COMORBIDITY BURDEN IN END STAGE RENAL DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS

Objective: To perform an assessment of comorbidities of our hemodialysis dependent patients.Material & Methods: This was a cross-sectional descriptive study conducted in the Institute of Kidney Diseases Hayatabad,Peshawar and Khyber Teaching Hospital, Peshawar, Pakistan. The study included 177 patients and the studyduration was 04 months (December 2015 to March 2016). ESRD patients on maintenance hemodialysis were askedabout their comorbid conditions. This information was recorded on a questionnaire.Results: A total of 177 patients responded to a specially designed questionnaire asking questions about their comorbiditystatus. Out of these 177 patients 111 (62.7%) were male (M:F 1.7:1). The mean age for male patients was 43.1years (SD ±14.8 and range from 18 to 70 years). While the mean age for females was 42.3 years (SD ±15.2 and rangefrom 18 to 80 years). About 79% patients were on hemodialysis for duration of less than 03 years. Only 7.3% patientswere undergoing hemodialysis at the recommended frequency of 03 or more sessions per week. All but 24.3% patientsreported no emergency visits to hospital and all except 33.9% patients had no hospital admission in the previous 06months. Around 34% patients had more than 5 emergency visits, while 37.8% patients had more than 5 admissionsin the previous 06 months. Around 55.3% of patients were taking more than 5 types of drugs in a single day, while76.7% were taking more than 3 drugs per day. Hypertension was the commonest comorbidity found in about 93.8%of patients. This was followed by cardiac diseases (46.9%) and diabetes (40.6%). Viral hepatitis was found in 21.4%patients, Infections in 12.4%, pulmonary diseases in 9.0%, and strokes were reported by 4.0% patients. Off the malepatients, 67.5% (n=75) had two or more co-morbidities while 37.8% (n=42) had both Diabetes and hypertension. Off thefemale patients 89.3% (n=59) had two or more comorbidities while 45.4% (n=30) had both Diabetes and Hypertension.Conclusion: Comorbidities are common in our ESRD patients. Hypertension is the most common comorbidity followedby Diabetes Mellitus and cardiac diseases. The frequency of these comorbidities is higher in our patients when comparedto the international data. This could explain the higher morbidity and mortality of our ESRD patients