HAEMODIALYSIS NON-GOVERNMENTAL ORGANISATION (NGO) CENTRES
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1 HAEMODIALYSIS IN NON-GOVERNMENTAL ORGANISATION (NGO) CENTRES Stock and Flow Death on Haemodialysis and Transfer to PD NGO Haemodialysis Centres Haemodialysis Patient Characteristics Survival Analysis Work related rehabilitation and quality of life Haemodialysis practices Dyslipidaemia in HD patients Treatment of Renal Bone Disease Management of Blood Pressure Management of Anaemia Nutritional status Prevalence of anti-hcv antibodies and HBsAg 77
2 3.2 HAEMODIALYSIS IN NON-GOVERNMENTAL ORGANISATION (NGO) CENTRES 3.2. STOCK AND FLOW Table 3.2.0: Stock and Flow HD patients, NGO Centres New patients Died Transferred to PD Transplanted Lost to Follow up On HD at 3 st December Figure 3.2.0: Stock and Flow HD patients, NGO Centres New patients on RRT at 3 st December 3000 No. of patients
3 3.2.3 DEATH ON HAEMODIALYSIS, NGO CENTRES Table : Death Rate on HD and Transfer to PD, NGO Centres No. of patients at risk Deaths Death rate % Transfer to PD Transfer to PD rate % All Losses All Losses rate % Figure : Death Rate on HD, NGO Centres, Annual death rate Death rate %
4 Table : Causes of Death, NGO Centres Causes of death No. % No. % No. % No. % Cardiovascular Died at home Sepsis GIT bleed Cancer Liver disease Others Unknown Total
5 3.2.4 NGO HAEMODIALYSIS CENTRES Table : Centre Distribution of HD patients, NGO Centres, 2002 Centre No percent No.on RRT at 3 st December AMD Rotary Dialysis Centre, Penang Aixin-NKF Dialysis Centre Amitabha Haemodialysis Centre 25 4 Bakti-NKF Dialysis Centre, Kelang Batu Pahat Rotary Haemodialysis Centre Berjaya NKF Dialysis Centre, Petaling Jaya Buddhist Tzu Chi Dialysis Centre, Butterworth Buddhist Tzu-Chi Dialysis Centre, Jitra Buddhist Tzu-Chi Dialysis Centre, Penang 39 0 CHKMUS-MAA Medicare Charity Dialysis Centre 83 3 Charis-NKF Dialysis Centre, Cheras Che Eng Khor Haemodialysis Centre 33 3 Fo Yi Haemodialysis Centre 30 4 Haemodialysis Association Klang 43 5 JB Lion MAA-Medicare Charity Dialysis KAS-Rotary/NKF Dialysis Centre, Sarawak 26 7 KB Rotary-MAA Dialysis Centre 27 8 Kluang Rotary Haemodialysis Centre 33 9 Kuala Lumpur Lions Renal Centre Lion Club of Alor Setar-NKF Dialysis Centre 32 2 MAA-Medicare Charity Dialysis Centre, Butterworth MAA-Medicare Charity Dialysis Centre, Cheras MAA-Medicare Charity Dialysis Centre, Kajang MAA-Medicare Charity Dialysis Centre, Kuala Lumpur MAA-Medicare Charity Dialysis Centre, Teluk Intan MAA-Medicare Kidney Charity Fund, Kota Kinabalu 9 28 Mersing Rotary Haemodialysis Centre Moral Uplifting-NKF Dialysis Centre, Ipoh Muar Lions Renal Centre NKF Dialysis Centre, Kuala Lumpur Pahang Buddhist Association Haemodialysis Centre 25 8
6 32 Penang Caring Dialysis Centre Persatuan Buah Pinggang Sabah Persatuan Bulan Sabit Merah Cawangan Miri Persatuan Dialisis Kurnia PJ 7 36 Persatuan Membaiki Akhlak Che Luan Khor Pertubohan Hemodialisis Pasar Meru Pertubuhan Bakti Fo En Bandar Kulim Pertubuhan Hemodialisis Seberang Perai Selatan 3 40 Pontian Rotary Haemodialysis Centre Province Wellesley Renal Medifund Dialysis Centre 5 42 Pusat Dialisis Klinik Waqaf An-nur Pusat Dialisis Terengganu/NKF Pusat Hemodialisis Darul Iltizam Pusat Hemodialisis Manjung-NKF Pusat Hemodialisis Mawar N. Sembilan, Bahau Pusat Hemodialisis Mawar N. Sembilan, Lukut Pusat Hemodialisis Mawar N. Sembilan, Seremban Pusat Hemodialisis Rotary Kota Tinggi Pusat Hemodialisis Rotary Kulai Pusat Hemodialisis SJAM Bacang Melaka Pusat Hemodialisis Yayasan Felda Pusat Hemodialisis Zakat 5 54 Pusat Muhibah Hemodialisis Pesatuan Tionghua 77 3 Segamat 55 Pusat Rawatan Dialisis Yayasan Pembangunan 23 Keluarga Johor-NKF 56 Pusat Rawatan Islam, Kuala Lumpur Pusat Rawatan Islam, Petaling Jaya Rotary Club Damansara-NKF Dialysis Centre, Kepong Rotary Club Tawau Tanjung Haemodialysis Centre Rotary Haemodialysis Centre, Johor Bahru 35 6 SJAM-KPS Haemodialysis, Kelang Sibu Kidney Foundation Haemodialysis Centre Superkids Trinity-NKF Dialysis Centre, Alor Setar The Nayang-NKF Dialysis Centre, Setapak The Penang Community Haemodialysis Society Woh Peng Cheang Seah Dialysis Centre 4 82
7 67 Yayasan Dialisis Pertubohan Pendidikan Akhlak-NKF, 29 Taiping 68 Yayasan Hemodialisis Kebajikan Southern Melaka Yayasan Kebajikan SSL Heamodialisis
8 3.2 HAEMODIALYSIS PATIENTS CHARACTERISTICS, NGO CENTRES Table : Age Distribution of Dialysis Patients, NGO Centres New Dialysis patients years years years years years years >65 years Dialysing at 3 st December years years years years years years >65 years Table : Patients Characteristics, NGO Centres New Dialysis patients Mean age + sd % Male % Diabetic % HbsAg % Anti-HCV
9 3.2.6 SURVIVAL ANALYSIS, NGO CENTRES Table 3.2.0: HD Patient Survival, NGO Centres Interval % survival SE No % survival SE No % survival SE No (months) Interval % survival SE No % survival SE No % survival SE No (months) No. = number at risk SE = standard error Figure 3.2.0: HD Patient Survival, NGO Centres Kaplan-Meier survival estimates, by.00 Yr 2002 Cumulative survival Yr 200 Yr 2000 Yr 999 Yr Duration in months 85
10 Table 3.2.: HD Technique Survival, NGO Centres Interval % survival SE No % survival SE No % survival SE No (months) Interval % survival SE No % survival SE No % survival SE No (months) No. = number at risk SE = standard error Figure 3.2. HD Technique Survival by year of entry, NGO centres Kaplan-Meier survival estimates, by.00 Yr 2002 Cumulative survival Yr 200 Yr 2000 Yr 999 Yr Duration in months 86
11 3.2.7 WORK RELATED REHABILITATION AND QUALITY OF LIFE ON HAEMODIALYSIS, NGO CENTRES Table 3.2.2: Work Related Rehabilitation on HD, NGO centres REHABILITATION STATUS No. % No. % No. % No. % Full time work for pay Part time work for pay Able to work but unable to get a job Able to work but not yet due to dialysis schedule Able but disinclined to work Home maker Full time student Age<5 years Retired Age>65 years Unable to work due to poor health Total
12 Table 3.2.3: Quality of Life on Haemodialysis, NGO Centres QOL Index Summated Score No. % No. % No. % No. % 0 (Worst QOL) (Best QOL) Total
13 3.2.8 HAEMODIALYSIS PRACTICES IN NGO CENTRES Table 3.2.4: Vascular Access on Haemodialysis, NGO Centres Access types No % No % No % No % Wrist AVF BCF* Venous graft Artificial graft PERMCATH Temporary CVC* Total * BCF = Brachiocephalic fistula * CVC = Central venous catheter Table 3.2: Difficulties reported with Vascular Access, NGO Centres Access difficulty No % No % No % No % Difficulty with needle placement Difficulty in obtaining desired blood flow rate Other difficulty No difficulty Total
14 Table 3.2.6: Complications reported with Vascular Access, NGO Centres Complication No. % No. % No. % No. % Thrombosis Bleed Aneurysmal dilatation Swollen limb Access related infection, local/systemic Distal Limb ischaemia Venous outflow obstruction Carpal tunnel Other No complication Total Table 3.2.7: Blood Flow Rates in NGO HD Units Blood flow rates No. % No. % No. % No. % <50 ml/min ml/min ml/min ml/min ml/min > 350 ml/min Total
15 Table 3.2.8: Number of HD Sessions per week, NGO HD Units HD sessions Per week No. % No. % No. % No. % Total Table 3.2.9: Duration of HD in NGO HD Units Duration of HD per session No. % No. % No. % No. % <3 hours hours hours hours hours >5 hours Total Table : Dialyser membrane types in NGO HD Units Dialyser membrane No. % No. % No. % No. % Cellulosic Cellulose acetate Synthetic Total
16 Table 3.2.2: Dialyser Reuse Frequency in NGO HD Units Dialyser reuse frequency No. % No. % No. % No. % * > Total * is single use i.e. no reuse Table : Dialysate Buffer used in NGO HD Units Dialysate buffer No. % No. % No. % No. % Acetate Bicarbonate Total
17 Table : Distribution of Prescribed KT/V, NGO Centres Median LQ UQ % > Figure : of Prescribed KT/V by year Kt/v 93
18 3.2.9 DYSLIPIDAEMIA IN HD PATIENTS, NGO CENTRES Table : Distribution of serum Cholesterol Concentrations (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients < 5.3 mmol/l Figure : of serum cholesterol concentration by year Serum cholesterol (mmol/l) 94
19 Table 3.2: Distribution of serum Triglyceride (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients < 3 mmol/l Figure 3.2: of serum triglyceride concentration by year Serum triglyceride (mmol/l) 95
20 Table : Distribution of serum LDL (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients <5 mmol/l Figure : of serum LDL by year Serum LDL (mmol/l) 96
21 Table : Distribution of serum HDL (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients < 2mmol/L Figure : of serum HDL by year Serum HDL (mmol/l) 97
22 3.2.0 MANAGEMENT OF RENAL BONE DISEASE, NGO CENTRES Table : Treatment for Renal Bone Disease, HD patients, NGO Centres % on CaCO 3 % on Al(OH) 3 % on Vitamin D Table : Distribution of serum Phosphate (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients <.6 mmol/l Figure : of serum Phosphate by year Serum phosphate (mmol/l) 98
23 Table : Distribution of serum Calcium (mmol/l), HD patients, NGO Centres Median LQ UQ % Patients > 2.2 & <2.6 mmol/l Figure : of serum Calcium by year Serum calcium (mmol/l) 99
24 Table 3.2.3: Distribution of serum ipth (ng/l), HD patients, NGO Centres Median LQ UQ % Patients > 00 & < 250 ng/l Figure 3.2.3: of serum ipth by year Serum Intact PTH (ng/l) 00
25 3.2. MANAGEMENT OF BLOOD PRESSURE, NGO CENTRES Table : Treatment for hypertension, HD patients, NGO Centres No. % on antihypertensives % on antihypertensives % on 2 antihypertensives % on 3 antihypertensives Table : Distribution of Systolic BP without anti-hypertensives, HD patients, NGO Centres Median LQ UQ % Patients < 60 mmhg Figure : of Systolic BP without anti-hypertensives by year Systolic BP (mmhg) 0
26 Table : Distribution of Diastolic BP without anti-hypertensives, HD patients, NGO Centres No. of No. of Median LQ UQ % Patients < 90 mmhg Figure : of Diastolic BP without anti-hypertensives by year Diastolic BP (mmhg) 02
27 Table : Distribution of systolic BP on anti-hypertensives, HD patients, NGO Centres Median LQ UQ % Patients < 60 mmhg Figure : of systolic BP on anti-hypertensives by year Systolic BP (mmhg) 03
28 Table : Distribution of diastolic BP on anti-hypertensives, HD patients, NGO Centres Median LQ UQ % Patients < 90 mmhg Figure : of diastolic BP on anti-hypertensives by year Diastolic BP (mmhg) 04
29 3.2.2 TREATMENT OF ANAEMIA, NGO HD CENTRES Table : Treatment for Anaemia, HD patients, NGO Centres No % on rhuepo % received blood transfusion % received oral iron % received parenteral iron Table : Distribution of rhuepo dose per week, HD patients, NGO Centres No. of patients % on 2000 u/week % on u/week % on u/week % on u/week % on u/week % on >2000 u/week
30 Table : Distribution of serum Iron without rhuepo, HD patients, NGO Centres Median LQ UQ % Patients > 0 umol/l Figure : of serum Iron without rhuepo by year Serum iron (umol/l) 06
31 Table : Distribution of serum Iron on rhuepo,hd patients, NGO Centres Median LQ UQ % Patients > 0 umol/l Figure : of serum Iron on rhuepo by year Serum iron (umol/l) 07
32 Table 3.2.4: Distribution of serum Transferrin Saturation without rhuepo, HD patients, NGO Centres Median LQ UQ % Patients > 20% Figure 3.2.4: of serum Transferrin Saturation without rhuepo by year Transferrin saturation (%) 08
33 Table : Distribution of serum Transferrin Saturation on rhuepo, HD patients, NGO Centres Median LQ UQ % Patients > 20% Figure : of serum Transferrin Saturation on rhuepo by year Transferrin saturation (%) 09
34 Table : Distribution of serum Ferritin without rhuepo, HD patients, NGO Centres Median LQ UQ % Patients > 00 ug/l Figure : of serum Ferritin without rhuepo by year Serum ferritin (ug/l) 0
35 Table : Distribution of serum Ferritin on rhuepo, HD patients, NGO Centres Median LQ UQ % Patients > 00 ug/l Figure : of serum Ferritin on rhuepo by year Serum ferritin (ug/l)
36 Table : Distribution of Haemoglobin without rhuepo, HD patients, NGO Centres Median LQ UQ % Patients <0 g/dl % Patients >0 & <2 g/dl % Patients >2 g/dl Figure : Cumulative Distribution of Haemoglobin without rhuepo by year Hb (g/dl) 2
37 Table : Distribution of Haemoglobin on rhuepo, HD patients, NGO Centres Median LQ UQ % Patients <0 g/dl % Patients >0 & <2 g/dl % Patients >2 g/dl Figure : of Haemoglobin on rhuepo by year Hb (g/dl) 3
38 3.2.3 NUTRITIONAL STATUS OF HD PATIENTS, NGO CENTRES Table : Distribution of serum Albumin (g/l), HD patients, NGO Centres Median LQ UQ % Patients >40g/L Figure : of serum Albumin by year Serum albumin (g/l) 4
39 Table : Distribution of Body Mass Index, HD patients, NGO Centres Median LQ UQ % Patients <8 % Patients >8 & <25 % Patients > Figure : of BMI by year BMI (Kg/M 2 ) 5
40 3.2.4 SEROLOGICAL STATUS, HD PATIENTS, NGO CENTRES Table : Prevalence of positive anti-hcv and HbsAg, HD patients, NGO Centres No % HBsAg positive % anti-hcv positive Figure : Prevalence of positive anti-hcv and HbsAg HD patients, NGO Centres HBsAg anti-hcv 25 Prevalence %
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