Outcomes of Dialysis Among Patients With End-Stage Renal Disease (ESRD)

Ejaz, Ayesha; Junejo, Abdul Manan; Ali, Muhammad; Ashfaq, Ahsan; Hafeez, Abdul; Khan, Sadaqat Ali

doi:10.7759/cureus.17006

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…Nearly 7 million ESRD cases die due to a lack of dialysis accessibility. 22 Missed hemodialysis sessions were responsible for the overcrowding of our center for receiving many ESRD patients needing regular renal replacement therapy, lack of public awareness of the disease and the hemodialysis itself, discrimination, and social pressure on the patients. In addition to this, inadequate skills of dialysis providers, higher costs belonging to each dialysis session that most of the patients are not affordable (low socioeconomic status), as well as lack of access to the center because of rural and far distance distribution of the cases were also the principal causes of missed dialysis occasions.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Mohamed¹,

Jeele²

2022

IJGM

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Background End-stage renal disease (ESRD) in Somalia remains unexamined due to a lack of a national registry system, and the impact of the disease in the country is not estimated yet. The present study is the first report that aims to evaluate the epidemiological characteristics, causes, and dialysis-related factors associated with readmissions in ESRD patients who were going to routine hemodialysis. Patients and methods This cross-sectional observational study enrolled 208 patients with ESRD. Also, this study investigated patients readmitted to the hospital (n=135) after they enrolled in hemodialysis. The sociodemographic characteristics, risk factors, and comorbidities associated with these patients were reviewed. Admission site, length of hospital stay, outcome, and dialysis-related factors associated with readmissions in the first six months after being on a regular hemodialysis program were also assessed. Results The mean age of the patients was 52.7±15.0 years, 43.3% were >60 years, and 61.5% were male. The most common cause was diabetes at 39.4%, followed by hypertension (35.6%) and 12.5% for postrenal obstruction. The prevalence of 6-month hospital readmissions was 65%. The most common dialysis-related factor associated with readmissions was uremic complications due to missed hemodialysis sessions (40%), vascular access/catheter infection (20%), and anemia (17.8%) (95% CI: 0.825–5.357, OR: 3.017, p<0.04). Female cases were more vulnerable to vascular catheter site infection, anemia, and hyponatremia (p<0.001). 27.5% of the patients were admitted to the intensive care unit (ICU), and the most common reason for ICU admissions was pulmonary edema (53.8%), sepsis (42.8%), and uremia due to hemodialysis skip (26.4%) (95% CI: 1.507–13.632, OR: 2.08, p=0.01). The mortality rate was 5.2%. Conclusion The prevalence of unplanned hospital readmissions within six months was very high, and a missed hemodialysis session was identified as the leading cause. Inadequate knowledge, wrong social beliefs about the concept of dialysis and a lack of a health insurance system that covers the higher costs of each dialysis session are believed to be the causes of missed dialysis occasions.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Mohamed¹,

Jeele²

2022

IJGM

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“…The lack of benefit between these dietary patterns and mortality can have several explanations. The magnitude of ESKD’s deleterious effect on health in a unique population with multiple comorbidities compared to the general population may be so significant that it can override any discernible beneficial impact of these dietary patterns [ 31 , 32 , 33 , 34 , 35 ]. The higher frailty and lower socioeconomic status in the ESKD population compared to the general population could also have biased the results [ 36 , 37 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Charkviani

Tangpanithandee

Krisanapan

et al. 2022

Clinics and Practice

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Background: The Mediterranean, Dietary Approach to Stop Hypertension (DASH), and plant-based diets may provide cardiovascular benefit to the general population. However, data on their effect on end stage kidney disease (ESKD) patients are limited. This systematic review aims to assess the impact of Mediterranean, DASH, and plant-based diets on outcomes among ESKD patients. Methods: A literature review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception through September 2022 to identify studies that assess the clinical outcomes of Mediterranean, DASH, or plant-based diets on ESKD patients on hemodialysis (HD) or peritoneal dialysis (PD). Effect estimates from the individual studies were derived utilizing the random-effect, generic inverse variance approach of DerSimonian and Laird. Results: Seven studies with 9400 ESKD patients (8395 HD and 1005 PD) met the eligibility criteria and were included in the data analysis. Pooled odds ratios (ORs) of mortality for ESKD patients who adhered to the Mediterranean versus plant-based diet were 0.49 (95% CI: 0.07–3.54; two studies, I2 = 67%) and 0.87 (95% CI: 0.75–1.01; two studies, I2 = 0%), respectively. Data on mortality for ESKD patients on a DASH diet were limited to one study with an OR of 1.00 (95% CI: 0.89–1.12). The pooled OR of cardiovascular mortality among ESKD patients who adhered to a plant-based diet was 0.86 (95% CI: 0.68–1.08; two studies, I2 = 0%), compared to those who did not. Data on cardiovascular mortality among those with Mediterranean and DASH diet were limited to one study with ORs of 1.14 (95% CI: 0.90–1.43) and 1.19 (95% CI: 0.99–1.43), respectively. Mediterranean diet adherence was found to be associated with reduced risk of left ventricular hypertrophy (LVH) with an OR of 0.82 (95% CI: 0.68–0.99) in a study including 127 ESKD patients. The risk of hyperkalemia was not significant among those with a plant-based diet with an OR of 1.00 (95% CI: 0.94–1.07) in a study including 150 ESKD patients. Conclusions: While our systematic review demonstrated no significant associations of Mediterranean, DASH, and plant-based diets with reduced all-cause mortality or cardiovascular mortality, there was also no evidence that suggested harmful effects of these diets to ESKD patients.

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“…If mismanaged, CKD can lead to ESRD affecting quality of life significantly [3]. ESRD Symptoms include loss of appetite, cramps, depression, and edema [4]. Causes are multifaceted from chronic inflammation, vascular diseases, urinary tract infections, congenital abnormalities, metabolic abnormalities to harmful drug intake.…”

Section: Introductionmentioning

confidence: 99%

“…Causes are multifaceted from chronic inflammation, vascular diseases, urinary tract infections, congenital abnormalities, metabolic abnormalities to harmful drug intake. Highprotein and high-sodium diets can worsen the condition [4]. While common, CAPD and hemodialysis treatments pose challenges, such as peritoneal infections or financial burdens.…”

Section: Introductionmentioning

confidence: 99%

Perspectives on fluid overload management among caregivers of end-stage renal disease patients undergoing hemodialysis

Ummee,

Rerkkasem,

Wungrath

2024

IJPHAP

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Background: Fluid overload is a significant problem often encountered in patients with end-stage renal disease. If not properly managed, it can have multiple adverse effects on a patient's health or may even be life-threatening. Objectives: This qualitative study explored the perspectives of caregivers concerning fluid overload management in end-stage renal disease (ESRD) patients undergoing hemodialysis. Methods: Eighteen caregivers, selected based on direct caregiving responsibilities and willingness to share their experiences were interviewed at Maharaj Nakorn Chiang Mai Hospital, Thailand, from January to April 2022. Data was collected through in-depth interviews. Thematic content analysis revealed varying degrees of knowledge and misconceptions among caregivers about fluid management strategies. Results: Some participants demonstrated a comprehensive understanding of dietary modifications, medication adherence, and lifestyle adjustments, recognizing their importance in maintaining fluid balance. However, gaps and misconceptions were identified with some caregivers lacking knowledge of specific strategies or believing that solely restricting fluid intake was sufficient. Participants underscored the pivotal role of healthcare professionals in guiding and supporting them emphasized the need for clear instructions, educational materials, and continuous communication. Conclusion: The findings highlighted the need to improve caregivers' knowledge and understand the significant role of healthcare providers in equipping caregivers with necessary information and skills. These insights can guide healthcare providers in tailoring education and support strategies to improve fluid overload management in ESRD patients. Further studies should explore the development and evaluation of targeted educational interventions for caregivers.

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Outcomes of Dialysis Among Patients With End-Stage Renal Disease (ESRD)

Cited by 7 publications

References 18 publications

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Epidemiology of End-Stage Renal Disease in Mogadishu, Somalia: First Report at a Tertiary Care Hospital

Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Perspectives on fluid overload management among caregivers of end-stage renal disease patients undergoing hemodialysis

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