Abstract:
Background: Dialysis adequacy is an important aspect to be monitored continuously in
hemodialysis patients in order to achieve better prognosis and Quality of Life (QoL). Regular
assessment of patients' biochemical profile, including electrolytes and creatinine levels is essential
for effective patient care.
Objective: To analyze the dialysis adequacy, and pre and post dialysis changes in selected
biochemical parameters in patients undergoing hemodyalysis treatments in National Nephrology
Hospital, Polonnaruwa
Methods: A cross-sectional study was conducted including 145 maintenance hemodialysis
patients attending the National Nephrology Hospital, Polonnaruwa. Data were collected from
medical records, laboratory test reports on serum concentrations of urea, creatinine, sodium and
potassium, and via an interviewer-administered questionnaire. Dialysis adequacy of the patients
were calculated using the Urea Reduction Ratio (URR).
Results: The study population mostly consisted of males (70.3%), >60 years of age (50.3%), with
a mean±SD age of 58±12 years. The majority (77.5%) had a dialysis vintage <2 years and most
patients (89.3%) attended for dialysis sessions once in five days. Mean±SD URR of the population
was 71±10 and 73.8% of patients had an efficient dialysis session. Mean±SD values of pre
dialysis serum urea, creatinine, sodium and potassium were 112±32, 13±3.9, 142±4 and 5±0.7
mmol/L, respectively. Mean±SD values of post-dialysis serum urea, creatinine, sodium and
potassium were 32±15, 4.6±1.9 mg/dL, 141±4 mmol/L and 3.7±0.6 mmol/L, respectively. After
dialysis, 76.9% and 79.7% of participants reached normal serum urea and sodium levels. High
creatinine and low potassium levels were identified among 96.5% and 43.4% of the patients after
hemodialysis. The analysis of paired sample t-test indicated a significant difference between the
mean values of pre and post; urea (p<0.001), creatinine (p<0.001) and potassium (p<0.001).
Conclusions: Majority of patients had an efficient dialysis session. Even after dialysis, a
significant proportion of the population depicted abnormal levels of creatinine and potassium.
Further research should be conducted to analyze the effect of dialysis adequacy, and pre and post
dialysis changes on the QoL and mortality of hemodialysis recipients.
