Disease profile, complications and outcome in patients on maintenance haemodialysis at King Faisal University Hospital, Saudi Arabia

Abstract

Objective: To determine the primary renal disease, acute complications and long term outcome of patients with end stage renal disease(ESRD) undergoing maintenance haemodialysis (MHD).

Design: A prospective descriptive study.

Setting: King Faisal Hospital of the University, Al-Khobar, Saudi Arabia.

Patients: Patients who had chronic renal failure with end stage renal disease (ESRD) and had been on regular dialysis for more than three months between September 1983 and September 1996 were included in the study. They were classified into three age groups, namely, group I comprising those aged below 29 years (48 patients); group II 30-59 years (147 patients), and group III, those aged 60 years and above (38 patients). Data were collected on disease characteristics, laboratory and radiological investigations, intra-dialytic complications and long-term outcome. The nature of renal disease was ascertained by review of medical data, clinical examination and laboratory investigations.

Results: Two hundred and thirty-three patients with ESRD on MHD were studied. The major causes of ESRD were chronic glomerulonephritis (42.9%) and diabetic nephropathy (27.9%). Hypotension, the most frequent acute complication was seen in 27% of dialytic treatments. Long-term complications resulted mainly from the vascular access and included thrombosis (60 cases), infection (50 cases), haemorrhage from access sites (20 cases) and aneurysmal dilatation (13 cases). These were more frequent in diabetics. Survival in groups I, II and III were 95%, 84% and 27% respectively at the end of the study. The 53 (22.7%) deaths that occurred in the whole study population were mostly due to cerebrovascular accidents (24.5%), cardiovascular events (15.1%), pulmonary oedema and sepsis, each contributed 13.2% of the deaths.

Conclusion: In our patients with chronic renal failure on MHD, younger patients had better survival than the elderly. The main causes of death were cardiovascular and cerebrovascular diseases. Hypotension was the most frequent acute complication. Long-term complications were frequent, especially in diabetics.