الفهرس 
DOPPS STUDYOnly 14 pages are availabe for public view
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Abstract
End-stage renal disease (ESRD) is one of the main health problems in Egypt. Currently, hemodialysis represents the main mode for treatment of chronic kidney disease stage 5 (CKD5) .
Although hemodialysis is often used for treatment of ESRD, no practice guidelines are available in Egypt. Healthcare facilities are seeking nowadays to develop practice guidelines for the sake of improving healthcare services. In the healthcare sector in Egypt, trials for establishing guidelines have been lead by the MOH.
This work is a part of project aiming at Statement of the current status of dialysis patient in Egypt using a questionnaire. This project is modulated by Nephrology department, Ain Shams university.This study was done In May , june 2013.
Our study sample consisted of 210 clinically stable chronic patients on regular thrice- weekly HD. Patients were collected from Bahteem Central hospital,Tookh hospital ,Kafr Shoukr hospital and AL-Amal private center..
In all patients we recorded full history and clinical examination stressing on etiology of renal disease and associated complications, Full review of all medical records over the last 6 months ,and details of HD prescription (Doctors, nurses, administration orders).
Results of this study demonstrated that there were many causes for ESRD in the study population ,where HTN 55.7% , DM 14.8% ,and in11% the cause was unknown, this results agrees with most of the studies where HTN & DM were the main causes of renal failure .
Different associated diseases in the study population were HTN in (81.9%), DM in (20%), IHD in (9.5 %), CLD in (7.1%) of patients.
In our study we found that all patients were recieving 3 HD sessions /week each lasting 4 hours , this was with KDOQI guidelines recommendations for HD adequacy .
The mean value of HD period was 3.28 (± 3.1) years.
The mean value of Patients dry weight of the study population was 73.6 (± 14.1) Kg ,with mean interdialytic wt. gain: 2.7 kg .
In our study population (63.8%) were not working , while (36.2%) were still working .
Dependency status in the study population showed that (19.5%) of the patients were dependant, (80.5%) were not dependant , while (14.6%) of dependant cases were wheelchair bound .
As regard Sponsoring status in the study population (91.9%) of them were sponsored by Governorate , (7.1%) of them were sponsored by Health Insurance, while(1%) were sponsored by army .
In our study we found that 81.9% of patients were using AVF as a vascular access to HD , 0.5 % were using AVG while 17.6 % were using central venous catheter .
In our study, methods for measurment of HD adequacy were not routinely done for all patients.
In our study the mean hemoglobin level of our patients was 9.32±(1.57)gm/dl , which is rela¬tively low consi¬dering the recommended target ranges and surveys from other parts of the world.
In our study the percentage of patients receiving regular erythropoietin was (96.7%) , the ESA used in all patients was Epoetin alfa,while (3.3%) of patients were not on ESA therapy.
In our study we found that PTH level was not available for all patients .
As regard vitamins use in the study population (81.9%) of them received vitamin B complex , as regard L-Carnitine (38.6%) of them received it , as regard vitamin D there were ( 82.9%) of our patients received it.
History of iron injection in the study population showed that (80%) received iron injection , while the other (20%) did not receive it .
We also found that the mean calcium level was (6.9) ± (0.9)mg/dl and the mean phosphorus level was (6.1) ± (1)mg/dl , but ,it is to be noted that serum phosphorus&serum calcium was not routinely measured in most of study patients.
In our study 92.9 % of the patients were on phosphate binders therapy.
The percentage of HCV positive patients was (50%), HBV positive patients percentage was(1%), while (49%) of Patients were negative to both . All HBV positive patients are totally isolated from HCV positive and negative patients .
Our study showed that (94.3 %) of patients were using dialyzer with surface area 1.3m, polysulfone, sterilized by steam, low flux. While (5.7%) were using the same dialyzer but with surface area of 1.6 m.
As regard dialysate buffer used in the study population (83.3%) were using bicarbonate ,while (16.7%) were using acetate .
Dialysate composition in the study patients was sodium (ranging from 137- 142 mmol/L ) , potsium (2mmol/L) , calcium (1.50mmol/L in 87.1% and 1.75mmol/L in 12.9% of patients) , Magnesium (0.5 mmol/L).
Anticoagulation type used in the study population showed that all the patients were using HMWH