Mortality trend among hemodialysis patients during the islamic month of ramadan: a 24 years retrospective study

The effect of month of Ramadan on the mortality in hemodialysis patients, and to compare it with that in all other Islamic months. A descriptive study. Hemodialysis Unit, The Kidney Center, Karachi, from January 1989 to December 2012. All those patients who were diagnosed to have end stage kidney disease and on maintenance hemodialysis for more than 3 months, regardless of underlying cause of kidney failure were included. Patients with acute kidney injury were excluded. Status of the patients was recorded at the end of the study period. The fasting status of the patients was not mentioned. The deaths of the patients were further evaluated and frequencies of death in all twelve Islamic months were calculated. A total of 1,841 patients were registered, out of whom 897 [48.7%] died, and 269 [14.6%] survived till the end of the study. One thousand and fifty six [57.3%] were males, 651 [35.4%] were diabetic. Total number of 143 [7.76%] events occurred in Ramadan, out of which 94 patients died which make nearly 11% of the total deaths distributed in 12 Islamic months. Frequency of death was higher in Ramadan when compared with other months. Ramadan reflected a higher frequency of death. Therefore, there is a need to evaluate the risk factors in a prospective study so that the dialysis patients can be better managed during this period

Dialyzer reuse: justified cost saving for south Asian region

In spite of controversies, dialyzer reuse has remained an integral part of hemodialysis because of lower cost, good overall safety record, and improved membrane biocompatibility. Reuse declined in developed countries from the beginning of this century because of mass production of hemodialyzers at favourable price with better biocompatible membrane. Abandoning dialyzer reuse became challenging in South Asian region, where more than 40% of the population live below the International Poverty Line of [dollar sign]1.25 per day, less than 10% of end stage renal disease patients receive renal replacement therapy, and upto 70% of those starting dialysis stop treatment due to cost within the first 3 months. Dialyzer reuse is an efficient cost-saving method that allows the use of more efficient and expensive biocompatible synthetic membranes, thereby providing high-quality dialysis to individuals living in countries with limited medical resources without compromising the safety or effectiveness of the treatment