Autodialysis in Morocco: how much longer can we wait?

Abstract

Introduction: autodialysis is the dialysis performed by the patient himself at a local center instead of a hemodialysis center. In Morocco, the practice
of hemodialysis dates back to 1970; however, an autodialysis center does not yet exist. The objective was to assess the potential medical fitness
and adherence of the patients to an autodialysis program. Methods: descriptive and analytical multicenter study conducted in March 2015 involving
patients from of eight hemodialysis centers in Casablanca (Morocco). The study was conducted in two steps: 1) a transversal assessment of the
medical potential to achieve autodialysis that included 556 patients; 2) a survey of the autodialysis membership that included 383 out of 556 patients
who were deemed eligible for autodialysis. Results: the average age was 54.63 ± 15.16 years; the average of hemodialysis duration was
85.9 ± 78.1 months. Diabetic nephropathy (22.7%) was the predominant cause of kidney disease. The assessment of medical potential to achieve
autodialysis highlighted that almost all of the patients were in good condition (93%), independent (81%), and those without major comorbidities
were less than 76 years old. Regarding the potential patients' adherence to autodialysis, among the 383 patients previously deemed suited for
autodialysis, 293 (76.5%) responded favorably to the proposal of self-dialysis. Conclusion: the practice of hemodialysis should be implemented in
a short time in Morocco because our patients' profile is perfectly suitable to this therapeutic method especially when they are young, in good general
condition, autonomous, without major comorbidities, and willing to learn.