An analysis of (he effectiveness and benefits of peritoneal dialysis and haemodialysis using Nigerian made PD fluids.

Abstract

Haemodialysis (HD) and peritoneal dialysis (PD) remains the cornerstone of management of patients with renal failure in developing countries as renal transplantation is just developing in most. Although both HD and PD are cost intensive, specific advantages and disadvantages have been identified with either of them. Comparative assessment of their effectiveness, benefits and cost will assist in providing a rational basis for preference of one or the other especially in third world countries where renal replacement therapy remains unaffordable and therefore relatively inaccessible to majority of patients. We therefore conducted this prospective randomised study to compare the effectiveness, benefits, cost and complications of acute or intermittent PD (IPD) and HD using locally manufactured PD fluids. Two groups of twenty patients with renal failure matched for age and clinical diagnosis were managed with IPD and HD and the effectiveness, costs and complications of both modalities compared. We found that both were comparably effective in the control of uraemia with significant reductions in the serum urea, creatinine and potassium from 29.2 ± 7.2 mmol/L, 1693.7 ± 580.5µmol/L and 4.8 ± 1.2 mmol/L to 13.2 ± 4.6 mmol/L, 796.0 ± 458.0µmol/ L and 3.3 ± 0.6 mmol/L respectively for HD (P<0.05) and 34.4 ±9.0 mmol/L, 1536.0 ±832.5µmol/L and4.8± 1.3mmol/ L to 14.6 ±7.5 mmol/L, 830.0 ±570.7µmol/L and 3.9 ± 0.8 mmol/L respectively for HD (P<0.05).