Abstract:
Background: The increasing incidence and prevalence of chronic kidney disease is an important challenge for
health systems around the world. Access for care of the disease in Ethiopia is extremely limited. The main purpose
of the study was to investigate survival pattern and assess risk factors for poor outcome of patients on maintenance
hemodialysis for end stage renal disease in Ethiopia.
Methods: Medical records of patients on maintenance hemodialysis for end stage renal disease at Saint Gabriel
General Hospital between 2002 and 2010 were reviewed. The data was collected by complete review of patient’s
clinical data. Descriptive statistics was used for most variables and Chi-square test, where necessary, was used to
test the association among various variables. Kaplan-Meier survival analysis was done to assess both short and long
term survival. P-values of < 0.05 were considered as statistically significant.
Results: A total of 190 patients were registered for hemodialysis at the hospital 91 of which were included in the
final assessment. Mean age at dialysis initiation was 58 ± 15 years. Fifty-five (60.4%) of the patients had prior history
of diabetes. Almost all of them had serum creatinine of > 5mg/dl and some degree of anemia at dialysis initiation.
Forty-one (45.1%) deaths occurred during dialysis treatment and 21 (23.1%) of patients died within the first 90 days
of starting dialysis. Only 42.1% of them survived longer than a year. The frequently registered causes of death were
septicemia (34.1%) and cardiovascular diseases (29.3%). Use of catheter as vascular access was associated with
decreased short term and long term survival.
Conclusion: Dialysis as treatment modality is extremely scarce in Ethiopia and affordable to only the rich. Survival
pattern in those on the treatment is less satisfactory and short of usual standards in the developed world and
needs further investigation. We thus recommend a large scale analysis of national dialysis registry at all dialysis
centers in the country
