ABSTRACT
BACKGROUND: End stage kidney disease (ESKD) has become a major public health problem and is associated with considerable co-morbidity and mortality. In Rwanda, the extent and the distribution of ESKD have not been reported despite provision of dialysis services. This paper describes the clinical and demographic characteristics of ESKD patients in at a tertiary referral hospital in Rwanda. METHODS: This was a retrospective descriptive study of ESKD hemodialysis patients treated at a tertiary referral hospital from January 2014 to December 2017, start of hemodialysis services to date. Demographic and clinical data were obtained regarding all eligible patients treated. Descriptive statistics were reported using frequency and percent for categorical data; median and Interquartile range (IQR) for continuous data. Analysis of survivors versus non-survivors was performed using Chi-square test for categorical variables and Wilcoxon rank sum test for continuous, nonparametric variables. RESULTS: Over a three-year period, there were 64 patients with ESKD. Median age was 48 years (IQR: 35 to 57.5) and 42 (66%) were male. Edema (n=50, 78%) and anuria (n=40, 63%) were the most common presenting symptoms. Underlying comorbidities of ESKD included hypertension (n= 50, 78%), diabetes (n=24, 38%). Urea (n=52, 81%) and creatinine (n=57, 89%) were elevated in most patients. CONCLUSION: ESKD is a the leading cause of hemodialysis in young adults who would otherwise be contributing to the national development. It is a challenging to clearly establish etiologies as the majority present with more than one comorbidity. Hence healthcare providers should be proactive in prevention and prompt management of chronic kidney disease
Subject(s)
Hospitals, Teaching , Kidney Diseases , Kidney Failure, Chronic , Renal Dialysis , RwandaABSTRACT
Background: Kidney dysfunction is both a national and international problem. Its incidence is increasing in the general population, mostly due to the high prevalence of diabetes, hypertension and the long-term consequences of acute kidney injury. The incidence and prevalence of kidney dysfunction necessitating dialysis are unknown in Rwanda as studies are lacking.Methodology: This study describes the outcomes of the patients who received hemodialysis at CHUK. Data was retrospectively collected and statistically analyzed for 152 patients treated in the hemodialysis unit at CHUK between September 2014 and March 2017.Results: The results have shown that 51.3% and 48.7% of the population being studied were identified to have acute kidney injury and chronic kidney failure respectively. The main risk factors for hemodialysis treatment were hypertension (48%), diabetes mellitus (46.7%), eclampsia (13.2%), and volume deficit (15.8%). Hyperkalemia, pulmonary edema, encephalopathy, and other uremic symptoms were present in 39-43% of patients and were the most common indications for hemodialysis. Encephalopathy and poor oxygen saturation were independent risk factors for death. 20.6% could not afford the usual provision of three sessions of hemodialysis per week and therefore didn't receive dialysis as frequently as recommended. Forty-five patients (20.6%) could not afford the usual provision of three sessions of hemodialysis per week and received less frequent dialysis.Conclusion: There is high mortality in patients referred for hemodialysis in CHUK. Almost half of the patients have chronic renal failure and require permanent renal replacement therapy. Many patients limit therapy due to financial reasons