HAEMODIALYSIS PRACTICE IN A RESOURCE-LIMITED SETTING IN THE TROPICS

Background : Objective: To provide information on the challenges of haemodialysis in a resource limited setting in South-Western Nigeria. Methods : This is a 5 year audit of all haemodialysis sessions carried out at the renal unit of the Ladoke Akintola University Teaching Hospital  (LAUTECH), Osogbo, Nigeria. Results : A total of 225 patients were offered haemodialysis (HD) during this period with age range of 10 to 85 years (mean age of 49  years±16.25). There were 155 males and 70 females (male to female  ratio of 2.2:1). Chronic kidney failure accounted for 180 (80%) of the cases while acute kidney injury (AKI) constituted 45 (20%) of the cases offered haemodialysis. The sessions of HD in both cases ranged from 1 to 27 with an average of 3 sessions. Hypotension is still the commonest intradialytic complication at our setting while diabetic nephropathy is rapidly emerging as a major cause of end stage renal disease at our setting  requiring HD. As seen in other parts of the tropics sepsis, nephrotoxins and pregnancy related cases still accounted for a large percentage of AKI cases requiring haemodialysis. Only three patients were able to afford haemodialysis support for more than three months. Conclusion : Haemodialysis still remains a veritable option in renal  replacement therapy. Problems encountered were similar to many other settings in the tropics. Intensive efforts should still be geared at preventing the risk factors for both acute kidney injury and chronic kidney disease in our environment. Keywords : Haemodialysis, practice, tropics, Resource limited