Sociodemographic and Economic Correlates of Dialysis Vintage in a Resource Challenged Setting: A Four-Year Prospective Study in Southwest Nigeria

Abstract

Background: Dialysis vintage is largely dependent on the effectiveness of the delivered dose coupled with the extent of patient compliance with the prescribed treatment regimen. This study assessed the determinants and correlates of dialysis vintage. Methodology: This was a 4-year prospective, observational study. The data was collected from the dialysis and medical records, both had the contacts of patients and relatives.

Results: A total of 314 participants (males 67.20%) with a mean age of 47.91±8.81 years underwent 2265 maintenance haemodialysis sessions. The females were older and had more hospital admissions; (P=0.07). Approximately 32.17% of the participants traveled at least fifty kilometers to access dialysis treatment. In a month, only 23.57% of the participants received the minimum prescribed twelve sessions, and 24.84% received the required erythropoietin dose. The mean dialysis vintage for all population was 9.13 ± 3.15 months, it was shorter for participants with hospitalization, (p<0.001), dialysis termination (p<0.001), intradialytic hypotension (p<0.001), and hypertension (p<0.001), Approximately, 14.2% of the participants had health insurance coverage, more so with the men After dialysis initiation, 6.69% of the participants were alive to the fourth year. The predictors of dialysis vintage were income (OR-4.62, 95% CI-2.88-6.24), health insurance (OR-8.11, 95% CI-4.82-13.35), dialysis duration (OR-6.38, 95% CI-2.40-9.55) and spKt/V (OR-4.24, 95% CI-0.48-5.91).

Conclusion: Dialysis vintage was short (9.13 ± 3.15 months), more so in females, poor funding, peridialysis complications, and without health insurance. More concerted efforts from governments, multinational donor agencies, and philanthropists are needed in health insurance coverage, particularly for kidney care to increase the dialysis vintage.

Keywords: Cardiovascular Function; Chronic Kidney Disease; Dialysis Vintage; Haemodialysis; Maintenance; Mortality; Resource-challenged Settings.