Dialysis Adequacy, and Pre and Post Dialysis Changes in Selected Biochemical Parameters in Hemodialysis Patients Attending the National Nephrology Hospital Polonnaruwa.

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.