CHARACTERISTIC OF ROMA ON HEMODIALYSIS TREATMENT IN NORTH MACEDONIA
Keywords:
Roma, Hemodialysis, SurvivalAbstract
The aim of this study was to find the differences between Roma and non-Roma Hemodialysis (HD) patient in their demographic and clinical parameters in Republic of North Macedonia. The Department of Nephrology in Skopje, the Republic of North Macedonia, engaged 169 HD patients in a prospective research on demographic features and survival. Patients were observed for a total of 37 months. Patients with HD were questioned regarding significant demographic characteristics, including ethical autonomy. With an AGE Reader, skin autoflurescence was assessed a measure of Advanced Glycation End Products (AGEs). The two dietary records, one from autumn and one from spring, were gathered from HD patients in order to examine the daily calorie, protein, and AGE intake and investigate the possibility of seasonal fluctuation. Regarding the Hemodialysis treatment, we discovered that Roma had statistically significant (p=0.023) lower participation or none of them were included in the extended duration of HD treatment programme, as they refused to remain in the HD unit for longer than the minimum time required for HD treatment. At 37 months, 49 out of 169 HD patients had died, or 29%. In the univariate Cox regression analysis, we discovered that alcohol consumption, age, hypertension as a cause of end-stage renal disease (ESRD), and Hepatitis B were related with a shorter survival time. Age, alcohol, hypertension, and Hepatitis B were all independent survival inhibitors in our HD patients.We found no difference in the survival of Roma and non-Roma HD patients. In this study was found a short HD session time in Roma patients. Roma hemodialysis patients suffer specific obstacles, such as stigma, prejudice, cultural restrictions, financial load, social isolation, and psychological distress. Knowing these obstacles and the cultural beliefs and practises of Roma patients can assist healthcare providers in providing culturally sensitive treatment and assistance to this vulnerable community.
References
American Diabetic Association. "Revisions for the 2004 Clinical Practice Recommendations." Diabetes Care 27 (2004).
European Association for the Study of Diabetes. (2017). Roma and diabetes: the challenges and opportunities. Retrieved from https://www.easd.org/news/press-releases/roma-and-diabetes-the-challenges-and-opportunities.html
European Kidney Health Alliance. (2017). The psychosocial aspects of end-stage kidney disease. Retrieved from https://www.eurokidney.org/patient-information/psychosocial-aspects-end-stage-kidney-disease
Goldberg, T., Cai, W., Peppa, M., Dardaine, V., Baliga, B.S,. Uribarri, J., & Vlassara, H. (2004). Advanced glycoxidation end products in commonly consumed foods. J Am Diet Assoc 104:1287-1291
Hypertension Diagnosis and Treatment (Guideline). Institute for Clinical Systems Improvement,Bloomington,MN, 2008.
Meerwaldt, R., et al. (2005). "Skin autofluorescence, a measure of cumulative metabolic stress and advanced glycation end products, predicts mortality in hemodialysis patients." J.Am.Soc.Nephrol. 16.12 687-93
Osmani, A. (2018). The health of the Roma in Europe: challenges and opportunities. Public Health, 152, 36-40. https://doi.org/10.1016/j.puhe.2017.10.018
Rózsa, L., Szabó, Z., & Simon, M. (2010). In Hungary, there are disparities in availability to renal replacement therapy for Romani patients. 15(3) Ethnicity & Health, 313-327. https://doi.org/10.1080/13557858.2010.496249
Saran, R., Robinson, B., & Abbott, K.C. (2018). US Renal Data System 2017 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2018; 71 (Svii,S1-S676)
The United States Department of Agriculture (2002) Nutritive Value of Foods. http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/hg72/hg72_2002.pdf.
Veselá, K., Kříž, J., & Zámečník, J. (2016). Population of Roma and kidney transplantation in the Czech Republic. Research on Kidney and Blood Pressure, 41(6), 569-576. https://doi.org/10.1159/000449091
World Health Organization. (2017). Roma and health. Retrieved from https://www.euro.who.int/en/health-topics/noncommunicable-diseases/roma-and-health
World Health Organization. (2017). Hemodialysis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/hemodialysis
WHO/DIMDI. International classification of disease and related health problems 10th revision. http://apps.who.int/classifications/apps/icd/icd10online/ . 2006.
