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.
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.
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.
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.
OLUYOMBO R, AYODELE OE, AKINWUSI PO, OKUNOLA OO, AKINSOLA A, AROGUNDADE FA, SANUSI AA, ONAYADE A. A community study of the prevalence, risk factors and pattern of chronic kidney disease in Osun state, south West Nigeria. West Afr J Med. 2013;32:85–92. PubMed
LIYANAGE T. et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet 2015 May 16;385(9981):1975–1982.
NAICKER S. End-stage renal disease in sub-Saharan Africa. Ethn Dis. 2009;19(S1):13–5.
ELSHARIF ME, ELSHARIF EG, GADOUR WH. Costs of hemodialysis and kidney transplantation in Sudan: a single center experience. Iran J Kidney Dis. 2010;4:282–4. PubMed
ALEBIOSU CO, AYODELE OO, ABBAS A, OLUTOYIN AI. Chronic renal failure at the Olabisi Onabanjo University teaching hospital, Sagamu, Nigeria. Afr Health Sci. 2006;6:132–8. PubMed
AGABA EI, LOPEZ A, MA I, MARTINEZ R, TZAMALOUKAS RA, VANDERJAGT DJ, GLEW RH, TZAMALOUKAS AH. Chronic hemodialysis in a Nigerian teaching hospital: practice and costs. Int J Artif Organs. 2003;26:991–5. PubMed
- Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania
Alfred J. Meremo
David P. Ngilangwa
Masumbuko Y. Mwashambwa
Matobogolo B. Masalu
- BioMed Central
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