Nigerian Medical Journal

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 61  |  Issue : 6  |  Page : 307--311

Demographics, cost, and sustainability of haemodialysis among end-stage kidney disease patients in Southern Nigeria: A single-center study


Effiong E Akpan1, Udeme E Ekrikpo1, Emmanuel Edet Effa2, Aniema I. A. Udo1, Victor A Umoh1 
1 Department of Internal Medicine, Renal Unit, University of Uyo Teaching Hospital, Uyo, Nigeria
2 Department of Internal Medicine, Renal Unit, University of Calabar Teaching Hospital, Calabar, Nigeria

Correspondence Address:
Dr. Emmanuel Edet Effa
Department of Internal Medicine, University of Calabar Teaching Hospital, P.M.B 1278, 540001
Nigeria

Context: Access to chronic hemodialysis for patients with end-stage kidney disease has improved over the years. However, it is unclear if this has resulted in lower cost and improved dialysis vintage. Aim: We aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end-stage kidney disease (ESKD) patients. Methods: Retrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time-to-HD discontinuation and reasons for discontinuation were recorded. Using Kaplan–Meier graphs, the time-to-dialysis discontinuation experience of the cohort was shown. Log-rank test was used to compare the experience between both genders. Univariable and multivariable Cox proportional hazard models were built to identify independent associations with time-to-dialysis discontinuation. Results: Over the 5-year period, 702 individuals initiated HD, males were older than females, the complete cohort contributed 65,714 person-days to the study and the median time-to-HD discontinuation was 10 days (interquartile range, 2–42). Females had a shorter time to HD discontinuation (8 days [1–32 days]) compared to males (11 days [2–48 days]). Only 28.5%, 15.3% and 8.3% of the patients had HD beyond 30, 90, and 180 days, respectively. About 128 (18.2%) had thrice-weekly HD. Most sustained the treatment for the 1st week. Majority (98.4%) of the patients were presumed dead, while 4 (0.65%) were still alive and 6 (0.98%) had renal transplantation. All patients who discontinued dialysis did so for financial reasons. Multivariable Cox proportional hazards model showed that individuals who could afford dialysis more than once a week had reduced hazard of dialysis discontinuation. Conclusion: Most patients cannot sustain HD beyond a few weeks for financial reasons. Several cost containment strategies need to be deployed to bring down the cost of care.


How to cite this article:
Akpan EE, Ekrikpo UE, Effa EE, Udo AI, Umoh VA. Demographics, cost, and sustainability of haemodialysis among end-stage kidney disease patients in Southern Nigeria: A single-center study.Niger Med J 2020;61:307-311


How to cite this URL:
Akpan EE, Ekrikpo UE, Effa EE, Udo AI, Umoh VA. Demographics, cost, and sustainability of haemodialysis among end-stage kidney disease patients in Southern Nigeria: A single-center study. Niger Med J [serial online] 2020 [cited 2021 Oct 21 ];61:307-311
Available from: https://www.nigeriamedj.com/article.asp?issn=0300-1652;year=2020;volume=61;issue=6;spage=307;epage=311;aulast=Akpan;type=0