Bahadi Abdelaali, El Farouki Mohammed Reda, Zajjari Yassir, El Kabbaj Driss
Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, boîte postale 10000, Rabat, Maroc.
Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, boîte postale 10000, Rabat, Maroc.
Nephrol Ther. 2017 Dec;13(7):525-531. doi: 10.1016/j.nephro.2017.02.012. Epub 2017 Nov 14.
End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR).
This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015. We found the history of following these patients and sought their clinical characteristics at the time of setting hemodialysis.
During the study, 318 patients were admitted for management of ESRD. Their average age was 54.31 years and diabetic nephropathy was the most common cause of 41% of cases. Only 105 patients (33%) had a nephrological follw up in almost two thirds of cases, hemodialysis was started by using a temporary central venous catheter especially femoral. we have identified five factors associated with LR: nemia, hypoalbuminemia, inflammatory syndrome, a longer initial hospitalization, a greater use of temporary catheterization as first access.
LR patients with ESRD remains very common in our context. It is about 67% and complicates implementation hemodialysis patients with anemia and more use of central catheters that are predictors of mortality previously described in the literature. Economically, LR significantly increases the cost of care by significantly increasing the duration of hospitalization.
