Pattern of intradialytic complications at the Lagos University Teaching Hospital

The safety of haemodialysis (HD) procedure has improved greatly over the years but, the procedure is not without risks; complications still occur during dialysis. In this study, we report on the pattern of intradialytic complications seen over a one year period at the dialysis centre of the Lagos University Teaching Hospital Lagos (LUTH), Nigeria.

We reviewed the dialysis and hospital records of consecutive patients with chronic kidney disease (CKD) who received haemodialysis treatment in the dialysis centre during the period between January and December 2010. Data comprised patients' demographics, aetiology of kidney failure and complications encountered during the HD treatment sessions.

The study involved 201 patients with CKD; there were 113 (56.2%) males, the mean age was 47.5 +/- 15.7years. There were 140 (69.7%) new patients and 61 (30.3%) old patients. The most common aetiology of CKD was hypertension (42.8%) followed by glomerulonephritis (15.9%). A total of 1010 haemodialysis sessions were recorded with complications occurring in 36.2% of the HD sessions. The most frequently encountered complication was hypertension which occurred in 15.2% of HD sessions followed by hypotension 8.5%. Hypotension occurred more frequently during first HD session (18.4%) compared with subsequent sessions (6.1%) X2 = p < 0.001. Patients who experienced hypertension had significantly higher pre-dialysis systolic blood pressure (BP) values (mean 168 +/- 28.6mmHg vs 149.3 +/- 20.1mmHg) and pre-dialysis diastolic BP (100.6 +/- 18mmHg vs 90.3 +/- 11.4mmHg) compared with those who did not p <0.001.

Hypertension was the most frequently encountered complication. Hypotension was still commonly encountered especially during first HD treatments. Clinicians must make concerted to optimise blood pressure in patients undergoing haemodialysis therapy.