الفهرس 
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Abstract
SUMMARY
end stage renal disease (ESRD) is one of the main health problems in Egypt. Currently, hemodialysis represents the main mode for treatment of chronic kidney disease stage 5 (CKD5), previously called ESRD or chronic renal failure.
Although hemodialysis is often used for treatment of ESRD, no practice guidelines are available in Egypt. Healthcare facilities are seeking nowadays to develop practice guidelines for the sake of improving healthcare services.
This work is a part of project aiming at assessmentof the current status of dialysis patient in Egypt using a questionnaire. This project is modulated by Nephrology department, Ain Shams university. This study was done in APRIL, MAY 2015.
Our study sample consisted of 296 clinically stable chronic patients on regular HD. Patients were collected from Al-Khanka central hospital, Alhayat private hospital, Kalila private hospital, Almostafa private hospital and Alrahma private hospital.
In all patients, we recorded full history and clinical examination stressing on etiology of renal disease and associated complications. Full review of all medical records over the last 6 months, and details of HD prescription.
Results of this study demonstrated that there were many causes for ESRD in the study population, where HTN 32.4%, DM 23.0%, these results agrees with most of the studies where HTN & DM were the main causes of renal failure.
Different co morbidities in the study population were HTN in (51.4%), DM in (38.5%), chronic arthropathy in (11.1%) and IHD in (20.9%).
In our study we found that most of the patients81.1% recieve 3 HD sessions per week and most of them 62.2% receive 4 hours per session.
The mean value of HD period is 3.4 (± 2.5) years. The mean value of patients dry weight was 64.4 (± 15.7) Kg.
In our study population (75.0%) were not working, while (25.0%) were working.
Dependency status in the study population showed that (47.0%) of the patients were dependant, (53.0%) were not dependant.
As regard Sponsoring status in the study population (52.4%) of them were sponsored by Governorate, (42.2%) of them were sponsored by health insurance, while (12.0%) were sponsored by army and 1.4%private.
In our study we found that86.6% of patients were using AVF while 13.2 % were using venous cathter. This was in agreement with KDOQI guidelines for venous accessplacement.
In our study the mean hemoglobin level of our patients was 9.55± (1.51) gm/dl, we found that according to NKF- KDOQI guidelines recommendations (60.2 %) of our patients were below the recommended level, (12.2 %) were above it.
In our study the percentage of patients receiving regular erythropoietin was (64.9%), the most frequent ESA used was generic (100.0%), while (35.1%) of patients were not on ESA therapy.
As regard vitamins use in the study population(82.2%) of them received vitamin B complex, as regard L-Carnitine (35.5%) of them received it, as regard vitamin Dthere were (30.1%)of our patients received it.
History of iron injection in the study population showed that (66.9%) received iron injection.
We also found that the mean calcium level was (8.15) ± (1.04)mg/dl, According to KDIGO 2009 guidelines(29.1 %) ofour patients were below the recommended level, (54.4%) within the recommended level and (5.4 %)above the recommended level.
In our study we found that the mean phosphorus level was (5.72)±(1.55) mg/dl. According to KDIGO 2009 guidelines 4.9% of our patients were below the recommended level, (22.6%) within the recommended level and (54.4 %) above the recommended level, while (18%) were wiyh no valid records.
In our study (85.8 %) of the patients were on phosphate binders therapy.
Calcium phosphorus product level was above 55 in (32.6%), while in (45.9%) was below 55.
As regards dialysis complication, hypotension was the most common complication (38.6%) followed by bony aches (27.2%). Fractures were the least common complication (0.38%).
The percentage of HCV positive Patients is (50.2%), HBV positive Patients percentage is (0%), while (49.8%) of Patients are negative. all HCV positive Patients are totally isolated from negative patients.
As regard dialyzer in study population, 250 patients (95.8 %) were using a low flux dialyzer, while the other 11 patients (4.2%) were high flux dialyzer.
50 patientswere using dialyzer with surface area 1.6m(19.2%), while the other 211 patients (80.8%) were using dialyzer with surface area 1.3m. All patients using dialyzers with synthetic martial.
Criteria of dialysate used in the study population showed that Out of 261 patients, (38.6%) were using dialysate with K concentration 2mmol/L, Ca concentration 1, 50 mmol/L, Na 137 mmol/L, Mg 0.50 mmol/L and bicarbonate based, While (32.3%) dialysate with K concentration 2mmol/L, Ca concentration 1, 75 mmol/L, Na 137 mmol/L, Mg 0.50 mmol/L and bicarbonate based, (29.1%) dialysate with K concentration 1.5mmol/L, Ca concentration 1, 25 mmol/L, Na 138 mmol/L, Mg 0.75 mmol/L and acetate based.