الفهرس 
Hemodialysis prescriptionOnly 14 pages are availabe for public view
 |  | from | 120 |  |  |
| | | from | 120 | | |
Abstract
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 April & May 2014.
Our study sample consisted of 339 clinically stable chronic patients on regular HD. Patients were collected from Maghagha ,Beni-mazar ,Eledwa &Matay hospital.
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).
In our study we found that 261 of the patients (77%) were kept on 3 HD sessions per week, while 75 patients (22.1%) were kept on 2 HD sessions per week & 3 patients(0.9%) were kept on only one HD session per week, which doesnot correlates with KDOQI guidelines recommendations for HD adequacy.
This study showed that the commonest known cause of ESRD among the study population is hypertension (38.1%), which agrees with Data from several renal databases that identifies systemic hypertension as the most common causes for ESRD.
Different comorbidities in the study population were HTN (29.2%), DM (2.1%), Ishemic heart disease (12.1%), chronic arthropathy (10.3%).
Work status in the study population showed that 298 of them were not working (87.9 %), while the other 41 patients were working (12.1 %).
Dependancy status in the study population was showed that 106 of them were dependant (31.3%), 233 were not dependant (68.7 %) with a wheel chair pound 40 cases.
Sponsoring status in the study population showed that Out of 339 patients, 246 of them were sponsored by Governorate (72.6%),and 93 of them by health insurance (27.4%)
In our study we found that( 93.5%) of the study population use AVF with a frequency of access failure of (35.7%) ,(2.4%) of them use AVG and (4.2%) use venous catheter.
The AVF has the best long-term primary patency rate and requires the fewest interventions of any type of access.
As regard vitamins use in the study population (20.4%) of our patients were receiving vitamin B complex, (0.6 %) were receiving folic acid supplements and (78.8%) were receiving vitamin D.
In our study we found that the mean hemoglobin was (9.92 ± 0.32 g/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 (92 %) & the percentage of patients who received IV iron was (31%) and a mean serum ferritin of 561.52 ng/ml.
In our study we found that the mean calcium level was (8.86 ± 0.2 mg/dl), and that the mean phosphorus level was (4.78 ± 0.2 mg/dl).
The commonest complication during HD session in the study population is muscle cramps (25.1%) and hypotension (15.9) then bony aches (14.7%) & the mean interdialytic weight gain was (2.47 kg).
In our study the percentage of patients who received blood transfusion was (33.6%) &Viral status in the study population showed that the percentage of HCV positive patients was (65.2%), HBV positive was (0.6%), while (34.2%) of patients were negative.
Dialysate calcium used in the study population showed that out of 339 patients 286 of them were using dialysate calcium 1.25 (84.4%) and 53 of them were using dialysate calcium 1.5 (15.6%).
In our study methods for measurment of HD adequacy were not routinely done for the patients.
Anticoagulation type used in the study population showed that out of 339 patients, 288 of them were using HMWH (85%), while 51of them using fraxparine (15%).