Alkhatib Ismail, Alasfar Sami, Burnham Gilbert, Orhun Nimetcan Mehmet
Public Health Department, Faculty of Medicine, Ankara Yıldırım Beyazıt Üniversitesi, Ankara, Türkiye.
Department of Medicine, Division of Nephrology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
BMC Health Serv Res. 2025 May 2;25(1):638. doi: 10.1186/s12913-025-12673-1.
There are an estimated 850 persons with End-Stage Kidney Disease (ESKD) receiving hemodialysis in the conflict-affected Northwest Syria. This study examines patients' perspectives, and experiences with hemodialysis and their knowledge about their disease and treatment.
This study used telephone interviews with 101 randomly selected ESKD patients from 12 of the 14 hemodialysis units in Northwest Syria during early 2023 in a cross-sectional study.
The mean age of respondents was 50.3 ± 16.7 years (range 7 to 81), with 55.4% males. The sample included 53 local residents and 48 Internally Displaced Persons (IDPs) from elsewhere in Syria. A quarter (28.7%) of patients reported being unable to access one or more hemodialysis sessions in the previous year. In the past year, 61 of 101 dialysis patients had changed household location because of reported insecurity. Frequent household relocations disrupted dialysis continuity resulting in the use of multiple dialysis sites. Because of the decentralized distribution of facilities, half of patients could reach their dialysis facility in 30 min or less, and at minimal costs. Two-thirds (67.3%) reported the presence of comorbidities, with hypertension and diabetes being the most common. Of the 35 patients with diabetes, 15 required insulin. Only about half (52.5%) had seen a nephrologist or physician in the past six months. The health literacy level concerning ESKD, and hemodialysis was low for many patients.
While considerable resilience is seen among hemodialysis patients in conflict areas of Northwest Syria, there are deficits in care and health literacy concerning ESKD and hemodialysis which should be addressed. There are a number of low resource actions which could be undertaken for this population to improve their health and understanding of their disease which are currently being considered.
在受冲突影响的叙利亚西北部，估计有850名终末期肾病（ESKD）患者接受血液透析。本研究调查了患者对血液透析的看法、经历以及他们对自身疾病和治疗的了解。
本研究采用电话访谈的方式，于2023年初对叙利亚西北部14个血液透析单位中12个单位的101名随机选取的ESKD患者进行了横断面研究。
受访者的平均年龄为50.3±16.7岁（范围7至81岁），男性占55.4%。样本包括53名当地居民和48名来自叙利亚其他地区的境内流离失所者（IDP）。四分之一（28.7%）的患者报告称上一年无法进行一次或多次血液透析治疗。在过去一年中，101名透析患者中有61人因安全问题而更换了家庭住址。频繁的家庭搬迁扰乱了透析的连续性，导致患者使用多个透析地点。由于设施分布分散，一半的患者能够在30分钟或更短时间内、以最低成本到达透析机构。三分之二（67.3%）的患者报告患有合并症，其中高血压和糖尿病最为常见。在35名糖尿病患者中，15人需要胰岛素治疗。在过去六个月中，只有约一半（52.5%）的患者看过肾病科医生或内科医生。许多患者对ESKD和血液透析的健康素养水平较低。
虽然叙利亚西北部冲突地区的血液透析患者展现出了相当的适应能力，但在ESKD和血液透析的护理及健康素养方面仍存在不足，需要加以解决。目前正在考虑针对这一人群采取一些资源需求较低的行动，以改善他们的健康状况并增进他们对自身疾病的了解。
