Challenges of hemodialysis in Vietnam: experience from the first standardized district dialysis unit in Ho Chi Minh City

BMC Nephrology

Mary-Louise McLaws¹  Phong Duy Nguyen²  Dariusz Piotr Olszyna³  Cuong Minh Duong¹ 

[1] School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Level 3 Samuels Building, Sydney 2052, NSW, Australia;Training Center for Family Physicians, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam;Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore, Singapore

关键词: Non-compliance;    Hepatitis C virus;    Hepatitis B virus;    Challenges;    Hemodialysis;   

Others  :  1222302
DOI  :  10.1186/s12882-015-0117-2

 received in 2015-03-05, accepted in 2015-07-20,  发布年份 2015

【 摘 要 】

Background

Hemodialysis is an increasingly common treatment in Vietnam as the diagnosis of end stage renal disease continues to rise. To provide appropriate hemodialysis treatment for end-stage renal disease patients, we conducted a 1-year cross-sectional study to measure the prevalence of bloodborne infection and factors associated with non-compliant behaviors in hemodialysis patients.

Methods

One hundred forty-two patients were tested for hepatitis B virus (HBV) surface antigen and hepatitis C virus (HCV) core antigen. They provided demographic, medical and dialysis information. Non-compliant behaviors were obtained from their medical records.

Results

Overall, 99 % of patients reused their dialyzers and 46 % had arteriovenous fistula on admission. Both HBV and HCV equally accounted for 8 % of patients and concurrent infection accounted for 1 %. Non-compliance rates of dietary and medication were 39 and 27 % respectively. 42 % of patients missed hemodialysis session, 8 % were verbally or physically abusive and 9 % were non-cooperative. Of the 54 % catheterized patients, 7 % improperly cared for their dialysis access. Dietary non-adherence was associated with male patients (p = 0.03) and medication non-adherence was associated with younger age (p = 0.05). Duration between diagnosis of chronic kidney disease and initiation of hemodialysis was associated with improper care of dialysis access (p = 0.04). Time on hemodialysis was associated with missed hemodialysis session (p = 0.007) and verbal or physical abuse (p = 0.01).

Conclusion

Health services need to provide safe practice for dialyzer reuse given the endemicity of hepatitis. We believe a national survey similar to ours about seroprevalence and infection control challenges would prepare Vietnam for providing safer satellite treatment units. Safe hemodialysis services should also comprise patient preparedness, education and counseling.

【 授权许可】

   
2015 Duong et al.

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