Factors associated with hemodialysis adequacy among end stage renal diseasepatients on maintenance hemodialysis in Rwanda.

Abstract

Introduction: Hemodialysis substitutes the natural work of the kidney and helps ESRD patients to increase quantity and quality of life. Inadequate dialysis treatment has been observed among ESRD patients in Rwanda and this leads to poor patient survival, increase cost and mortality rate. Aim of the study: The aim of this study was to assess the factors associated with dialysis adequacy in ESRD patients on maintenance in Rwanda. Methodology: A descriptive cross-sectional design was conducted. Asample size of 66 Hemodialysis patients was selected using purposive sampling strategy.An interview scheduled guide was used to collect data. Dialysis adequacy was calculated using kt/v Daugirdas &Schneditz formula. Data was coded and entered into SPSS version 21 in preparation for analysis. Descriptive statistical methods and inferential statistics of chi square and multiple regressions were used to analyse the data. . Results: The mean of hemodialysis adequacy was 1.26± 0.34. Most participants (62%) had optimal hemodialysis adequacy of equal or greater than to 1.2, 19(29%) had near optimal hemodialysis adequacy (0.8 - 1.2 kt/v) where 6(9%) had less than optimal hemodialysis adequacy (kt/v <0.8).Factors associated with hemodialysis adequacy were name of hospital (p = .010), age (p = .007), BMI (p =.004) and blood pressure level ((p = .018). where, mode of transport and type of drinking water was also significantly associated with hemodialysis adequacy (p = 0.032 and 0.030 respectively). Conclusions: Generally, the level of hemodialysis adequacy was average among ESRD patients and the associated factors were predominantly demographic characteristics. Therefore, there is need for nephrology staff to assess the interventions that promote adequacy during hemodialysis depending on the personal attributes of the patient. Moreover, further research inquiry is needed on other factors which include technical to establish their association with hemodialysis adequacy