scholarly journals FACTORS AFFECTING NON-ADHERENCE TO TREATMENT OF HEMODIALYSIS PATIENTS IN MAKKAH CITY, KINGDOM OF SAUDI ARABIA

2020 ◽  
Vol 3 (14) ◽  
pp. 21-38
Author(s):  
Ghanim. Hamid. Al-Khattabi

Background: Adherence of hemodialysis patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. There is solid evidence that non-adherence of end-stage renal disease patients correlates with morbidity and mortality, is the norm for dialysis patients rather than the exception, multiple factors influence it and inconsistencies exist in findings of the relationships between risk factors and non-adherence. Despite the importance of this topic, there is remarkable paucity in the studies which identify factors associated with non-adherence in hemodialysis patients in Saudi Arabia. Objectives: To determine factors related to non-adherence to fluid, diet, medication, and hemodialysis sessions among hemodialysis patients in Makkah. Materials and Methods: The current study is a cross-sectional one, where a sample of 361 hemodialysis patients was selected randomly from hemodialysis centers in three governmental hospitals in Makkah in order to determine factors related to their non-adherence to treatment by using an end-stage renal disease-adherence questionnaire (ESRD-AQ) in addition to clinical examination and laboratory investigation for other data. Results: Younger (<30 years), unmarried, non-Saudis, those with chronic diseases other than hypertension and diabetes mellitus, and those with long dialysis duration (60+ months) were found more likely to be non-adherent to the fluid. Females patients and those with short dialysis duration (<60 months) were found more likely to be non-adherent to diet and medications, respectively. Conclusion: Patients who had factors associated with non-adherence deserve special attention and support to improve their adherence behavior. The findings from this study can be used as a base for designing an intervention aimed to increase the adherence to treatment in end-stage renal disease patients who are undergoing hemodialysis in order to decrease the direct and indirect cost that appear as a consequence of non-adherence.

2021 ◽  
Vol 4 (17) ◽  
pp. 95-112
Author(s):  
Ghanim. Hamid. Al-Khattabi

Background: Adherence of hemodialysis patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. There is solid evidence that non-adherence to end-stage renal disease patients correlates with morbidity and mortality, is the norm for dialysis patients rather than the exception, multiple factors influence it and inconsistencies exist in findings of the relationships between risk factors and non-adherence. Despite the importance of this topic, there is remarkable paucity in the studies which identify factors associated with non-adherence in hemodialysis patients in Saudi Arabia. Aims and Objectives: The current study aims at ameliorating the adverse consequences of non-adherence among hemodialysis patients through providing scientific background and a better understanding of the factors associated with non-adherence. The objectives of this study were to determine factors related to non-adherence to fluid, diet, medication, and hemodialysis sessions among hemodialysis patients in Makkah city. Materials and Methods: The present study is a cross-sectional one, where a sample of 361 hemodialysis patients was selected randomly from hemodialysis centers in three governmental hospitals in Makkah in order to determine factors related to their non-adherence to treatment by using an end-stage renal disease-adherence questionnaire (ESRD-AQ) in addition to clinical examination and laboratory investigation for other data. Results: Younger (<30 years), unmarried, non-Saudis, those with chronic diseases other than hypertension and diabetes mellitus, and those with long dialysis duration (60+ months) were found more likely to be non-adherent to fluid. Females patients and those with short dialysis duration (<60 months) were found more likely to be non-adherent to diet and medications, respectively. Conclusion: Patients who had factors associated with non-adherence deserve special attention and support to improve their adherence behavior. The findings from this study can be used as a base for designing an intervention aimed to increase the adherence to treatment in end-stage renal disease patients who are undergoing hemodialysis in order to decrease the direct and indirect costs that appear as a consequence of non-adherence.


2021 ◽  
Vol 8 (6) ◽  
pp. 11-15
Author(s):  
Qadhi et al. ◽  

In recent years, the number of hemodialysis (HD) patients has increased in the Kingdom of Saudi Arabia. End-stage renal disease (ESRD) is associated with increased rates of hospital admission, morbidity, and mortality. Globally, the most common causes of ESRD are diabetic nephropathy, hypertension, glomerulonephritis, infections, and chronic obstruction. However, very limited data have been presented regarding the etiology of ESRD in Saudi Arabia, especially in Makkah City. Therefore, this cross-sectional study is designed to determine the underlying etiologies of ESRD in hemodialysis patients. The study was conducted among 306 patients who were recruited from Makkah hospitals and HD centers. The obtained data showed that diabetes was the most common cause of ESRD (34.3%), followed by hypertension (20.9%), drug misuse (12.1%), hereditary conditions (10.1%), urinary tract obstruction, and urinary retention (9.8%), unknown reason (8.2%), and chronic inflammation of the kidneys (3.3%). In conclusion, this study highlights the most important factors contributing to ESRD in the Makkah region. Thus, national campaigns should be performed to increase awareness about these factors and to possibly reduce the incidence of the disease.


2006 ◽  
Vol 2 (12) ◽  
pp. 678-687 ◽  
Author(s):  
Daniel Cukor ◽  
Rolf A Peterson ◽  
Scott D Cohen ◽  
Paul L Kimmel

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jeremy Zaworski ◽  
Cyrille Vandenbussche ◽  
Pierre Bataille ◽  
Eric Hachulla ◽  
Francois Glowacki ◽  
...  

Abstract Background and Aims Renal involvement is a severe manifestation of ANCA-associated vasculitis. Patients often progress to end-stage renal disease. The potential for renal recovery after a first flare has seldom been studied. Our objectives were to describe the evolution of the estimated glomerular filtration rate (eGFR) and identify factors associated with the change in eGFR between diagnosis and follow-up at 3 months (ΔeGFRM0–M3) in a cohort of patients with a first flare of pauci-immune glomerulonephritis. Methods This was a retrospective study over the period 2003–2018 of incident patients in the Nord-Pas-de-Calais (France). Patients were recruited if they had a first histologically-proven flare of pauci immune glomerulonephritis with at least 1 year of follow up. Kidney function was estimated with MDRD-equation and analysed at diagnosis, 3rd, 6th and 12th months. The primary outcome was ΔeGFRM0–M3. Factors evaluated were histological (Berden classification, interstitial fibrosis, percentage of crescents), clinical (extra-renal manifestations, sex, age) or biological (severity of acute kidney injury, dialysis, ANCA subtype). Results One hundred and seventy-seven patients were included. The eGFR at 3 months was significantly higher than at diagnosis (mean ± standard deviation, 40 ± 24 vs 28 ± 26 ml/min/1.73 m2, p &lt; 0.001), with a ΔeGFRM0–M3 of 12 ± 19 ml/min/1.73 m2. The eGFR at 12 months was higher than at 3 months (44 ± 13 vs 40 ± 24 ml/min/1.73m2, p = 0.003). The factors significantly associated with ΔeGFRM0–M3 in univariate analysis were: sclerotic class according to Berden classification, percentage of interstitial fibrosis, percentage of cellular crescents, acute tubular necrosis, neurological involvement. The factors associated with ΔeGFRM0–M3 in multivariate analysis were the percentage of cellular crescents and neurological involvement. The mean increase in eGFR was 2.90 ± 0.06 ml/min/1.73m2 for every 10-point gain in the percentage of cellular crescents. ΔeGFRM0–M3 was not associated with the risks of end-stage renal disease or death in long-term follow-up. Conclusions Early renal recovery after a first flare of pauci-immune glomerulonephritis occurred mainly in the first three months of treatment. The percentage of cellular crescents was the main independent predictor of early renal recovery.


2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.


Author(s):  
Evangelos C. Fradelos ◽  
Konstantinos Tsaras ◽  
Foteini Tzavella ◽  
Evmorfia Koukia ◽  
Ioanna V. Papathanasiou ◽  
...  

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i450-i450
Author(s):  
Rita Valério Alves ◽  
Rita Abrantes ◽  
Hernâni Gonçalves ◽  
Maria Leonor Gonçalves ◽  
Karina Lopes ◽  
...  

2016 ◽  
Vol 6 (3) ◽  
pp. 230-236
Author(s):  
Juan Manuel López-Quijano ◽  
Antonio Gordillo-Moscoso ◽  
Jesús Antonio Viana-Rojas ◽  
Jorge Carrillo-Calvillo ◽  
Peter B. Mandeville ◽  
...  

Background: Chronic kidney disease is a disorder of epidemic proportions that impairs cardiac function. Cardiovascular diseases are the leading cause of death in hemodialysis patients, and the understanding of new nontraditional predictors of mortality could improve their outcomes. Right ventricular systolic dysfunction (RVSD) has recently been recognized as a predictor of cardiovascular death in heart failure and hemodialysis patients. However, the factors contributing to RVSD in hemodialysis patients remain unknown. The aim of this study was to evaluate the clinical and echocardiographic factors associated with RVSD in hemodialysis patients. Methods: A cross-sectional study was conducted in which 100 outpatients with end-stage renal disease on chronic hemodialysis were evaluated. A transthoracic echocardiographic examination was performed at optimal dry weight. Right ventricular systolic function was evaluated using tricuspid annular plane systolic excursion (TAPSE). Clinical and echocardiographic data were recorded for each patient. A multivariate linear logistic regression was created using RVSD (TAPSE <14 mm) as the dependent variable. Results: Fifteen patients with RVSD and 85 patients without RVSD were analyzed. TAPSE had a positive correlation with left ventricular ejection fraction (LVEF) and myocardial relaxation velocity. Independent contributors to RVSD were LVEF (OR 1.14, 95% CI 1.05-1.26), left ventricular mass index (OR 1.02, 95% CI 1.00-1.04), and myocardial relaxation velocity (OR 1.81, 95% CI 1.18-3.19). Conclusions: Echocardiographic factors were significant contributors to RVSD. These measurements could be included as part of the routine workup in all end-stage renal disease patients on hemodialysis.


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