was common. About 51.81% of patients in the tertiary and 58.67% in the private hospital was undergoing hemodialysis for 1-5 y with Arterio-Venous Fistula (59.04%, 94.67%) as the permanent vascular access (P<0.001).
Conclusion: This study shows that hypertension was the leading cause of CKD in both hospitals. In the tertiary hospital twice weekly hemodialysis with arteriovenous fistula (AVF) and Permanent Catheter (IJV), were both preferred as the permanent vascular access. Whereas in the private hospital majority were undergoing thrice weekly hemodialysis and AVF was highly preferred.
2. Singh A, Farag Y, Mittal B, Subramanian K, Reddy S, Acharya V, et al. Epidemiology and risk factors of chronic kidney disease in India–results from the SEEK (Screening and early evaluation of kidney disease) study. BMC Nephrol 2013;14:114.
3. Yang F, Khin LW, Lau T, Chua HR, Vathsala A, Lee E, et al. Hemodialysis versus peritoneal dialysis: a comparison of survival outcomes in South-East Asian patients with end-stage renal disease. PloS One 2015;10. Doi:10.1371/journal. pone.0140195.
4. Kulkarni MJ, Jamale T, Hase NK, Jagdish PK, Keskar V, Patil H, et al. A cross-sectional study of dialysis practice-patterns in patients with chronic kidney disease on maintenance hemodialysis. Saudi J Kidney Diseases Transplantation 2015;26:1050.
5. Lakshminarayana G, Sheetal L, Mathew A, Rajesh R, Kurian G, Unni V. Hemodialysis outcomes and practice patterns in end-stage renal disease: experience from a tertiary care hospital in Kerala. Indian J Nephrol 2017;27:51.
6. Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dialysis Transplantation 2005;20:1638-42.
7. Hecking M, Bieber BA, Ethier J, Kautzky Willer A, Sunder-Plassmann G. Sex-specific differences in hemodialysis prevalence and practices and the male-to-female mortality rate: the dialysis outcomes and practice patterns study (DOPPS). PLoS Med 2014;11. Doi:10.1371/journal. pmed.1001750
8. Goldberg I, Krause I. The role of gender in chronic kidney disease. E Med J 2016;1:58-64.
9. Pounds LL, Teodorescu VJ. Chronic kidney disease and dialysis access in women. J Vascular Surgery 2013;57:49-53.
10. Canaud B, Tong L, Tentori F, Akiba T, Karaboyas A, Gillespie B, et al. Clinical practices and outcomes in elderly hemodialysis patients: results from the dialysis outcomes and practice patterns study (DOPPS). Clin J Am Soc Nephrol 2011;6:1651-62.
11. Mukherjee T, Devi G, Geetha S, Anchan N, Subbaiyan S. A comparison of practice pattern and outcome of twice-weekly and thrice-weekly hemodialysis patients. Indian J Nephrol 2017;27:185.
12. Thenmozhi P. Quality of life of patients undergoing hemodialysis. Asian J Pharm Clin Res 2018;11:219-23.
13. Bieber B, Qian J, Anand S, Yan Y, Chen N, Wang M, et al. Two-times weekly hemodialysis in China: frequency, associated patient and treatment characteristics and quality of life in the china dialysis outcomes and practice patterns study. Nephrol Dialysis Transplantation 2013;29:1770-7.
14. Tavallaii SA, Nemati E, Vishteh HR, Farahani MA, Lankarani MM, Assari S. Marital adjustment in patients on long-term hemodialysis. Iran J Kidney Dis 2009;3:156-61.
15. Leticia Buffet, Pharm D, Charlotte Ricchetti, Pharm D, BCPS, CDE. Chronic kidney disease and hypertension: a destructive combination. US Pharm 2012;37:26-9.
16. Bhowmik D, Tiwari SC. Challenges of hemodialysis in India. J Int Med Sci Acad 2012;25:99-100.
17. Winkelmayer WC, Chang TI, Mitani AA, Wilhelm-Leen ER, Ding V, Chertow GM, et al. Longer-term outcomes of darbepoetin alfa versus epoetin alfa in patients with ESRD initiating hemodialysis: a quasi-experimental cohort study. Am J Kidney Diseases 2015;66:106-13.
18. Dare AJ, Fu SH, Patra J, Rodriguez PS, Thakur JS, Jha P, et al. Renal failure deaths and their risk factors in India 2001–13: nationally representative estimates from the million death study. Lancet Global Health 2017;5:89-95.
19. Bansal D, Kher V, Gupta KL, Banerjee D, Jha V. Haemodialysis vascular access: current practices amongst Indian nephrologists. J Vasc Access 2018;19:172-6.
20. Goel N, Kwon C, Zachariah TP, Broker M, Folkert VW, Bauer C, et al. Vascular access placement in patients with chronic kidney disease stages 4 and 5 attending an inner city nephrology clinic: a cohort study and survey of providers. BMC Nephrol 2017;18:28.
21. Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int 2006;69:1945-53.
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