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Hemodialysis in Ibadan: a preliminary report on the first 100 dialysis
A Arije1, S Kadiri, O O Akinkugbe
1Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
Insights
High costs of hemodialysis hinder end-stage renal disease treatment in developing nations. Innovations are needed to reduce expenses and improve patient access to this life-saving therapy.
Area of Science:
- Nephrology
- Public Health
Background:
- Hemodialysis is a critical treatment for end-stage renal disease (ESRD).
- Implementing hemodialysis in resource-limited settings presents unique challenges.
- Owena Dialysis Centre, University College Hospital, Ibadan (UCH), initiated its first 100 hemodialysis sessions.
Purpose of the Study:
- To present the initial experiences and challenges of the first 100 hemodialysis sessions at Owena Dialysis Centre.
- To identify technical and clinical problems encountered during early hemodialysis treatments.
- To assess the impact of financial constraints on patient adherence to hemodialysis.
Main Methods:
- Retrospective review of the first 100 hemodialysis sessions over a 7-month period.
- Analysis of patient demographics, vascular access routes, and equipment reuse.
- Documentation of technical and clinical complications, and reasons for treatment discontinuation.
Main Results:
- Nine patients underwent hemodialysis, with femoral vein access being most common.
- Frequent technical issues included power failures and dialyzer ruptures.
- Common clinical problems were low arterial pressure, pruritus, and sepsis.
- Financial constraints led to treatment discontinuation for six patients.
Conclusions:
- The high cost of hemodialysis is a significant barrier in developing countries.
- There is an urgent need for cost-reduction strategies to enhance hemodialysis accessibility.
- Improvisation and cost-effective measures are essential for sustainable ESRD treatment.
Abstract:
The experience with the first 100 hemodialysis sessions at the Owena Dialysis Centre of the University College Hospital, Ibadan (UCH) is hereby presented. A total of 9 patients were dialysed during a 7-month period. The femoral vein was the most often utilised vascular access route (53 episodes in 5 patients) while a forearm fistula was functional in only one patient. The dialyzer and blood lines were reused for each patient for a maximum of 5 times. Technical problems encountered were: power failure (12 episodes), ruptured dialyzer (3), water-pipe leakage (4) machine breakdown (2) and heparin pump failure (2). Clinical problems were: failure of fistula access (2), thrombosed femoral veins (2), clotted cannula (3), low arterial pressure (20); nausea and vomiting (2), pruritus (46), muscle cramps (5), Sepsis (8) and hypotension (2). Six patients discontinued treatment after less than 10 dialyses due to financial constraints. The high cost of hemodialysis remains the major setback to its use in the treatment of end-stage renal disease in developing countries; there is the need for acceptable improvisation to reduce the overhead cost so as to make it available to most patients requiring dialysis.