Adequacy of haemodialysis and associated factors among patients with end-stage kidney disease in Tanzania

Abstract

Objectives: Adequate haemodialysis helps maintain normal renal function by removing toxins and other waste products in patients with end-stage kidney disease. This study was aimed at determining the prevalence and predictors of adequacy of haemodialysis and outcomes in patients with end-stage kidney disease. Methods: This longitudinal analytical hospital-based study was conducted at two dialysis centres in Dodoma city, Tanzania, between February and July of 2020. Adequacy of haemodialysis was measured with single-pool (sp) Kt/V and urea reduction rate (URR) formulae. Binary logistic regression and multivariable analysis were used to assess the independent predictors of adequacy of haemodialysis. Results: The analysis included 100 patients with a mean age of 50.6 ± 15.0 years. The prevalence of adequacy of haemodialysis according to URR and sp-Kt/V was 72 % and 75 %, respectively. Having <12 months since dialysis initiation (AOR ¼ 7.3, 95 % CI ¼ 0.11e0.90, p ¼ 0.032), fewer than three dialysis sessions per week (AOR ¼ 6.9, 95 % CI ¼ 1.52e31.49, p ¼ 0.013) and severe anaemia (AOR ¼ 2.2, 95 % CI ¼ 0.26e0.93, p ¼ 0.033) were predictors of inadequate haemodialysis, according to the URR formula. Having fewer than three dialysis sessions per week was significantly associated with inadequate haemodialysis (AOR ¼ 5.6, 95 % CI ¼ 1.47e19.66, p ¼ 0.011), according to the sp-Kt/V formula. The mortality rate was 11.2 %, and cardiovascular disease and uremic syndrome were responsible for most deaths. Conclusion: This study indicated a high percentage of adequacy of haemodialysis among patients with endstage kidney disease. Having fewer than three dialysis sessions per week, late initiation of dialysis after diagnosis of end-stage kidney disease and severe anaemia were predictors of inadequate haemodialysis among patients.