Background: Acute intradialytic complications remain a major challenge among patients undergoing
maintenance hemodialysis and contribute substantially to morbidity, treatment interruption, and poor
patient outcomes. Understanding the factors associated with these complications is essential for
improving dialysis care and patient safety.
Objective: To identify the determinants of acute intradialytic complications among patients undergoing
maintenance hemodialysis at Kenyatta National Hospital (KNH).
Methods: The study was conducted in Kenyatta National Hospital main renal unit using a descriptive
cross-sectional study design. Approval was sort from Kenyatta National Hospital-University of Nairobi
ethics and research committee (p144/02/2025). Simple random sampling was used to select 40 nurses.
Data was collected through interviewer-administered questionnaires that included both open and close-
ended questions. Analysis was done using statistical package for social sciences (SPSS) version 26.
Results: The most reported Intradialytic complications included restlessness, chest pain, and chills.
Patient related factors significantly associated with complications were diabetes mellitus and
cardiovascular disease (p˂0.05). Alpha –blocker use was the only treatment related factor significantly
associated with complications (p=0.000). Despite 97.4% (n=37) of nurses demonstrating good
knowledge and skill levels, none of the nurse related factors, including demographics, training, or
experience, showed a statistically significant relationship with occurrence of intradialytic complications
(p˃0.05). Similarly, treatment and care protocol related factors such as access to standard operating
procedures (SOPs), training frequency, and perceived autonomy did not show significant associations
with complication occurrence (p˃0.05).
Discussion: Diabetes mellitus, cardiovascular disease, and use of alpha-blockers were significantly
associated with intradialytic complications, while patient, nurse, and institutional protocol factors
showed no statistical significance, suggesting that comorbidity burden and specific pharmacologic
regimens may play a greater role in complication risk than staff competence or general protocol
availability.
Conclusion: Acute intradialytic complications remain prevalent at KNH, with diabetes, cardiovascular
disease, and alpha-blockers use being key contributors. Nurse and institutional protocol related factors
did not significantly influence complication rates, indicating a need for individualized patient level
interventions and stronger implementation of evidence based protocols.
