%0 Journal Article
%T Circumstances of Initiation of Hemodialysis: Importance of Nephrological Follow-Up
%A Moussa Traore
%A Soriba Bangoura
%A Mohammed Lamine Tegui Camara
%A S&#232
%A m&#232
%A vo G&#233
%A &#224
%A vanie Dannon
%A Fouss&#233
%A ny Diakite
%A Mamadou Saliou Balde
%A Aly Traore
%A Mohammed Camara
%A Marthe Sidibe
%A Mouctar Diallo
%A Aminata Diallo
%A Mohammed Lamine Kaba
%J Open Journal of Nephrology
%P 26-40
%@ 2164-2869
%D 2025
%I Scientific Research Publishing
%R 10.4236/ojneph.2025.151004
%X <b>Introduction: </b>The timing of initiation of renal replacement therapy (RRT) depends not only on the level of residual renal function, estimated by calculating glomerular filtration rate (GFR), but also on patients&#8217; clinical condition and local medical practices. The aim of this study was to investigate the value of early nephrological follow-up for patients during and after initiation of hemodialysis. <b>Patients and </b><b>Methods</b><b>: </b>prospective descriptive and analytical study lasting 3 months, from September 01 to November 30, 2022, on chronic hemodialysis patients at Donka National Hemodialysis Center. Two groups were included, according to the period of follow-up prior to initiation of hemodialysis: the first, known as &#8220;early referral&#8221;, included patients who had been followed for a minimum of six months prior to initiation of &#8220;planned hemodialysis&#8221;; the second, known as &#8220;late referral&#8221;, included patients who had had less than six months of nephrological follow-up prior to initiation of &#8220;emergency hemodialysis&#8221;. <b>Results-Discussion: </b>We noted 70 cases of CKD. The mean age was 46.43 &#177; 14.7 years, with extremes of 17 and 75 years. Females were predominant, with a sex ratio M/F = 0.7. Clinical signs on admission were dominated by anemia syndrome (100%) and uremic syndrome (74.3%). Mean creatinine clearance was 5.475 &#177; 3.4 ml/min/1.73 m<sup>2</sup>. The majority of our patients had been referred late (81.4%), while 18.6% had been referred early before being placed on hemodialysis. Apart from six cases of permanent central catheterization, all our patients (91.4%) had started their iterative hemodialysis on a temporary central catheter (femoral or jugular). After bivariate analysis, we found that late referral was significantly linked to certain factors, such as diabetes comorbidity (p = 0.02), uremic intoxication (p = 0.02), and temporary central catheterization (femoral with p = 0.001 and jugular with p = 0.013). Permanent or tunneled central catheterization was also significant, with identical rates in both groups. Mean creatinine levels were significantly higher in the early referral group (198.270 &#177; 101.2 mg/L; p = 0.020). However, the late referral group was more prone to excess mortality during the first three months of dialysis initiation, although there was no statistically established link between referral mode and mortality. <b>Conclusion: </b>Early nephrological referral is still beneficial for a better quality of life in iterative hemodialysis.
%K Circumstances
%K Hemodialysis Initiation
%K Early Nephrological Follow-Up
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=140324