In the article entitled“Relationship of demoralization with anxiety,depression,and demographics of Chinese dialysis patients”by Zhuang CL,Zheng JL,Gao L,Huang YL,and Hu WJ(J Integr Nurs 2021;3(4):155-160.DOI:10.4103...In the article entitled“Relationship of demoralization with anxiety,depression,and demographics of Chinese dialysis patients”by Zhuang CL,Zheng JL,Gao L,Huang YL,and Hu WJ(J Integr Nurs 2021;3(4):155-160.DOI:10.4103/jin.jin_46_21),[1]the ethical statement was not provided.展开更多
Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian p...Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, <i>p</i> < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, <i>p</i> < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, <i>p</i> < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, <i>p</i> = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.展开更多
Hemodialysis is the main alternative therapy for patients with end-stage renal disease;most of the hemodialysis centers in China are not designed together with the inpatient ward.During the hospitalization period,hemo...Hemodialysis is the main alternative therapy for patients with end-stage renal disease;most of the hemodialysis centers in China are not designed together with the inpatient ward.During the hospitalization period,hemodialysis patients often move back and forth between wards and hemodialysis rooms because of the treatment needed.Hemodialysis patients are a special group of hospitalized patients,most of them are elderly patients.The overall basic diseases of the patients vary very much,and the cause of the disease is complex.Moreover,the chronic inflammation progresses slowly,and immune function declines.Some of the patient are seriously ill or even hav organ failure.All these factors affect the patients in general.Therefore,the transfer safety of patients during hospitalization is facing great challenges.The researchers reviewed the status of transshipment research in Chinese hemodialysis patients and laid the foundation for the research and development of related handover tools and perfect handover mode in the future.展开更多
Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activiti...Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). The aim of this study was to investigate chronological change in MR-ADL among chronic dialysis patients in need of long-term care and the effect of admission to long-term care facilities on their MR-ADL. Methods: Data were analyzed from a long-term care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Then data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated. To reveal change in MR-ADL, this study performed a three-way analysis of variance with mean survey scores from assessment categories 2 - 5 containing questions related to MR-ADL as the independent variable and the number of eligibility assessment surveys (within-subjects factor), facility admission, and dialysis therapy (between-subjects factors) as dependent variables. Results: We observed the effect of facility admission in individuals aged >70 years for categories 2 - 5, and observed the effect of the number of assessment surveys taken only in women ≥80 years for categories 2 and 5. Regarding the effect of dialysis therapy, female dialysis patients aged ≥80 years and in need of long-term care scored significantly higher on survey items for transferring, grooming, toileting, eating, and instrumental activities of daily living, all of which are indicators of a moderate decline in ADL. Conclusions: Because dialysis is often initiated in women aged around 80 years, ADL in this group of individuals can be improved by the initiation and proper provision of dialysis.展开更多
Since Colon capsule endoscopy (CCE) was approved for reimbursement under the national health insurance system of Japan in January 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile ...Since Colon capsule endoscopy (CCE) was approved for reimbursement under the national health insurance system of Japan in January 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile intestine, impaired platelet function, or oral administration of nonsteroidal antiinflammatory drugs (NSAIDs) or anticoagulants. Increasing experience with CCE different bowel preparation regimens have been used with variable results. The patient on dialysis has moisture restrictions. We experienced the case of the half a dose of the previous protocol by a method using the castor oil. In this study, we evaluated the efficacy of bowel preparation with castor oil for improving the capsule excretion rate. In 23 of 24 (95.8%) patients capsule transit time and duration of capsule endoscopy were shortened. The results are presented and briefly discussed in this report.展开更多
An increasing number of failed transplant patients returning to dialysis (FTRD) have been observed with reported worse survival compared to transplant-naive dialysis (TxN) patients. This study aimed to assess outcomes...An increasing number of failed transplant patients returning to dialysis (FTRD) have been observed with reported worse survival compared to transplant-naive dialysis (TxN) patients. This study aimed to assess outcomes of FTRD vs. matched TxN controls in a Gulf region multi-center trial of 800 HD patients. Similar mortality was seen, likely due to earlier start and better HD adequacy in FTRD. Younger age, less diabetes and living donor transplantation in majority with 27% graft nephrectomy (Nx) might also confer benefits. Subgroup analysis of Nx patients showed more hospitalizations and prior rejection episodes with lower graft survival. The deaths, however, oc-curred only in nonNx group and are likely explained by older age, longer duration on HD, more prevalence of diabetes and CAD. FTRD showed similar survival to TxN. Early intensive HD might account for the benefit. Whether Nx confers advantage is unclear because of the small sample size.展开更多
Objective To investigate the relationship between intramuscular adipose tissue index(IATI)calculated from computed tomography images at transverse process of the first lumbar and all-cause mortality in maintenance dia...Objective To investigate the relationship between intramuscular adipose tissue index(IATI)calculated from computed tomography images at transverse process of the first lumbar and all-cause mortality in maintenance dialysis patients,and to provide a reference for improving the prognosis in these patients.Methods It was a multicenter retrospective cohort study.The clinical data of patients who received maintenance hemodialysis or peritoneal dialysis treatment from January 1,2017 to December 31,2019 in 4 grade I hospitals including Zhongda Hospital Affiliated to Southeast University,Taizhou People's Hospital Affliated to Nanjing Medical University,Affiliated Hospital of Yangzhou University,and the Third Affiliated Hospital of Soochow University were retrospectively collected.IATI was calculated by low attenuation muscle(LAM)density/skeletal muscle density.The receiver-operating characteristic curve was used to determine the optimal cut-off value of IATI,and the patients were divided into high IATI group and low IATI group according to the optimal cut-off value.The differences of baseline clinical data and measurement parameters of the first lumbar level between the ttwo groups were compared.Thefollow-upended on December 23,2022.展开更多
Objective To explore the influencing factors of hemodialysis(HD)initiation in non-diabetic kidney disease(NDKD)patients with predialysis arteriovenous fistula(AVF)creation.Methods This was a singlecenter prospective c...Objective To explore the influencing factors of hemodialysis(HD)initiation in non-diabetic kidney disease(NDKD)patients with predialysis arteriovenous fistula(AVF)creation.Methods This was a singlecenter prospective cohort study.The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018.According to the estimated glomerular filtration rate(eGFR,the Chronic Kidney Disease Epidemiology Collaboration equation)and age,patients were divided into different subgroups,eGFR:group 1[eGFR<10 ml·min^(-1)·(1.73 m^(2))^(-1)],group 2[eGFR between 10 to 15 ml·min^(-1).(1.73 m^(2))^(-1)].展开更多
Objectives:Unplanned readmissions severely affect a patient's physical and mental well-being after kidney transplantation(KT),which is also independently associated with morbidity.A retrospective study was conduct...Objectives:Unplanned readmissions severely affect a patient's physical and mental well-being after kidney transplantation(KT),which is also independently associated with morbidity.A retrospective study was conducted to identify the incidence,causes and risk factors for unplanned readmission after KT among Chinese patients.Methods:Patients who underwent KT were admitted to the organ transplant center of the Affiliated Hospital of University of Science and Technology of China(2017-2018).Medical records for these patients were obtained through the hospital information system(HIS).Results:In 518 patients,the incidence of unplanned readmissions within 30 days(n=9)was 1.74%,and 90 days(n=64)was 12.35%.The one-year unplanned readmission rate was 22.59%(n=122).Overall,122 patients were readmitted because of infection,renal events,metabolic disturbances,surgical complications,etc.Hemodialysis(OR=10.462,95%CI:1.355-80.748),peritoneal dialysis(OR=8.746,95%CI:1.074-71.238)and length of stay(OR=1.023,95%CI:1.006-1.040)were independent risk factors for unplanned readmissions.Conclusion:Unplanned readmission rates increased with time after KT.Certain risk factors related to unplanned readmissions should be deeply excavated.Targeted interventions for controllable factors to alleviate the rate of unplanned readmissions should be identified.展开更多
AIM: To understand factors associated with quality of life (QOL), examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS: The method used databases (Pubmed, Google...AIM: To understand factors associated with quality of life (QOL), examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS: The method used databases (Pubmed, Google scholar) and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO defnition of QOL. RESULTS: For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 question-naire manuals. Of the 34 studies, 82% were quantita-tive while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney dis-ease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO defnition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL. CONCLUSION: Culture and disease specific QOL in-struments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed.展开更多
AIM: To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines. METHODS: Literature searches were condu...AIM: To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines. METHODS: Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included “hepatitis B (HB)”, “vaccine”, “dialysis”, “hemodialysis”, “sex”, “male” and “female”. Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed.RESULTS: Analysis of response to HB vaccination in our dialysis population showed males significantly res-pond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ2 = 14.30 (df = 19); I2 = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a signifcant difference regarding dialysis mode in response to HB vaccination regarding sex ( P = 0.042, Z = 2.03).CONCLUSION: This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.展开更多
Aim: We measured carnitine levels in patients with carnitine including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 27 patien...Aim: We measured carnitine levels in patients with carnitine including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 27 patients with liver cirrhosis who were receiving treatment in our hospital, and administered L-carnitine (600 mg - 1800 mg) to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to eight dialysis patients, before and after the administration to 19 nondialytic patients. Results: The total carnitine levels before the dialysis of dialysis patients were an average of 42.2 μmol/L and fell to 17.7 μmol/L after more dialysis, but it was increased to 155 μmol/L after the administration of L-carnitine. In the nondialytic patients, the total carnitine levels were significantly increased from 71.7 μmol/L to 101.7 μmol/L after the administration of L-carnitine (P = 0.038). For symptomatic patients, significant improvement of muscle clamps was observed in the L-carnitine administrated group when compared with the non-administrated group (P = 0.0002). Conclusions: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in patients with liver cirrhosis.展开更多
Objective To explore the association between the intraperitoneal pressure(IPP)and clinical symptoms in peritoneal dialysis(PD)patients.Methods It was a cross-sectional study.PD patients of Peking University First Hosp...Objective To explore the association between the intraperitoneal pressure(IPP)and clinical symptoms in peritoneal dialysis(PD)patients.Methods It was a cross-sectional study.PD patients of Peking University First Hospital from January 1,to October 31,2021,were enrolled according to the inclusion and exclusion criterion.展开更多
目的探讨透析中关节活动度运动对维持性血液透析(maintenance hemodialysis,MHD)患者的影响。方法选取2023年4月─10月南昌大学第一附属医院血液透析中心的MHD患者为研究对象,由研究者随机投掷硬币将东湖院区和象湖院区随机分为试验组...目的探讨透析中关节活动度运动对维持性血液透析(maintenance hemodialysis,MHD)患者的影响。方法选取2023年4月─10月南昌大学第一附属医院血液透析中心的MHD患者为研究对象,由研究者随机投掷硬币将东湖院区和象湖院区随机分为试验组和对照组,对照组患者给予常规护理,试验组患者在常规护理的基础上实施透析中关节活动度运动。比较2组患者干预前后的疲乏量表-14(fatigue scale-14,FS-14)得分、6分钟步行试验(6 minutes walk test,6MWT)、30秒坐立试验(30-second sit-to-stand test,30s-STS)和简短生活质量量表得分(36-item short form health survey,SF-36)差异。结果透析中关节活动度运动干预后试验组患者的FS-14得分低于对照组(Z=-7.782,P<0.001),6MWT(t=5.812,P<0.001)、30s-STS(t=6.111,P<0.001)、SF-36得分(t=2.583,P=0.012)高于对照组。结论透析中关节活动度运动可有效缓解患者的疲乏症状,提高运动能力、生活质量。展开更多
文摘In the article entitled“Relationship of demoralization with anxiety,depression,and demographics of Chinese dialysis patients”by Zhuang CL,Zheng JL,Gao L,Huang YL,and Hu WJ(J Integr Nurs 2021;3(4):155-160.DOI:10.4103/jin.jin_46_21),[1]the ethical statement was not provided.
文摘Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, <i>p</i> < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, <i>p</i> < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, <i>p</i> < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, <i>p</i> = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.
基金project was supported by Health and Family Planning Commission of Chongqing Medical Research Project(No.2016ZDXM008)the outstanding young nurses in Second Hospital Affiliated to Chongqing Medical University(No.201707)Hospital Research and Construction Project of Chinese Medical Doctor Association(No.201522)
文摘Hemodialysis is the main alternative therapy for patients with end-stage renal disease;most of the hemodialysis centers in China are not designed together with the inpatient ward.During the hospitalization period,hemodialysis patients often move back and forth between wards and hemodialysis rooms because of the treatment needed.Hemodialysis patients are a special group of hospitalized patients,most of them are elderly patients.The overall basic diseases of the patients vary very much,and the cause of the disease is complex.Moreover,the chronic inflammation progresses slowly,and immune function declines.Some of the patient are seriously ill or even hav organ failure.All these factors affect the patients in general.Therefore,the transfer safety of patients during hospitalization is facing great challenges.The researchers reviewed the status of transshipment research in Chinese hemodialysis patients and laid the foundation for the research and development of related handover tools and perfect handover mode in the future.
文摘Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). The aim of this study was to investigate chronological change in MR-ADL among chronic dialysis patients in need of long-term care and the effect of admission to long-term care facilities on their MR-ADL. Methods: Data were analyzed from a long-term care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Then data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated. To reveal change in MR-ADL, this study performed a three-way analysis of variance with mean survey scores from assessment categories 2 - 5 containing questions related to MR-ADL as the independent variable and the number of eligibility assessment surveys (within-subjects factor), facility admission, and dialysis therapy (between-subjects factors) as dependent variables. Results: We observed the effect of facility admission in individuals aged >70 years for categories 2 - 5, and observed the effect of the number of assessment surveys taken only in women ≥80 years for categories 2 and 5. Regarding the effect of dialysis therapy, female dialysis patients aged ≥80 years and in need of long-term care scored significantly higher on survey items for transferring, grooming, toileting, eating, and instrumental activities of daily living, all of which are indicators of a moderate decline in ADL. Conclusions: Because dialysis is often initiated in women aged around 80 years, ADL in this group of individuals can be improved by the initiation and proper provision of dialysis.
文摘Since Colon capsule endoscopy (CCE) was approved for reimbursement under the national health insurance system of Japan in January 2014. Dialysis patients are potentially susceptible to bleeding because of the fragile intestine, impaired platelet function, or oral administration of nonsteroidal antiinflammatory drugs (NSAIDs) or anticoagulants. Increasing experience with CCE different bowel preparation regimens have been used with variable results. The patient on dialysis has moisture restrictions. We experienced the case of the half a dose of the previous protocol by a method using the castor oil. In this study, we evaluated the efficacy of bowel preparation with castor oil for improving the capsule excretion rate. In 23 of 24 (95.8%) patients capsule transit time and duration of capsule endoscopy were shortened. The results are presented and briefly discussed in this report.
文摘An increasing number of failed transplant patients returning to dialysis (FTRD) have been observed with reported worse survival compared to transplant-naive dialysis (TxN) patients. This study aimed to assess outcomes of FTRD vs. matched TxN controls in a Gulf region multi-center trial of 800 HD patients. Similar mortality was seen, likely due to earlier start and better HD adequacy in FTRD. Younger age, less diabetes and living donor transplantation in majority with 27% graft nephrectomy (Nx) might also confer benefits. Subgroup analysis of Nx patients showed more hospitalizations and prior rejection episodes with lower graft survival. The deaths, however, oc-curred only in nonNx group and are likely explained by older age, longer duration on HD, more prevalence of diabetes and CAD. FTRD showed similar survival to TxN. Early intensive HD might account for the benefit. Whether Nx confers advantage is unclear because of the small sample size.
文摘Objective To investigate the relationship between intramuscular adipose tissue index(IATI)calculated from computed tomography images at transverse process of the first lumbar and all-cause mortality in maintenance dialysis patients,and to provide a reference for improving the prognosis in these patients.Methods It was a multicenter retrospective cohort study.The clinical data of patients who received maintenance hemodialysis or peritoneal dialysis treatment from January 1,2017 to December 31,2019 in 4 grade I hospitals including Zhongda Hospital Affiliated to Southeast University,Taizhou People's Hospital Affliated to Nanjing Medical University,Affiliated Hospital of Yangzhou University,and the Third Affiliated Hospital of Soochow University were retrospectively collected.IATI was calculated by low attenuation muscle(LAM)density/skeletal muscle density.The receiver-operating characteristic curve was used to determine the optimal cut-off value of IATI,and the patients were divided into high IATI group and low IATI group according to the optimal cut-off value.The differences of baseline clinical data and measurement parameters of the first lumbar level between the ttwo groups were compared.Thefollow-upended on December 23,2022.
文摘Objective To explore the influencing factors of hemodialysis(HD)initiation in non-diabetic kidney disease(NDKD)patients with predialysis arteriovenous fistula(AVF)creation.Methods This was a singlecenter prospective cohort study.The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018.According to the estimated glomerular filtration rate(eGFR,the Chronic Kidney Disease Epidemiology Collaboration equation)and age,patients were divided into different subgroups,eGFR:group 1[eGFR<10 ml·min^(-1)·(1.73 m^(2))^(-1)],group 2[eGFR between 10 to 15 ml·min^(-1).(1.73 m^(2))^(-1)].
基金This work was supported by the National Key Clinical Specialist Construction Projects of China[No.(2018)292]
文摘Objectives:Unplanned readmissions severely affect a patient's physical and mental well-being after kidney transplantation(KT),which is also independently associated with morbidity.A retrospective study was conducted to identify the incidence,causes and risk factors for unplanned readmission after KT among Chinese patients.Methods:Patients who underwent KT were admitted to the organ transplant center of the Affiliated Hospital of University of Science and Technology of China(2017-2018).Medical records for these patients were obtained through the hospital information system(HIS).Results:In 518 patients,the incidence of unplanned readmissions within 30 days(n=9)was 1.74%,and 90 days(n=64)was 12.35%.The one-year unplanned readmission rate was 22.59%(n=122).Overall,122 patients were readmitted because of infection,renal events,metabolic disturbances,surgical complications,etc.Hemodialysis(OR=10.462,95%CI:1.355-80.748),peritoneal dialysis(OR=8.746,95%CI:1.074-71.238)and length of stay(OR=1.023,95%CI:1.006-1.040)were independent risk factors for unplanned readmissions.Conclusion:Unplanned readmission rates increased with time after KT.Certain risk factors related to unplanned readmissions should be deeply excavated.Targeted interventions for controllable factors to alleviate the rate of unplanned readmissions should be identified.
文摘AIM: To understand factors associated with quality of life (QOL), examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS: The method used databases (Pubmed, Google scholar) and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO defnition of QOL. RESULTS: For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 question-naire manuals. Of the 34 studies, 82% were quantita-tive while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney dis-ease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO defnition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL. CONCLUSION: Culture and disease specific QOL in-struments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed.
基金Supported by Grant from the Baqiyatallah University of Medical Sciences
文摘AIM: To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines. METHODS: Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included “hepatitis B (HB)”, “vaccine”, “dialysis”, “hemodialysis”, “sex”, “male” and “female”. Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed.RESULTS: Analysis of response to HB vaccination in our dialysis population showed males significantly res-pond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ2 = 14.30 (df = 19); I2 = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a signifcant difference regarding dialysis mode in response to HB vaccination regarding sex ( P = 0.042, Z = 2.03).CONCLUSION: This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.
文摘Aim: We measured carnitine levels in patients with carnitine including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 27 patients with liver cirrhosis who were receiving treatment in our hospital, and administered L-carnitine (600 mg - 1800 mg) to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to eight dialysis patients, before and after the administration to 19 nondialytic patients. Results: The total carnitine levels before the dialysis of dialysis patients were an average of 42.2 μmol/L and fell to 17.7 μmol/L after more dialysis, but it was increased to 155 μmol/L after the administration of L-carnitine. In the nondialytic patients, the total carnitine levels were significantly increased from 71.7 μmol/L to 101.7 μmol/L after the administration of L-carnitine (P = 0.038). For symptomatic patients, significant improvement of muscle clamps was observed in the L-carnitine administrated group when compared with the non-administrated group (P = 0.0002). Conclusions: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in patients with liver cirrhosis.
文摘Objective To explore the association between the intraperitoneal pressure(IPP)and clinical symptoms in peritoneal dialysis(PD)patients.Methods It was a cross-sectional study.PD patients of Peking University First Hospital from January 1,to October 31,2021,were enrolled according to the inclusion and exclusion criterion.
文摘目的探讨透析中关节活动度运动对维持性血液透析(maintenance hemodialysis,MHD)患者的影响。方法选取2023年4月─10月南昌大学第一附属医院血液透析中心的MHD患者为研究对象,由研究者随机投掷硬币将东湖院区和象湖院区随机分为试验组和对照组,对照组患者给予常规护理,试验组患者在常规护理的基础上实施透析中关节活动度运动。比较2组患者干预前后的疲乏量表-14(fatigue scale-14,FS-14)得分、6分钟步行试验(6 minutes walk test,6MWT)、30秒坐立试验(30-second sit-to-stand test,30s-STS)和简短生活质量量表得分(36-item short form health survey,SF-36)差异。结果透析中关节活动度运动干预后试验组患者的FS-14得分低于对照组(Z=-7.782,P<0.001),6MWT(t=5.812,P<0.001)、30s-STS(t=6.111,P<0.001)、SF-36得分(t=2.583,P=0.012)高于对照组。结论透析中关节活动度运动可有效缓解患者的疲乏症状,提高运动能力、生活质量。