COMORBIDITY BURDEN IN END STAGE RENAL DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS
Keywords:
End stage renal disease, ESRD, Chronic Kidney disease, co-morbidity, Hemodialysis, CKD stage 5-D.Abstract
Objective: To perform an assessment of comorbidities of our hemodialysis dependent patients.
Material & Methods: This was a cross-sectional descriptive study conducted in the Institute of Kidney Diseases Hayatabad,
Peshawar and Khyber Teaching Hospital, Peshawar, Pakistan. The study included 177 patients and the study
duration was 04 months (December 2015 to March 2016). ESRD patients on maintenance hemodialysis were asked
about their comorbid conditions. This information was recorded on a questionnaire.
Results: A total of 177 patients responded to a specially designed questionnaire asking questions about their comorbidity
status. Out of these 177 patients 111 (62.7%) were male (M:F 1.7:1). The mean age for male patients was 43.1
years (SD ±14.8 and range from 18 to 70 years). While the mean age for females was 42.3 years (SD ±15.2 and range
from 18 to 80 years). About 79% patients were on hemodialysis for duration of less than 03 years. Only 7.3% patients
were undergoing hemodialysis at the recommended frequency of 03 or more sessions per week. All but 24.3% patients
reported no emergency visits to hospital and all except 33.9% patients had no hospital admission in the previous 06
months. Around 34% patients had more than 5 emergency visits, while 37.8% patients had more than 5 admissions
in the previous 06 months. Around 55.3% of patients were taking more than 5 types of drugs in a single day, while
76.7% were taking more than 3 drugs per day. Hypertension was the commonest comorbidity found in about 93.8%
of patients. This was followed by cardiac diseases (46.9%) and diabetes (40.6%). Viral hepatitis was found in 21.4%
patients, Infections in 12.4%, pulmonary diseases in 9.0%, and strokes were reported by 4.0% patients. Off the male
patients, 67.5% (n=75) had two or more co-morbidities while 37.8% (n=42) had both Diabetes and hypertension. Off the
female patients 89.3% (n=59) had two or more comorbidities while 45.4% (n=30) had both Diabetes and Hypertension.
Conclusion: Comorbidities are common in our ESRD patients. Hypertension is the most common comorbidity followed
by Diabetes Mellitus and cardiac diseases. The frequency of these comorbidities is higher in our patients when compared
to the international data. This could explain the higher morbidity and mortality of our ESRD patients
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