article · Tanzania Medical Journal
A study conducted at the Muhimbili National Hospital dialysis unit in Tanzania reviewed 180 patients receiving maintenance dialysis to evaluate their comorbidities, dialysis-related complications, and medication patterns. The participant group was predominantly male, with a median age of 52 years. The most frequently observed comorbidities were hypertension, anaemia, coronary artery disease, and diabetes mellitus. During dialysis sessions, participants frequently experienced complications such as fatigue, nausea and vomiting, and headache. In terms of medication, drugs targeting the cardiovascular system accounted for just over half of all prescriptions, followed by treatments for digestive and metabolic conditions, as well as therapies for blood and blood-forming organs. The findings highlight the significant burden of concurrent health conditions and acute side effects in this patient group, indicating a heavy requirement for cardiovascular management alongside routine dialysis care.
Patients undergoing long-term dialysis often balance multiple complex illnesses simultaneously. Identifying the specific complications and medication demands within a tertiary hospital context aids healthcare providers in tailoring treatment regimens, improving patient comfort during dialysis, and directing resources towards high-demand areas like cardiovascular support.
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Background Chronic kidney disease (CKD) is a major public health challenge and a widely prevalent non-communicable disease in both the developed and developing world. Patients with CKD on maintenance dialysis have been shown to present with different comorbidities and hemodialysis-associated complications that make them at risk of multiple drug prescriptions. We investigated comorbidities, hemodialysis-associated complications, and prescription patterns among patients with CKD on maintenance dialysis at a tertiary hospital in Tanzania. Methods This was a retrospective cross-sectional study conducted among 180 patients who attended maintenance dialysis service at the Muhimbili National Hospital dialysis unit from 01 January to 30 June 2022. A structured questionnaire was used to collect both sociodemographic and clinical data from the dialysis unit database. Prescription pattern was assessed by arranging medications to their first level of an anatomical main group according to the Anatomical Therapeutic Chemical (ATC) classification system. Results A total of 180 patients with CKD on maintenance dialysis were included in this study. The median age of study participants was 52 years (range 23-80 years), with male predominance (75.0%). The most common comorbidities were hypertension (35.2%), anaemia (21.6%), coronary artery disease (21.6%) and diabetes mellitus (12.7%). The major hemodialysis-associated complications observed include fatigue (34.5%), nausea and vomiting (17.9%), and headache (16.0%). Based on the Anatomical Therapeutic Chemical (ATC) classification system, drugs for the cardiovascular system were the most prescribed class of drugs (50.1%) followed by drugs for digestive and metabolic disorders (25.1%) and drugs for blood and blood forming organs (21.2%). Conclusions The majority of patients with CKD on maintenance dialysis have comorbidities and present with intradialytic complications. The prevalent comorbidities and complications observed in the study were hypertension and anaemia, and fatigue, nausea, vomiting, and headache, respectively. These findings underscore the critical need for comprehensive management of such patients, with a focus on cardiovascular health, as cardiovascular drugs were the most frequently prescribed.
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DOI: 10.4314/jfeemv12
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