الفهرس 
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Abstract
End-stage renal disease (ESRD) is one of the main health
problems in Egypt. Currently, hemodialysis represents the
main mode for treatment of chronic kidney disease stage 5
(CKD5), previously called ESRD or chronic renal failure.
Although hemodialysis is often used for treatment of
ESRD, no practice guidelines are available in Egypt.
This effort aimed to study current status of clinical
practice of hemodialysis in Egypt using questionnaire. Seven
hemodialysis units in Cairo participated in this study. These
units included 320 patients on regular hemodialysis.
The study was conducted during the period from January
to June 2014.
In all patients we recorded full history and clinical
examination stressing on etiology of renal disease and
associated complications, Full review of all medical records
over the last 6 months and details of HD prescription.
In this study, we found that the common causes of the
chronic renal failure which lead to dialysis was hypertension
represented by 87 cases (27.2%) and diabetes mellitus 65 cases
(20.3%).The mean age of our patients was 53.13 ± 13.81 years,
177 patients (55.3%) were males & 143 patients (44.7%) were
females.
284 patients (88.8%) of studied population weren’t
working while only 36 patients were working (11.3%).
The mean of dialysis period was 4.57 ± 3.86 years
398 patients (97.5%) of our studied population underwent
dialysis 3 times/week.
In studied group 293 patients (91.6%) spent 4 hours per
session, 12 patients (3.8%) spent 3.5hours per session, while
15 patients (4.7%) spent 3 hours per session.
As regard sponsoring status in the study population
(55.9%) of them were sponsored by governorate while (17.2%)
of them were sponsored by health insurance, (1.6%) sponsored
by company, (16.6%) sponsored by army and (8.8%) of them
were private cases.
AVF was the preferred vascular access. 300 patients
(93.8%) had been dialyzed from A.V. F. Failure of access was
in 99 cases (30.9%) of study population.
There were not cases of HBV or HIV positive. 36.56%
of patients were HCV positive in the studied group. The mean HB level was 9.7 gm/dl which below the target
level (11-12g/dl) according to NKF-DOQI guideline (2007).
Most of HD units in our study did not measure iron
status routinely.
15.3% of patients had s.ferrtin>500 and 34.7% of
patients had s. ferritin <500
32.2% of patients had TSAT <30 % and 17.8% had
TSAT>30 %.
50% of patients (160 cases) did not perform s.ferritin or
TSAT tests.
In the current study 70.6% of patients used iron
injection.
According to KDIGO, (2009), (31.6%) of patients had
s.Ca within the target level (8.4-10.2 mg/dl) and (9.7%) had
s.Ca below the target while 58.8 % of patients did not do Ca
labs.
According to KDIGO (2009), (26.6%) of patients had
s.Po4 within the target level (3.5-5.5mg/dl), (11.6%) had s.Po4
above the target, (1.9%) had s.P below the target and 60% of
patients did not do po4 test
In the present study, mean s.PTH was 618.4 pg/ml.
According to KDIGO guidelines 2009 iPTH levels should be maintained in the range of approximately two to nine times the
upper normal limit for the assay
In the studied group: 316 patients (98.8%) used
phosphate binder (calcium containing only). 187 patients
(58.4%) used Vitamin D supplement.
In the studied group we searched for the common
complication of dialysis and we found that hypotention
represented 178 cases (55.6%), cramps represented 32.5% (104
cases), itching present in 11.6% (37 cases), bony aches
represented by 36 cases (11.2%) and Fractures 2 cases (0.6%).
from 320 patients enrolled in this study, kt/v was
measured for 61 patients and the mean level was 1.25 which
meets the minimal level recommended.
In the current study Bicarbonate dialysate was used as the
buffer in 79.7 % of patients.20.3% of patients were using
dialysate Ca 1.25 mmol/l. 79.7% of patients were using
dialysate K 2 mmol/l.
Synthetic and low flux dialysers were used for 93.1% of
the study population.