The quality of hemodialysis in patients with mental retardation

Mentally retarded renal failure patients receiving hemodialysis (HD) comprise a small group of HD patients. There was no previous study describing how to manage these patients during HD and if they could achieve adequate dialysis quality.

We reported seven cases of mentally retarded patients with renal failure among 1224 patients receiving hemodialysis. Demographic and medical data were obtained from chart reviews and hospital information system. Parameters for dialysis quality were calculated.

These mentally retarded patients ranged from 19 to 34 years of age (mean: 27.5 +/- 5.0 year-old), with six females and one male. The HD duration ranged from 24 to 84 months (mean: 54.6 +/- 27.2 months). The most common problem the medical stuff would encounter when they care mentally retarded dialysis patients is the maintenance of a smooth HD process due to the non-cooperation of these patients. Physical restriction or sedative agents such as diazepam, alprazolam, or chloral hydrate were prescribed in these patients for their irritability during HD session. All seven patients had good family support and care. The dialysis adequacy and nutritional parameters of these patients all met the guidelines suggested by the National Kidney Foundation Dialysis Outcome Quality Initiative (K/DOQI).

Mentally retarded uremic patients can have good dialysis quality.