Dialysis Adequacy among Haemodialysis Patients in Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Abstract

Introduction: Dialysis adequacy is one of the most important indicators for measuring the quality of care provided in hemodialysis (HD) wards. Despite individual studies, there is still no comprehensive study about dialysis adequacy in the Eastern Mediterranean Region (EMRO). This study was conducted to evaluate the dialysis adequacy in HD patients in the EMRO. Methods: In the present systematic review and meta-analysis international (EMBASE, Scopus, PubMed, Web of Science) and national (SID, MAGIRAN) databases were searched for related articles using keywords “dialysis adequacy” and “EMRO” from 1 January 2000 to April 30, 2020. The quality of studies was studied using Hoy et al instrument. Results: Out of 966 retrieved studies, 63 studies conducted on 15462 HD patients were included. The pooled mean of KT/V and URR were 1.24 (95% CI: 1.19, 1.30) and 63.03% (95% CI: 61.31, 64.75), respectively. The pooled prevalence of Kt/V>1.2 and URR>65.0% were 42.73% (95% CI: 31.58, 53.88) and 42.52% (95% CI: 25.3, 59.7), respectively. Conclusion: The results of the present study indicate the poor dialysis adequacy in the EMRO region and the need to improve the physical infrastructure, workforce, and pieces of equipment in hemodialysis wards.

Anxiety Level and Dialysis Adequacy of Patients Chronic Kidney Diseases During Covid-19 Pandemic in Indonesia

“…CKD patients in this study received good service from the dialysis center as indicated by the URR value of 65%, where the standard for dialysis adequacy using the URR formula was 65% even during the COVID-19 pandemic. The mean URR in Indonesia is better than the country in Eastern Mediterranean region (Ebadi et al, 2021). The not to high anxiety level allows good dialysis adequacy condition.…”

“…Dialysis can be performed by patients at a dialysis center in a hospital (T. Lee et al, 2021). Dialysis adequacy is one of the most important indicators for measuring the quality of care provided in HD wards (Ebadi et al, 2021). Adequate dialysis provides information about the adequacy of the dialysis dose received by the patient to obtain adequate results, namely the removal of toxins and waste products from the patient (Dehvan et al, 2018;Somji et al, 2020).…”

“…A meta-analysis study in the Eastern Mediterranean region in 2020 found that less than 50% of patients had good dialysis adequacy rates with a mean of URR below the standard 63% and Kt/V is still within the normal standard of 1.23 (Ebadi et al, 2021). Only one-third of patients undergo dialysis adequacy regularly (Somji et al, 2020).…”