SURVIVAL OF PATIENTS WITH END-STAGE KIDNEY DISEASE UNDERGOING HAEMODIALYSIS IN BRUNEI DARUSSALAM.

Ruzita GHANI¹, Nurhanisah JOHAN¹, Morgan CHIEW¹, Josephine JAVINA¹, May Kyaw THET¹, Rahmat ULLAH¹, Suleman RAJPUT¹, Chiao Yuen LIM¹, Jackson TAN^1,2.

¹Department of Renal Services, Ripas Hospital, Bandar Seri Begawan, Brunei Darussalam BA1712.

²Universiti Brunei Darussalam, Jalan Tungku Link, Brunei Darussalam BE1410, Brunei Darussalam.

ABSTRACT

Background: Haemodialysis is the main modality of kidney replacement therapy in Brunei, accounting for more than 85% of all end stage kidney disease (ESKD) patients in the country. This study aims to evaluate the survival and factors associated with poor outcomes in incident ESKD patients undergoing haemodialysis in Brunei. Methodology: Data from all incident ESKD patients from 2018 to 2020 in Brunei were extracted from the Brunei Dialysis and Transplant Registry. Kaplan-Meier survival curves and Log-Rank test were performed for statistical significance. Results: 410 patients satisfied the inclusion/exclusion criteria and were included for statistical analysis. The total follow-up period for the 410 patients was 1167 months. Kaplan-Meier survival plots showed an overall actuarial patient survival of 93%, 86%, 74% and 64% at 6, 12, 18 and 24 months. Diabetic patients, with a survival of 93%, 84%, 71% and 59%, were significantly inferior to patients with other kidney diseases (95%, 92%, 83% and 81%) on Log Rank test at the same 6 monthly reference timepoints. Older patients and those of Chinese ethnicity have significantly lower survival. Conclusion: Haemodialysis patients in Brunei have a comparable 1-year survival with other countries, but slightly inferior survival beyond that. Comparing results from previous national studies, HD patients have inferior outcomes as opposed to PD and transplant patients. This study gives supporting evidence for the promotion of PD and transplant as the preferred modalities for ESKD patients in the country.

Keywords: Brunei, End Stage Kidney Disease, Haemodialysis, Kidney Replacement Therapy, Survival.

Corresponding author: Dr Jackson Tan, Consultant Nephrologist, Department of Renal Medicine, Ripas Hospital, Bandar Seri Begawan, Brunei Darussalam BA1712.

Brunei Int Med J.2021;17:136-144