Prevalence of high interdialytic weight gain and its associated factors among patients receiving hemodialysis at Kiruddu and Mulago National Referral Hospitals

Abstract

Introduction: Majority of the patients with chronic kidney (CKD) disease in Uganda present to the renal clinics when they have progressed to End Stage Kidney Disease (ESKD). Proper Management of patients with ESKD requires timely hemodialysis sessions, strict diet and fluid intake restrictions and failure to comply to these may cause a high Interdialytic weight gain (IDWG). High IDWG increases the risk of cardiovascular and respiratory complications which in the end results into high mortality rates. However, there is paucity of information regarding the prevalence and factors associated with high IDWG among patients undergoing treatment of ESKD in Uganda. Thus, this study aimed to determine the prevalence of high interdialytic weight gain and associated factors among hemodialysis patients at KNRH and MNRH. Objective: The study aimed at determining the prevalence of high IDWG and its associated factors among patients receiving hemodialysis at Kiruddu and Mulago Referral hospital. Methods: This was a cross sectional study carried out at Kiruddu and Mulago National Referral Hospitals. The study included 188 ESKD patients who were on hemodialysis during the month of August 2022 who met the eligibility criteria. The patients were sampled consecutively as they came for their hemodialysis sessions. The outcome variable was high IDWG which was an IDWG ≥4.5% of the dry bodyweight. The independent variables included age, gender, occupation, education level, underlying comorbidities, dialysis vintage, daily urine output, dietary restrictions, dialysis session duration, baseline creatine and GFR results. Data were entered using Epidata and analyzed using STATA 14. Results: The prevalence of high IDWG was 36.7% (95% CI: 11.6 -71.9). Sex (adjusted Prevalence Ratio (aPR)-0.92, 95% CI: 0.88- 0.96), daily urine output (aPR – 0.77, 95% CI: 0.61 – 0.97) and diabetes mellitus (aPR-0.87, 95% CI: 0.84-0.90) were significantly associated with high IDWG.xi Conclusion: The prevalence of high IDWG was high. Being female, diabetes mellitus and having a daily urine volume of more than 200mls a day were negatively associated with high IDWG among patients receiving hemodialysis at KNRH and MNSH. Target weight should be frequently monitored and reported by the doctors for better management of IDWG. .