| An analysis of the effectiveness and benefits of peritoneal dialysis and haemodialysis using Nigerian made PD fluids. | |
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MedLine Citation:
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PMID: 16749353 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Haemodialysis (HD) and peritoneal dialysis (PD) remains the cornerstone of management of patients with renal failure in developing countries as renal transplantation is just developing in most. Although both HD and PD are cost intensive, specific advantages and disadvantages have been identified with either of them. Comparative assessment of their effectiveness, benefits and cost will assist in providing a rational basis for preference of one or the other especially in third world countries where renal replacement therapy remains unaffordable and therefore relatively inaccessible to majority of patients. We therefore conducted this prospective randomised study to compare the effectiveness, benefits, cost and complications of acute or intermittent PD (IPD) and HD using locally manufactured PD fluids. Two groups of twenty patients with renal failure matched for age and clinical diagnosis were managed with IPD and HD and the effectiveness, costs and complications of both modalities compared. We found that both were comparably effective in the control of uraemia with significant reductions in the serum urea, creatinine and potassium from 29.2 +/- 7.2 mmol/L, 1693.7 +/- 580.5micromol/L and 4.8 +/- 1.2 mmol/L to 13.2 +/- 4.6 mmol/L, 796.0 +/- 458.0micromol/ L and 3.3 +/- 0.6 mmol/L respectively for IPD (P<0.05) and 34.4 +/- 9.0mmol/L, 1536.0 +/- 832.5 micromol/L and4.8 +/- 1.3 mmoV L to 14.6 +/- 7.5 mmol/L, 830.0 +/- 570.7 micromol/L and 3.9 +/- 0.8 mmol/L respectively for HD (P<0.05). In addition, there were significant improvements in serum bicarbonate in both groups. There was no significant difference in percentage reduction in serum urea, creatinine and serum potassium in both groups (P>0.05). However, HD managed patients required more blood transfusion (P<0.05). There were also comparably significant reductiohs in systolic, diastolic and mean arterial blood pressures in both groups (P<0.05). The costs of dialysis as well as the total cost of hospitalization were found to be significantly lower in patients managed with IPD (P<0.05). The commonest complication observed in patients managed with IPD was peritonitis while in patients managed with HD it was dialysis-induced hypotension. The clinical outcome was equally good in all the ARF patients as all of them recovered irrespective of the treatment modality; CRF patients did not fare as well with 37.5% mortality observed. We conclude that IPD and HD are effective renal replacement therapies with the former being significantly cheaper. IPD should be encouraged in our patients with ARF or acute exacerbation of chronic renal failure. |
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Authors:
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F A Arogundade; D A Ishola; A A Sanusi; A Akinsola |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: African journal of medicine and medical sciences Volume: 34 ISSN: 0309-3913 ISO Abbreviation: Afr J Med Med Sci Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2006-06-05 Completed Date: 2006-10-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7801013 Medline TA: Afr J Med Med Sci Country: Nigeria |
Other Details:
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Languages: eng Pagination: 227-33 Citation Subset: IM |
Affiliation:
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Renal Unit, Department of Medicine OAUTHC, PMB 5538, Ile-Ife, Osun State, Nigeria. fatilu3@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium Adult Cost-Benefit Analysis Dialysis Solutions / economics* Female Humans Hypertonic Solutions / economics Isotonic Solutions / economics Kidney Failure, Acute / therapy Kidney Failure, Chronic / therapy Male Nigeria Peritoneal Dialysis / methods* Renal Dialysis / adverse effects, methods* Renal Replacement Therapy / adverse effects, economics* Time Factors Treatment Outcome* Uremia / prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Dialysis Solutions; 0/Hypertonic Solutions; 0/Isotonic Solutions |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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