Dissertation (MMED Internal Medicine)The prevalence and mortality due to end stage kidney disease (ESKD) are estimated to be high in Sub-Saharan Africa. Effective haemodialysis reduces complications and promotes better outcomes. Achieving haemodialysis adequacy is challenging in haemodialysis management. In Tanzania, little is known on hemodialysis adequacy in patients with ESKD particularly in Dodoma city. Haemodialysis adequacy refers to the dose of dialysis measured enough to uphold an optimal long-term clinical outcome. Objective: To determine the prevalence and predictors of haemodialysis adequacy among patients with End Stage Kidney Disease attending haemodialysis centres in Dodoma city, Tanzania. Methods: A cross-sectional analytical hospital based study was conducted from February, 2020 to July, 2020. Convenience sampling method was used to enroll the study participant. Haemodialysis adequacy was measured using clearance of urea multiplying with treatment duration in hours and then dividing by volume distribution of urea (Kt/v) and Urea Reduction Ratio (URR) levels, the minimum optimal dose targeted for adequacy haemodialysis is Kt/v of ≥ 1.2 and URR is ≥ 65% for thrice weekly dialysis patients. Data were analyzed using SPSS version 25. Chi-square test was used to determine bivariate association of the key selected variables and Logistic regression was used to determine the independent predictors of hemodialysis adequacy. A 95% Confidence interval and P-value of less than 5% was considered statistically significant. Results: The median age of the participants was 48 years with interquartile rage from 41 to 62 years. The prevalence of haemodialysis adequacy for URR was 72% and for Kt/v was 75%. The odds of having adequate haemodialysis was strongly predicted by duration since dialysis initiation (AOR 0.32, 95% CI = 0.110-0.904, p = 0.0318) and number of dialysis session per week (AOR 6.91, 95% CI = 1.52-31.49, p = 0.0125). Conclusion: This study reports a high prevalence of haemodialysis adequacy among patients undergoing haemodialysis in Dodoma city. This finding shows that, provision of a correct dose of haemodialysis to the patients with ESKD would help to improve hemodialysis adequacy and outcomes as well. Hence, individualization of haemodialysis prescription based on monthly assessment of single-pool Kt/v would be a useful and practical tool in providing adequate haemodialysis treatment.