Dr. Md. Rezaul Alam, Dr. Rafiqul Hasan and Dr. Ferdous Jahan
Background: Maintenance hemodialysis (MHD) is vital for managing end-stage renal disease (ESRD), but it requires careful prescription of dialysis frequency, session duration, and medications. Common complications include cardiovascular issues, electrolyte imbalances, and infections, affecting patient outcomes. This study aimed to evaluate current prescription practices and identify prevalent complications in maintenance hemodialysis (MHD) patients.
Methods: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2023 to February 2024. A total of 57 end-stage (Stage-V) renal disease patients over the age of 18, undergoing maintenance hemodialysis 2 or 3 times per week, were purposively selected for this study. Information regarding their demographic and clinical characteristics, comorbidities, and current medications was collected. The data were then processed, analyzed, and presented using MS Office tools.
Results: Cardiovascular, gastrointestinal, and anti-diabetic drugs were prescribed in 63.2%, 71.9%, and 54.4% of participants, respectively. Calcium channel blockers and ACE inhibitors were used by over 20% of patients, while 64.9% received proton pump inhibitors. Half of the patients (50.9%) were on oral anti-diabetics. In this study, 63% of participants were receiving maintenance hemodialysis twice a week, while 37% were undergoing it three times per week. In over 40% of participants, chest pain and muscle cramps, and in more than 25%, pneumonia, nausea, vomiting, itching, and anemia were identified as intradialytic complications. These were more common in patients undergoing maintenance hemodialysis twice weekly, except for anemia and volume overload.
Conclusion: Cardiovascular, gastrointestinal, and anti-diabetic drugs are commonly prescribed for maintenance hemodialysis (MHD) patients, with calcium channel blockers, ACE inhibitors, proton pump inhibitors, and oral anti-diabetics being the most frequent. Some MHD patients may experience complications such as nausea, muscle cramps, fever, chest pain, and back pain.
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