The Status And Influencing Factors Of Dialysis Delay In Patients With End-stage Renal Disease

ObjectivesTo investigate the current status of dialysis delay among patients with end-stage renal disease who accept dialysis for the first time, and to explore the influencing factors of dialysis delay in order to provide theoretical evidence for interventions focusing on prompting patients with end-stage renal disease to accept dialysis timely.MethodsConveniently selected221patients with end-stage renal disease who was on dialysis for the first time from a Grade Ⅲ-A hospitals in Shandong Province during April1,2010and March31,2014. Collected patients’ social-demographic characteristics and data related to dialysis delay with questionnaires and clinical data by consulting their medical records. SPSS18.0was used to establish database and analyze the data. Statistical method included descriptive analysis, two sample t-test, chi-square test and multiple logistic regression.Results1. Among227patients,157patients existed dialysis delay, with82men (52.2%) and75women (47.8%).2. Univariate analysis showed the impact of professional types, per capita monthly income, awareness of clinical manifestations, awareness of reimbursement policy, history of nephrology dept visits within six months before dialysis, the first clinical department, diabetic nephropathy, chronic glomerulonephritis,respiratory tract infection,glomerular filtration rate(GFR), serum creatinine(SCr), serum 3. calcium, serum phosphorus, serum potassium, and hemoglobin on dialysis delay were statistically significant.4. Multiple logistic regression showed the independent influencing factors of dialysis delay were awareness of clinical manifestations, the first clinical department, history of nephrology dept visits,diabetic nephropathy, respiratory tract infection, chronic glomerulonephritis, hemoglobin and serum potassium.Conclusions1. The prevalence of dialysis delay among patients with end-stage renal disease was relatively high and the their disease was serious. Average GFR of all patients was (5.64±3.29)ml/min.1.73m2before first dialysis, while average GFR of delay group was (4.13±1.12)ml/min.1.73m2.2. Awareness of clinical manifestations, the first clinical department, history of nephrology dept visits, diabetic nephropathy,respiratory tract infection, chronic glomerulonephritis,hemoglobin and serum potassium were the influencing factors of dialysis delay among patients with end-stage renal disease.3. Health education among patients with end-stage renal disease isn’t sufficient yet. It is important to strengthen the propaganda about dialysis as to prompt patients to seek medical-help early and accept dialysis timely.