Challenges of hemodialysis in a new renal care center: call for sustainability and improved outcome
Authors Oluyombo R, Okunola O, Olanrewaju T, Soje M, Obajolowo O, Ayorinde M
Received 9 April 2014
Accepted for publication 30 May 2014
Published 18 September 2014 Volume 2014:7 Pages 347—352
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Rotimi Oluyombo,1 Oluyomi O Okunola,2 Timothy O Olanrewaju,3 Michael O Soje,1 Omotola O Obajolowo,1 Margaret A Ayorinde1
1Renal Unit, Internal Medicine Department, Federal Medical Centre, Ido-Ekiti, Ekiti State, 2Renal Unit, Department of Internal Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, 3Renal Division, Internal Medicine Department, Faculty of Health Sciences, University of Ilorin, Ilorin, Kwara State, Nigeria
Background: Nephrologists are faced with enormous challenges in the management of patients with end-stage renal disease, especially in sub-Saharan Africa, where hemodialysis is the most common modality of renal replacement therapy in the region. Therefore, we reviewed our 3 years of experience with hemodialysis services in a tertiary hospital located in a rural community of South West Nigeria. This was with a view to presenting the profile of hemodialysis patients and the challenges they face in sustaining hemodialysis.
Methods: We reviewed the case records and hemodialysis registers for 176 patients over the 3 years from November 2010 to December 2013. The data were analyzed using Statistical Package for the Social Sciences version 20 software.
Results: Of the 176 patients, 119 (66.9%) were males. The mean age of the patients was 44.87±17.21 years. Most were semiskilled or unskilled (111; 63.5%) and 29 (16.5%) were students. Twenty-six (14.8%) had acute kidney injury in the failure stage. Chronic glomerulonephritis, hypertensive nephropathy, and diabetic nephropathy accounted for 45.3%, 23.3%, and 12.1%, respectively, of patients with end-stage renal disease. Only 6.8% of patients could afford hemodialysis beyond 3 months.
Conclusion: Sustainability of maintenance hemodialysis is poor in our environment. Efforts should be intensified to improve other modalities of renal replacement therapy, in particular kidney transplantation, which is cost-effective in the long-term. Also, preventive measures such as education for affected patients and the general population would assist in reducing the prevalence and progression to end-stage renal disease.
Keywords: end-stage renal disease, hemodialysis, sustainability, outcome
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]