Halle, Marie Patrice University of Douala - Faculty of medicine and pharmaceutical science of Douala, Douala general hospital - Department of internal medicine, Cameroon , Tsinga, Lionel University of Douala - Faculty of medicine and pharmaceutical science of Douala, Douala general hospital - Department of internal medicine, Cameroon , Fottsoh, Arnold Fokam Ministry of Public Health - National Malaria Control Programme- Littoral Regional Unit, Cameroon , Kaze, François Folefack University of Yaounde I - Faculty of medicine and biomedical sciences, Cameroon , Sone, Albert Mouelle University of Douala - Faculty of medicine and pharmaceutical science of Douala, Douala general hospital - Department of internal medicine, Cameroon , Ashuntantang, Gloria University of Yaounde I - Faculty of medicine and biomedical sciences, Faculty of medicine and pharmaceutical science of Douala, Douala general hospital - Department of internal medicine, Cameroon

Does Timing of Nephrology Referral Influence Outcome among Patients on Maintenance Hemodialysis in Cameroon?

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Objective. To assess the influence of the timing of nephrology referral on adverse outcomes in patients undergoing chronic haemodialysis (HD) and to identified associated factors to mortality in a referral hospital of Cameroon. Methods. A retrospective study including patients with ESKD who started HD in Douala general hospital from January 2008 to December 2011. Socio demographic and relevant clinical data including date of first nephrologists’ consultation, stage of CKD at presentation, presumed aetiology of CKD and starting date of HD were reviewed. Early referral (ER) was defined as first nephrologists’ consultation at least four months before initiation of HD, and LR as less than four months prior to dialysis. Study outcomes were morbidities, type of vascular access, withdrawal and mortality at one, three, six and twelve months on dialysis. Results. We recruited 188 participants. 66.5% of them were males, and the mean age was 46.8±14.7 years. ERs accounted for 29.8% of the population. Emergency dialysis on a temporary catheter was more frequent for LRs (p=0.000). During the period of dialysis, hospitalization and withdrawal rates were similar between both group (p= 0.76 and p=0.25). From zero to six months, the cumulative survival of ER patients was better (p=0.02) but at one year the difference was no longer significant (p=0.62). Factors associated to high mortality were male sex (p=0.007), diabetes mellitus (p= 0,006) hospitalization (p=0,002) and pulmonary oedema at initiation (p=0,004). Conclusion. One year outcome of HD patients is little modified by the timing of referral; it is more affected by co morbidity and initial morbidity.

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hemodialysis , nephrology , Douala

Health Sciences an‎d Diseases

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