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Haemodialysis (HD) is the commonest renal replacement therapy for patients with kidney failure in India. Survival of HD patients are determined by multiple factors, including socio-economic background. Outcome data on HD patients is limited from India and there are reports of poor outcomes in HD program in the public sector hospital. Our institute,Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Puducherry, a public sector hospital, established a standalone HD centre offering subsidized or free HD for the underprivileged 7 years ago. This report is a compilation of the patient outcome at our HD centre.
Medical records of patients enrolled at our dialysis centrebetween 1st December 2016 and 31st November 2018 were retrieved. Demographic & dialysis treatment related data was extracted from records, lab data was retrieved from electronic medical records (HIS). Frequencies with proportions or percentages were used to summarize the categorical variables. Mean ± SD or Median± IQR was used to summarize the continuous variables based on normality of distribution. Chi-square test and Logistic regression was used to identify the factors associated with survival at 3 and 5 years.
Among 140 patients enrolled during the 2 years, mean age was 40.62 years and 37 patients (26.4%) were females. 57.1% patients were on twice a week HD at enrollment, AVF(Arterio venous fistula)was the mode of access in 88.5 patients. 33(23.5%) were diabetic and 136(97.1%) had hypertension. BPL (below poverty line) category accounted for 70% of patients who received HD with no out-of-pocket expense. 53 underwent kidney transplantation, 45 were continuing HD at our centre at 5 years, 2 were transferred elsewhere and 40 died .
For patients who were not transferred,the survival rate at 3 and 5 year was 54.6% and 47.4% respectively.Annual mortality rate was 12% and the dropout rate was extremely low. Female sex, younger age, non-diabetic status ,better kt/v and BPL status were associated with better survival at 3 and 5 years.
Survival of HD patients at our centre offering subsidized/free HD services in the public sector was comparable or better than similar centres in India, with minimal drop out of patients.