Abstract:
Background
There is limited information concerning end stage renal disease in lower and middle income countries, Rwanda included. End stage renal disease has various adverse physical and social economic effects on individual patients and their families without sparing health care systems in general. The aim of our study was to determine the epidemiology, risk factors and 6 months outcomes of patients with end stage renal disease in three referral hospitals in Rwanda.
Methods
This was a prospective cohort study on patients with end stage renal disease that consulted 3 referral hospitals in Rwanda between October 2017 and October 2018. Data was collected on patients’ demographics, risk factors, baseline kidney functions, mode of insurance and ability to afford RRT. Patients were followed up to assess survival after 6 months in relation to known risk factors and access to renal replacement therapy.
Results
Among 88 participants, 55.7 % were male and the median age was 45. Community based health insurance was used by 84.1 % of participants. Hypertension was the most common co- morbidity in 80.6% of participants followed by diabetes in 34.1% and 21.6% were exposed to traditional drugs .Only 16.9% of participants were able to afford renal replacement therapy (RRT) in form of hemodialysis and 58.3 % of them discontinued before the end of 6 months due to death and financial reasons. By the end of follow up period, 47% of participants had died and 19.3% were lost to follow up. There was no statistically significant association between the different comorbidities /risk factors and the 6 months outcome.
Conclusion
End stage renal disease was found to occur in relatively young and active patients with hypertension as the most common co-morbidity. Most of them could not afford to initiate and sustain renal replacement therapy regardless of their socio economic status. Mortality was high after 6 months of follow up.
