JSWMC

Abstract:

Introduction: Chronic kidney disease (CKD) remains a significant global health challenge, necessitating life-sustaining hemodialysis for many individuals. The evidence demonstrates that mortality among ESRD patients is lower when sufficient hemodialysis treatments are provided. The achievement of adequate dialysis dose, measured by Kt/V, plays a pivotal role in improving patient outcomes.

Method and Material: This was a center-based descriptive cross-sectional study carried out in Hemodialysis unit of NIKDU, Dhaka, Bangladesh from January 1, 2012, to June 30, 2013, seeks to investigate whether increasing the frequency of hemodialysis sessions to three times per week, totaling 12 hours per week, significantly improves the attainment of target Kt/V in hemodialysis patients when compared to those receiving the conventional regimen of 8 hours per week. Purposive sampling of 120 ESRD patients on maintenance hemodialysis (MHD) getting dialysis for at least one month through Arterio-Venous Fistula (AVF) and at least 2 dialysis session per week.

Discussion: Out of 120 patients 72 (60.0%) were male and ratio was 1.5:1. The mean age of hemodialysis patients in this study was 51 years (range: 18-75 years). Most of the patients 62 (52%) were on 8 hours per week hemodialysis session. Our study showed mean Kt/V, URR, TACurea and nPCR  of all study population was 1.21 ± 0.40 62 ± 12, 83 ± 26 and 1.29 ± 0.46 respectively. In 8 hours per week hemodialysis group achieved target Kt/V > 2 was only 3(5%) and on the other hand 12 hours per week hemodialysis group achieved target Kt/V > 1.2 was only 26(45%). Among the study population only 52 (43%) achieved URR > 65% , 13 (11%) patients TACurea was less than 52 mg/dl and 107 (89%) patients achieved nPCR >  1 g/kg/day. Mean values of URR was significantly higher of Kt/V of >1.2 and nPCR of >1 g/kg/day group. Most of our hemodialysis patients inadequately dialyzed. In 12 hours per week dialysis group significantly higher BMI, hemoglobin, nPCR and low phosphorus and TACurea. To achieve hemodialysis adequacy of KDOQI 2006 recommendation needs to increase frequency of HD that is 3 sessions per week (12 hours /week) and needs to give more attention to others factors which increase urea clearance.

Conclusions: Furthermore, it underscores the need for continuous research to enhance our understanding of hemodialysis adequacy and improve the management of patients with end-stage kidney disease.