Characteristics of Clients at Incident Haemodialysis Treatment: A Retrospective Audit in a Northern Australian Hospital

J. T. Hughes, S. W. Majoni, F. Barzi, S. Signal, J. Kapojos, A. Abeyaratne, M. Sundaram, P. Goldrick, S. L. Jones, R. McFarlane, L. T. Campbell, D. Stephens, A. Cass

    Research output: Contribution to journalMeeting Abstract

    Abstract

    Background: The Northern Territory (NT) has the highest national prevalence of dialysis‐dependent end stage kidney disease (ESKD). All haemodialysis initiation in the Top‐End region occurs at the Royal Darwin Hospital dialysis unit (DU), or intensive care unit (ICU) with continuous veno‐venous haemofiltration if critically unwell.

    Aim: To describe the survival of clients presenting for an incident haemodialysis (i‐HD) treatment in the Top‐End NT between 1 January 2011 to 21 December 2012.
    Methods: Admissions data describing the incident HD (i‐HD) treatment in clients (>18 years) were identified from the ANZICS database and DU diary (available for 01/07/2011‐31/12/2012). Planned dialysis at i‐HD was defined as admission within DU of <8 hours. Survival was calculated to date of death or follow‐up (censored at 31/12/2015). Requirement for ongoing maintenance dialysis (mRRT) after 90 days was confirmed by ANZDATA and chart review.

    Results: Admissions for i‐HD occurred in 176 clients (52.7% male, Indigenous 71%, mean age 50.5 (range 18.5‐87.1) years, median eGFR within 90 days of i‐HD 24 (IQR 8‐61) ml/min/1.73m2), at the DU 39.2%, ICU 47.2% or both units (DU‐ICU) 13.6%. In this period, 57 clients (32.4%) at i‐HD continued with mRRT, though only 17/57 (29.8%) had i‐HD as a planned‐dialysis. 136 (77.2%) clients survived 30 days, with 50.6% overall survival. Survival was higher in clients with i‐HD in DU than ICU (69.6 v 37.3%%, p<0.001) or ICU‐DU (69.6 v 41.7%, p=0.01). Survival was unrelated to planned‐dialysis (p=0.08).

    Discussion:
    The Top‐End NT has a high demand for dialysis support with incident haemodialysis in the context of critical illness and unplanned‐dialysis; though only critical illness was associated with lower survival. Further research understanding factors associated with unplanned dialysis is required.
    Original languageEnglish
    Pages (from-to)78-78
    Number of pages1
    JournalNephrology
    Volume22
    Issue numberS3
    Early online date30 Aug 2017
    DOIs
    Publication statusPublished - 1 Sep 2017

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