Abstract: SA-PO983
The Nephrology Association of Karnataka (NAK) Multicentric Dialysis Practice Pattern: A Cross-Sectional Pilot Study in Karnataka, India
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Conjeevaram, Arvind, The Bangalore Hospital,, Bangalore, Karnataka, India
- Y J, Dr.Anupama, Nanjappa Hospital, Shimoga, Shimoga, India
- Vincent, Lloyd, Narayana Health, Bangalore, KARNATAKA, India
- Sastry, Nanda kumar Bidare, Ramaiah Medical College and Hospital, Bangalore, India
Group or Team Name
- For the NAK Study Group
Background
The rising prevalence of chronic kidney disease (CKD) in India poses a major challenge due to absence of a national registry and validated data capture systems. Policy makers as well as treating physicians face dilemmas due to absence of evidence. Karnataka, a State in South India, with over 200 dialysis centers, lacks systems and processes to ensure comprehensive data capture. The present cross sectional study, is part of NAK’s initial attempt to develop and validate norms and systems for a comprehensive statewide dialysis registry in India.
Methods
Nephrologists from various dialysis centers across Karnataka state were invited to participate. Data was captured from consenting centers, after ethics board clearance. Cloud based electronic repository (Amazon Web Space) with online platform (Renalyx NIS) was used. Only confirmed prevalent CKD-V pts on maintenance hemodialysis (HD) or peritoneal dialysis (PD) were included. Unlinked, anonymized demographics and clinical details were analyzed using SPSS, Version 16.0.
Results
2050 patients (70% male) from 32 hospitals were recruited. Mean age was 53.49 (±14.09) years. Mean BMI was 23.68. 1909 (93.1%) were on HD. Nearly 70% had dialysis vintage >1 year. Etiology wise, 801 patients (39.1%) had Diabetic Kidney Disease, 506 (24.7%) Hypertensive Nephrosclerosis, 272 (13.3%) Chronic glomerulonephritis and 92 (4.5%) chronic interstitial nephritis. At initiation of HD, 1378 (67%) had temporary catheters & 466 (22.7%) had arteriovenous fistulae (AVF). However 1691 (82.5%) prevalent pts had an AVF as current vascular access. While 56.4% were on 3/week HD, 33.2% were on 2/week HD. 121 patients (5.9%) were hepatitis C positive & 31 (1.5%) were hepatitis B positive. 8.7% pts were not on any blood pressure medications, 27.6% of pts were on 1 med, 27.7% were on 2 meds, 23.1% were on 3 or more meds. Of 104 patients (4.7%) on CAPD, 57.6% had percutaneous PD catheter insertion and 40.4 % had it surgically inserted. 81.7% were on 4 exchanges/day with 94% CAPD being manual.
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Conclusion
This study highlights wide differences in dialysis practices within the state of Karnataka in South India. The vast majority of the patients were on HD. Fistula first initiative needs greater focus. Granular data capture would provide more knowledge for improvement and policy.
Funding
- Private Foundation Support