[Epidemiology of end-stage renal disease before starting hemodialysis and factors influencing hemodialysis survival].
BACKGROUND
The incidence of end-stage renal failure is high and it is responsible for the increase of the rate of morbidity and mortality rates among our patients.


OBJECTIVE
The objective is to study patient characteristics before starting hemodialysis and to evaluate factors influencing their short and long term survival.


METHODS
This is a prospective study of 127 patients starting hemodialysis between June and December 2001. On May 31, 2005, their survival was analyzed according to different parameters.


RESULTS
Patients were 77 males and 50 females. Their mean age was 51.4 +/- 16.1 years (15 to 78 years). Diabetes was observed in 33.9% of cases. Only 70.9% of patients were covered by a social service. Chronic renal failure was diagnosed at the end stage in 34.6% of cases. Before starting hemodialysis, only 4 patients were vaccinated against B hepatitis and arteriovenous fistula were not made in any patients. Pericarditis was observed in 9.4% of patients. Albuminemia was < 35 g/l in 60.5% of patients. First hemodialysis session was programmed in 53.5% of patients and realized urgently in 46.3% of patients. Patients were hemodialysed 4, 8 and 12 hours per week respectively in 16.5%, 15.8% and 67.7% of cases. On May 31, 2005, 35.4% of patients died. Their actuarial survivals at 3 months, 1 year and 4 years were respectively at 87.5%, 79.5% and 64.4%. Acturial survival was bad in patients with pericarditis, diabetes, hemodialysed less than 12 hours/week and when the first hemodialysis session was started urgently.


CONCLUSIONS
The diagnosis of renal failure was frequently made at end-stage. There are no preparations before starting hemodialysis. We have to reinforce prevention programmes and increase the number of nephrologists and nephrology departments.
Service de Médecine Interne A Hôpital Charles, Tunis.
Fethi
F
Ben Hamida
Cyrine
C
Karoui
Ezzeddine
E
Abderrahim
Wided
W
Smaoui
Hayet
H
Kaaroud
Soumaya
S
Béji
Samia
S
Barbouche
Rim
R
Goucha
Taieb
T
Ben Abdallah
Fatma
F
Ben Moussa
Hédi
H
Ben Maiz
Adel
A
Kheder
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D016019:Survival Analysis