Assessment of haemodialysis adequacy among esrd in sokoto using urea reduction ratio and serum albumin concentration

Introduction: Among patients with end stage renal disease (ESRD) who are treated with haemodialysis, solute clearance and nutritional adequacy are determinants of mortality. The aim of this study was to assess the adequacy of haemodialysis among patients with ESRD in Sokoto. Material and Methods: This was a prospective study that included fifty three (53) ESRD patients that are on maintenance haemodialysis. Each patient was dialyzed thrice using same dialyzer after reprocessing with 4% formaldehyde. Demographic and socio-economic data were obtained using questionnaires administered to each patient. Blood samples were collected at the baseline, before and after each haemodialysis session and the urea, albumin and total protein were estimated for. Urea reduction ratio (URR) was calculated and used as a measure of haemodialysis adequacy. Results: The mean age of the patients was 40.49 ±2.00years. The mean urea reduction ratio was 57.83±0.83%, URR after first dialyzer use (i.e. 57.93 ±1.52%), was compared with URR after second and third use (i.e. 57.97 ±1.47% and 57.59 ± 1.35%) and p-values of no statistical significance (p>0.05) were obtained, pre-dialysis urea was significantly higher than post-dialysis urea (p<0.05). The mean BMI was 25.14±0.94kg/m2, albumin and total protein concentrations were less than reference ranges right from baseline. There were no significant difference (p>0.05) between pre-dialysis and post-dialysis albumin and total protein concentrations. Conclusion: The study showed that haemodialysis is inadequate in the studied population; use of same dialyzer up to three times was effective and safe. Albumin is not a reliable marker of malnutrition in ESRD patients.