Objective:The objective of this study was to analyze the current status of barriers to exercise participation(EP)among patients on maintenance hemodialysis(MHD).Materials and Methods:A cross-sectional study was conduc...Objective:The objective of this study was to analyze the current status of barriers to exercise participation(EP)among patients on maintenance hemodialysis(MHD).Materials and Methods:A cross-sectional study was conducted on 277 outpatients undergoing MHD in 2 tertiary first-class hospitals in Beijing from February 2023 to June 2023 who were selected using convenience sampling method.The data of patients on MHD were collected using the general information questionnaire,Physical Activity Rating Scale,Exercise Benefits/Barriers Scale(EBBS),and Exercise Self-Efficacy Scale(ESES).The relationship between EP and barriers to EP was analyzed through univariate and multivariate linear regression models.Results:Patients on MHD had a low exercise volume score of 13.71±0.68 points and a medium EBBS score of 63.36±0.40 points.Multivariate logistic analysis showed that exercise volume was significantly related to the following four aspects,including low monthly household income per capita(odds ratio[OR]=86.741,95%confidence interval[CI][1.164-6.465],P=0.042),primary underlying disease of diabetic nephropathy(OR=45.993,95%CI[1.353-1.564],P=0.033),the belief that“fatigue in lower extremities hinders exercise”(OR=4.697,95%CI[1.127-19.585],P=0.034),and the belief that“physical exercise bringing optimistic and positive life attitude”(OR=0.074,95%CI[0.007-0.830],P=0.035).Conclusions:Since patients on MHD had low physical exercise volume,the health-care provider should pay more attention on the controllable factors that affect the EP of patients on MHD.Therefore,feasible and effective intervention measures can be formulated based on ESES in clinical nursing.展开更多
As one of the most important water-soluble non-enzymatic antioxidants,vitamin C consists of ascorbic acid and its oxidized form,dehydroascorbic acid.Maintenance hemodialysis(MHD)patients have a generally lower plasma ...As one of the most important water-soluble non-enzymatic antioxidants,vitamin C consists of ascorbic acid and its oxidized form,dehydroascorbic acid.Maintenance hemodialysis(MHD)patients have a generally lower plasma vitamin C level compared with general population.Moreover,dialysis patients also exhibit a low plasma vitamin C level,which is largely related with increased inflammation,refractory anemia and oxidative stress.In this review,we described,in great detail,the vitamin C deficiency in MHD patients and its effects on anti-oxidation,anti-inflammation,pro-oxidation and secondary hyperparathyroidism.In addition,we described the possible potential value of vitamin C in anemia,and the side effects of over-doses of vitamin C supplementation in this particular population.In summary,MHD patients may benefit from vitamin C administration.However,further research should be carried out to confirm its potential beneficial effects,optimal dosage and side effects from vitamin C supplementation.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
Background With the increase in hemodialysis （HD） patients, the blood dialysis patient＇s quality of life （QoL） and long- term survival are still a challenge for clinicians. Recent studies have found that most of ...Background With the increase in hemodialysis （HD） patients, the blood dialysis patient＇s quality of life （QoL） and long- term survival are still a challenge for clinicians. Recent studies have found that most of the HD patients have sleep disorders, which have a certain correlation with long-term survival and QoL. But there are few studies of Chinese in this field. This study aimed to investigate whether increasing the dialysis dose can improve sleep quality, so we treated HD patients on long intermittent hemodialysis （LIHD）. Methods Forty patients who were treated by conventional HD at the Beijing Friendship Hospital Blood Purification Center were offered the option of LIHD. The patients＇ laboratory data, medication use, and questionnaire answers were analyzed. Conventional HD was delivered thrice weekly with 4 hours per treatment, and LIHD was delivered thrice weekly with 8 hours per treatment. The study lasted 6 months. Questionnaires included sleep quality survey and QoL SF-36; the former includes the Athens Insomnia Scale, Pittsburgh Sleep Quality Index （PSQI）, and Epworth Sleepiness Scale （ESS）. Results After conversion to LIHD the dialysis efficiency （K~/V） significantly increased than before （P 〈0.05） and clearance rate of urea nitrogen also increased from 67 to 78% （P 〈0.01）. After conversion, median values for Hb increased from 108.95 to 126.55 g/L （P 〈0.01）; albumin increased from 38.85 to 40,05 g/L （P 〈0.01）. Phosphorus decreased from 2.69 to 1.54 mmol/L （P 〈0.01）, but there was no alteration in blood calcium; phosphorus and calcium-phosphate product levels were under more control, but parathyroid hormone （iPTH） level did not change after conversion to LIHD. After conversion, blood pressure （BP） was better controlled than before and the mean number of antihypertensive drugs prescribed declined from 2.9 to 0.5 （P 〈0.01）. There was a significant reduction in the use of erythropoietin-stimulating agent of 5250 U/w （P 〈0.01）. Sleep quality significantly improved in the 2 months after conversion to LIHD, and the PSQI score decreased from 10.80 to 5.45 and the ESS score decreased from 12.05 to 5.30 （P 〈0.01）. However, sleep quality started to decline after 2 months on LIHD. QoL SF-36 score increased from 410.92 to 592.53 （P 〈0.01）. Conclusion LIHD offers an effective improvement in dialysis adequacy for Chinese maintenance HD patients, but it improves sleep quality only briefly which may be related to loss of serum calcium and parathyroid dysfunction.展开更多
Objective To determine the relationship between changes of blood pressure(BP)during dialysis and mortality in maintenance hemodialysis(MHD)patients.Methods A total of 364 cases of MHD patients were collected prospecti...Objective To determine the relationship between changes of blood pressure(BP)during dialysis and mortality in maintenance hemodialysis(MHD)patients.Methods A total of 364 cases of MHD patients were collected prospectively and the relationship between changes of blood pressure during dialysis and mortality was as-展开更多
Objective To explore the blood pressure variability(BPV)in pediatric patients undergoing maintenance hemodialysis(MHD)and to assess the factors associated with pre-dialysis BPV(pre-HD BPV).Methods The pediatric patien...Objective To explore the blood pressure variability(BPV)in pediatric patients undergoing maintenance hemodialysis(MHD)and to assess the factors associated with pre-dialysis BPV(pre-HD BPV).Methods The pediatric patients who underwent regular dialysis for more than twelve months from Oct 2005 to Oct 2011 in hemodialysis center of Guizhou Provincial People’s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Objective:The objective of this study was to analyze the current status of barriers to exercise participation(EP)among patients on maintenance hemodialysis(MHD).Materials and Methods:A cross-sectional study was conducted on 277 outpatients undergoing MHD in 2 tertiary first-class hospitals in Beijing from February 2023 to June 2023 who were selected using convenience sampling method.The data of patients on MHD were collected using the general information questionnaire,Physical Activity Rating Scale,Exercise Benefits/Barriers Scale(EBBS),and Exercise Self-Efficacy Scale(ESES).The relationship between EP and barriers to EP was analyzed through univariate and multivariate linear regression models.Results:Patients on MHD had a low exercise volume score of 13.71±0.68 points and a medium EBBS score of 63.36±0.40 points.Multivariate logistic analysis showed that exercise volume was significantly related to the following four aspects,including low monthly household income per capita(odds ratio[OR]=86.741,95%confidence interval[CI][1.164-6.465],P=0.042),primary underlying disease of diabetic nephropathy(OR=45.993,95%CI[1.353-1.564],P=0.033),the belief that“fatigue in lower extremities hinders exercise”(OR=4.697,95%CI[1.127-19.585],P=0.034),and the belief that“physical exercise bringing optimistic and positive life attitude”(OR=0.074,95%CI[0.007-0.830],P=0.035).Conclusions:Since patients on MHD had low physical exercise volume,the health-care provider should pay more attention on the controllable factors that affect the EP of patients on MHD.Therefore,feasible and effective intervention measures can be formulated based on ESES in clinical nursing.
文摘As one of the most important water-soluble non-enzymatic antioxidants,vitamin C consists of ascorbic acid and its oxidized form,dehydroascorbic acid.Maintenance hemodialysis(MHD)patients have a generally lower plasma vitamin C level compared with general population.Moreover,dialysis patients also exhibit a low plasma vitamin C level,which is largely related with increased inflammation,refractory anemia and oxidative stress.In this review,we described,in great detail,the vitamin C deficiency in MHD patients and its effects on anti-oxidation,anti-inflammation,pro-oxidation and secondary hyperparathyroidism.In addition,we described the possible potential value of vitamin C in anemia,and the side effects of over-doses of vitamin C supplementation in this particular population.In summary,MHD patients may benefit from vitamin C administration.However,further research should be carried out to confirm its potential beneficial effects,optimal dosage and side effects from vitamin C supplementation.
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Background With the increase in hemodialysis （HD） patients, the blood dialysis patient＇s quality of life （QoL） and long- term survival are still a challenge for clinicians. Recent studies have found that most of the HD patients have sleep disorders, which have a certain correlation with long-term survival and QoL. But there are few studies of Chinese in this field. This study aimed to investigate whether increasing the dialysis dose can improve sleep quality, so we treated HD patients on long intermittent hemodialysis （LIHD）. Methods Forty patients who were treated by conventional HD at the Beijing Friendship Hospital Blood Purification Center were offered the option of LIHD. The patients＇ laboratory data, medication use, and questionnaire answers were analyzed. Conventional HD was delivered thrice weekly with 4 hours per treatment, and LIHD was delivered thrice weekly with 8 hours per treatment. The study lasted 6 months. Questionnaires included sleep quality survey and QoL SF-36; the former includes the Athens Insomnia Scale, Pittsburgh Sleep Quality Index （PSQI）, and Epworth Sleepiness Scale （ESS）. Results After conversion to LIHD the dialysis efficiency （K~/V） significantly increased than before （P 〈0.05） and clearance rate of urea nitrogen also increased from 67 to 78% （P 〈0.01）. After conversion, median values for Hb increased from 108.95 to 126.55 g/L （P 〈0.01）; albumin increased from 38.85 to 40,05 g/L （P 〈0.01）. Phosphorus decreased from 2.69 to 1.54 mmol/L （P 〈0.01）, but there was no alteration in blood calcium; phosphorus and calcium-phosphate product levels were under more control, but parathyroid hormone （iPTH） level did not change after conversion to LIHD. After conversion, blood pressure （BP） was better controlled than before and the mean number of antihypertensive drugs prescribed declined from 2.9 to 0.5 （P 〈0.01）. There was a significant reduction in the use of erythropoietin-stimulating agent of 5250 U/w （P 〈0.01）. Sleep quality significantly improved in the 2 months after conversion to LIHD, and the PSQI score decreased from 10.80 to 5.45 and the ESS score decreased from 12.05 to 5.30 （P 〈0.01）. However, sleep quality started to decline after 2 months on LIHD. QoL SF-36 score increased from 410.92 to 592.53 （P 〈0.01）. Conclusion LIHD offers an effective improvement in dialysis adequacy for Chinese maintenance HD patients, but it improves sleep quality only briefly which may be related to loss of serum calcium and parathyroid dysfunction.
文摘Objective To determine the relationship between changes of blood pressure(BP)during dialysis and mortality in maintenance hemodialysis(MHD)patients.Methods A total of 364 cases of MHD patients were collected prospectively and the relationship between changes of blood pressure during dialysis and mortality was as-
文摘Objective To explore the blood pressure variability(BPV)in pediatric patients undergoing maintenance hemodialysis(MHD)and to assess the factors associated with pre-dialysis BPV(pre-HD BPV).Methods The pediatric patients who underwent regular dialysis for more than twelve months from Oct 2005 to Oct 2011 in hemodialysis center of Guizhou Provincial People’s
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。
