Predictors of physical incapacity degree to chronic hemodialysis patients in Kinshasa : Key role of the residual diuresis

Objective Identifying predictors of physical incapacity degree in patients on chronic hemodialysis in Kinshasa. Methods Bicentric analytical study, between January 2007 and July 2013. Degree of physical handicap was evaluated at 6 months of hemodialysis based on the scale of Rosser. Logistic regression sought the predictors of no or light physical incapacity (Rosser < 3) vs. moderate to maximum (Rosser ≥ 3). P was set at 0.05. Results One hundred twenty-seven patients (127) patients received at least 6 months of hemodialysis (53.3 ± 11 years; 73.2 % male), 79 (62.2 %) had no or light incapacity and 48 (37.8 %) moderate to maximum. Predictors of lower physical incapacity in univaried analysis were: secured funding, high socioeconomic level, lack of diabetes mellitus, high body weight, normal systolic and diastolic blood pressure, residual diuresis 3 months later, hemoglobin and hematocrit, low comorbidity, arteriovenous fistula, erythropoietin, at least 12 hours of hemodialysis per week and lack of intradialytic complications. After logistic regression, a high residual diuresis 3 months of hemodialysis has proved an independent predictor of lower physical Incapacity (aOR 0.998; P = 0.024) next to the lack of diabetes mellitus (aOR 0.239; P = 0.024), good control of systolic (aOR 0.958; P = 0.013) and diastolic (aOR 1.089; P = 0.003) blood pressure and the use of erythropoietin (aOR 5.687; P = 0.004). Conclusion Preserving residual diuresis is associated with lower physical incapacity and must be integrated in the management in hemodialysis.