الفهرس 
Hemodialysis PrescriptionOnly 14 pages are availabe for public view
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Abstract
Background
End-stage renal disease (ESRD) is one of the main health problems. Currently, hemodialysis represents the main mode for treatment of chronic kidney disease stage 5 (CKD5).This work is a part of project aiming at statement of the current status of dialysis practice in Egypt.
Objectives
To study the patterns of current clinical practice in hemodialysis prescription in in Kafr Elshikh Governorate(sector ΙΙ) and to compare these patterns with standard international guidelines in hemodialysis prescription.
Method
Demographic and clinical data of 300 clinically stable ESRD patients on regular HD were collected with full review of all medical records over the last 6 months with stress on the following data: Investigation: CBC, Iron study , Serum Calcium , Phosphorus , PTH and the frequency of these studies, Blood transfusion, use of hematinic and use of ESAs and details of HD prescription. All these data were compared to latest clinical practice guidelines.
Results
Both descriptive and analytical statics were done which demonstrated that there were many causes for ESRD in the study population, where HTN (47.3%),DM (17.7%), Unknown (12.7%), ADPKD(4.3%),Chronic GN(4.3%),and in (3.3%) the cause was obstructive uropathy,. Different comorbidities in the study population were HTN in (15.3%), DM in (13%), IHD in (5.3%), CLD in (5 %), CVS in (4.3%) of patients and COPD in (3.7%).In our study we found that most of the patients 93 % receive 3 HD sessions /week and HD sessions duration were 11.67 % lasting 3 hours, 24.67 % lasting 3.5 hours and 63.67 % lasting 4 hours ,The mean value of HD period is 5.3 (± 3.5) years. The mean value of weight gain between sessions was 3 (± 1.2) Kg . (81%) was not working, while (19%) were working. Dependency status in the study population showed that (19.7%) of the patients were dependent, (80.3%) were not dependent, 96.3% of patients were using AVF while 3 % were using venous catheter, 78.6 % were below the recommended level, (3.7 %) were above it.The most frequent ESA used was Epoetin alfa by 69% of patients, Darbepoetin alfa by 15.7% of patients .The commonest complication during HD session in the study population is bone aches (15%), then itching (10%) and hypotension (10%), then muscle cramps (9%), the least common is fractures (5%). All HCV and HBV positive patients were totally isolated from negative patients.
Conclusion
There are many defects in the way of practicing HD in Kafr Elsheikh Governorate sector (II) where there is lack of basic medical and laboratory records for most of patients. These make any research work very difficult and even make difficulty for the units to make any future improvement.There is lack of orders of routine Laboratory tests that should be done regularly and at specified periods for all HD patients to monitor for complications and response to treatment