A single-center epidemiological survey of maintenance hemodialysis patients of Guiping

Objective To obtain the data support for standardizing clinical treatment and continuously improving the quality of hemodialysis by investigating the current situation of maintain hemodialysis (MHD) patients in Guiping.Methods We retrospectively analyzed the clinical records of MHD patients treated for more than 3 months from 2011 to 2015 in Guiping.Results A total of 262 MHD patients were enrolled in this study, including 155 males and 107 females with a male/female ratio of 1.45 to 1. The top 3 primary causes for MHD were chronic glomerulonephritis (62.21%), diabetic nephropathy (10.69%) and kidney stones (9.92%). The first used vascular access was arteriovenous fistula (58.78%), and 74 cases were given primary long-term survival of tunneled cuffed hemodialysis catheters (TVCs) (28.24%). New farming and health care was the main payment method. The rate achieved to the recommended levels of hypertension was 20.61% and the rate achieved to the recommended levels of hemoglobin was 16.72%. There were only 33 cases (12.60%) of the patients who were given dialysis for 3 times per week, and the positive rate of hepatitis B antigen and hepatitis C antibody were respectively 10.68% and 1.14%. In the last 5 years, the mortality rate was 11%, 14%, 10% and 17% respectively. In the past two years, the incidence of complications such as cerebral hemorrhage, heart failure, gastrointestinal bleeding, catheter-related bloodstream infection and hyperkalemia was not significantly reduced. The rate achieved to the recommended levels of blood calcium and blood phosphorus was 32.89%, 17.57% to iPTH and 51.24% to Kt/V≥1.2. Kt/V value and weekly dialysis frequency in the patients with further distance were significantly lower than in those with the closer distance (P<0.05).Conclusions In our dialysis center, the first three primary causes leading to end-stage renal disease (ESRD) were chronic glomerulonephritis, diabetic nephropathy and kidney stones. The major vascular access was arteriovenous fistula. New farming and health care was the main payment method. The incidence of hypertension, bone and mineral disorders was high, but the control rate was low. In the last two years, there was no significant improvement in mortality rate, cerebral hemorrhage, heart failure and hyperkalemia. The rate achieved to the dialysis frequency and dialysis adequacy is low in the patients with further distance. Treatment compliance and popularly standardized treatment need to be strengthened.