[Causes of chronic renal failure and clinical status of patients during initiation of hemodialysis therapy in upper Silesian region].

The aim of this study was to evaluate the causes of chronic renal failure and clinical status of patients during the onset of hemodialysis therapy in Upper Silesian region. Medical documentation and questionnaires of 175 patients initiating hemodialysis therapy from November 1999 to October 2000 were analyzed. Concentrations of creatinine, calcium, phosphorus in serum, hemoglobin in blood, concomitance of hypertension, frequency of uremic symptoms, HBV and HCV infections, and occurrence of mature arterio-venous fistula before the first hemodialysis were assessed. The main causes of end stage kidney disease were: chronic glomerulonephritis (29%), diabetic nephropathy (27%), polycystic kidney disease (15%), interstitial (11%) and hypertensive (9%) nephropathy. The first contact with nephrologist for 30% of patients was the admission for the initiation of renal replacement therapy. 33% of patients were treated due to chronic renal failure shorter than 1 year. Only 53% of patients had matured arterio-venous fistula during the first hemodialysis session. Anemia, hyperphosphatemia (>1.7 mmol/l) and arterial hypertension were found in 87%, 49.5% and 82% of patients starting hemodialysis therapy, respectively. The main symptoms of chronic uremia were weakness, pruritus, swelling, nausea and insomnia.

CONCLUSIONS

Most of patients with chronic renal failure is referred to the nephrologists at the advanced stage of the disease. It is especially true for patients with diabetic nephropathy.