MO864PATIENT MEDICATION ADHERENCE ON HEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Marwa Omrane ◽  
Amel Babchia ◽  
Raja Jaballah ◽  
Afef Mahersia ◽  
Olfa Saidane
Keyword(s):  
Side Effects ◽  
Cross Sectional Study ◽  
Chronic Hemodialysis ◽  
Therapeutic Education ◽  
Maintenance Hemodialysis ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Adherence Assessment ◽  
The Mean ◽  
Stage Renal Disease

Abstract Background and Aims Non-adherence to treatment is a major problem in patients with end stage renal disease and contributes to the significant increase in morbidity, mortality and health costs. Method The objective of this work was to assess adherence to treatment prescriptions for hemodialysis patients and to identify the predictive factors of poor compliance. This is a cross-sectional study of 59 patients on chronic hemodialysis. Adherence to treatment was evaluated by the adherence assessment test. Results The mean age of our patients was 51.8 years, with an M/F sex ratio of 1.26. The socio-economic level was considered low in 83% of cases. The mean duration of hemodialysis was 81.6 months [6 months-252 months]. Causal nephropathy was dominated by vascular nephropathy (13 cases). Forty-two patients had high blood pressure. A total of 23.9% of patients were good observers, 59.5% had minimal compliance problems, and 16.7% were poor observers. Statistical analysis has shown that poor adherence to treatment is associated with male gender, low socioeconomic and intellectual level, the presence of comorbidities, increased medication, number of medications taken per day, and less knowledge of the pathology and risks as side effects of drugs. Conclusion Treatment adherence is unsatisfactory in our population of patients on maintenance hemodialysis. Therapeutic education targeting the expected benefit of the treatments, their mode of action, their side effects as well as a simplification of the intake would improve long-term adherence in patients.

scholarly journals Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

Arteriosclerosis in Dialysis Patients

1996 ◽  
Vol 19 (11) ◽  
pp. 638-644 ◽  
Author(s):  
J. Bommer ◽  
E. Strohbeck ◽  
J. Goerich ◽  
M. Bahner ◽  
I. Zuna
Keyword(s):  
Calcium Phosphate ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
Time Interval ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Vldl Cholesterol

Arteriosclerosis is a constant problem in long-term hemodialysis patients. Computer tomography of the abdominal aorta allows a well-defined and reproducible evaluation of aortosclerosis. In the cross-sectional study, aortosclerosis was significantly accelerated in 84 chronic hemodialysis patients and was comparable to the results found in 20-year older control patients without renal disease. The increase of aortosclerosis correlated significantly with age of the patient, smoking, and duration of dialysis therapy. Furthermore, increased VLDL cholesterol and decreased HDL cholesterol seem to enhance aortosclerosis in our dialysis patients. In the longitudinal study (two CT scans with a time interval of 87 ± 62.7 months) in 36 dialysis patients, progressed aortosclerosis correlated significantly with the long duration of hypertriglyceridemia, VLDL cholesterol, uric acid, and calcium phosphate products. Progression of aortosclerosis was reduced in parathyroidectomized patients. The study suggests that premature aortosclerosis is found in dialysis patients. In addition to the common risk factor of aortosclerosis, disturbed calcium phosphate and parathyroid hormone metabolism seem to enhance aortosclerosis in patients under maintenance hemodialysis.

scholarly journals The Scale of Quantitative Assessment Adherence to Treatment «QAA-25»: Updating of Formulations, Constructive and Factor Validity and a Measure of Consent

2022 ◽  
Vol 17 (6) ◽  
pp. 845-852
Author(s):  
N. A. Nikolaev ◽  
Yu. P. Skirdenko ◽  
A. A. Balabanova ◽  
A. V. Gorbenko ◽  
K. A. Andreev ◽  
...  
Keyword(s):  
Construct Validity ◽  
Lifestyle Modification ◽  
High Reliability ◽  
Internal Validity ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Adherence Assessment ◽  
Alternative Question

Aim: To update the definitions of selected questions of the "QAA-25" (quantitative adherence assessment) scale and evaluate it according to the criteria of validity and measure of agreement.Materials and Methods. In a descriptive cross-sectional study including 200 patients with coronary heart disease, adherence was determined using traditional and alternative versions of selected questions of the QAA-25 scale, followed by assessment of construct validity, factor validity, and measure of agreement.Results. Alternative question versions did not significantly affect test results, with 81% of respondents in the outpatient sample and 69% in the inpatient sample rating them as "more acceptable." The QAA-25 scale has good construct and internal validity (α – 0.818, αst – 0.832), with moderate agreement (κ – 0.562) and demonstrates high reliability of internal validity – when scale items are consistently excluded, α values remain in the 0.801-0.839 range.Conclusion. The QAA-25 scale with modified question definitions should be used instead of the previous version of the scale. Good construct validity and factor validity, sufficient measure of agreement and specificity, high sensitivity and reliability of the QAA-25 scale allow to recommend it as a tool for assessing adherence to drug therapy, medical support, lifestyle modification and integral adherence to treatment in scientific and clinical practice.

scholarly journals Seminal transferrin in the seminal quality evaluation of hemodialytic patients

2018 ◽  
Vol 90 (1) ◽  
pp. 49
Author(s):  
Gilmar Pereira Silva ◽  
Fabiana Pirani Carneiro ◽  
Vitor Pereira Xavier Grangeiro
Keyword(s):  
Cross Sectional Study ◽  
Chronic Hemodialysis ◽  
Total Testosterone ◽  
Control Groups ◽  
Cross Sectional ◽  
Normal Morphology ◽  
Fertility Index ◽  
The Mean ◽  
And Control ◽  
Relationship Of

Objective: to verify the association between seminal quality and seminal transferrin (ST) level and fertility index in patients undergoing chronic hemodialysis (CH). Material and methods: This is a cross-sectional study in a group of 60 men (case) undergoing CH for more than 6 months, and a group of 30 healthy men (control), aged 18-60 years, without clinical or laboratory signs of infection/inflammation. Spermiogram was performed, fertility index (FI) was calculated and ST and sex hormones (SH) levels were measured, including follicle-stimulating hormone, luteinizing hormone, total testosterone, and prolactin. Results: All individuals were eugonadal. No differences for age (49.47 ± 5.56, 47.90 ± 6.2, p = 0.22) were observed between cases and controls, whereas there were significant differences between the individuals in the case and control groups with respect to the mean FI (p = 0.000), seminal parameters (SP) (p = 0.000), and ST levels (40.12 ± 08.25 vs 73.32 ± 06.8, p = 0.000). ST levels were correlated with FI (r = 0.787, p = 0.00) and SP (motility: r = 0.857, p = 0.000; vitality: r = 0.551, p = 0.000; density: r = 0.850, p = 0.000; normal morphology: r = 0.386, p = 0.000). Linear regression model showed relationship of ST levels with total sperm motility (R2 = 0.701; p = 0.000) and and FI (R2 = 0.569; p = 0.000). Conclusions: Our results suggest that seminal quality is associated with ST levels and FI and that it can be used the initial investigation of subfertility/infertility of patients undergoing chronic hemodialysis..

scholarly journals Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Tilahun Kassew ◽  
Demeke Demilew ◽  
Addis Birhanu ◽  
Mesele Wonde ◽  
Biks Liyew ◽  
...  
Keyword(s):  
Side Effects ◽  
Linear Regression ◽  
Associated Factors ◽  
First Generation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Antipsychotic Medications ◽  
Specialized Hospital ◽  
The Mean

Background. Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia. Objectives. The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018. Methods. In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood’s insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% confidence interval was used. Results. The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms (β= -0.07, 95% CI: (-0.09, -0.05)), negative symptoms (β= -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness (β= -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics (β = -0.35, 95% CI: (-0.55,-0.14)), having sedation (β= -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects (β= -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness (β= 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications. Conclusion. The result suggests that the mean score of participants’ attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.

scholarly journals Intuitive eating is associated with weight loss after bariatric surgery in women

2019 ◽  
Vol 110 (1) ◽  
pp. 10-15
Author(s):  
Muriel Nogué ◽  
Erika Nogué ◽  
Nicolas Molinari ◽  
Valérie Macioce ◽  
Antoine Avignon ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Eating Behaviors ◽  
Cross Sectional Study ◽  
Therapeutic Education ◽  
Intuitive Eating ◽  
Postoperative Phase ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
The Mean

ABSTRACT Background Although the data on eating behavior after bariatric surgery are substantial, data on “intuitive eating” are lacking. Objective The aim of this study was to evaluate the link between intuitive eating and weight loss after bariatric surgery. Methods This cross-sectional study used a self-administered questionnaire freely available on social networks and targeted women who had undergone bariatric surgery. Intuitive eating was evaluated with the Intuitive Eating Scale-2 (IES-2). The 3 questionnaire subscores (Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Unconditional Permission to Eat) were also analyzed. The relation between IES-2 scores and the relative variation in body mass index [BMI (in kg/m2)] was assessed with linear regression models. Adjusted β (βAdj) and standardized β $( {{\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}} )$ were reported. Results We analyzed the responses of 401 women with a mean age of 39 ± 11 y, a mean preoperative BMI of 45.5 ± 7.9, and a mean current BMI of 30.5 ± 7. The mean relative BMI loss was 32.7 ± 12.9%, and the mean IES-2 score was 3.3 ± 0.6. The total IES-2 score was associated with the relative BMI loss, with ∼2.6% BMI loss for each 1-point increase in the IES-2 score [PAdj = 0.007; βAdj = −2.57 (95% CI: −4.44, −0.70); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$= −0.12] after adjusting for elapsed time since surgery and type of surgery. Eating for Physical Rather than Emotional Reasons was the subscore most strongly associated with BMI change after adjustment [PAdj = 0.002; βAdj = −2.08 (95% CI: −3.37, 0.79); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$ = −0.14]. Conclusions This study highlights a significant association between intuitive eating and BMI decrease after bariatric surgery. Furthermore, eating behaviors changed with increasing time since surgery. An intuitive nutritional approach may be complementary with bariatric surgery in the postoperative phase, which should prompt complementary prospective studies to evaluate the effectiveness of therapeutic education programs centered on intuitive eating in the postoperative period.

scholarly journals The Fate of Patients Who Started Hemodialysis during Childhood or Adolescence: Results of an Interregional Moroccan Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
F. Z. Souilmi ◽  
T. Sqalli Houssaini ◽  
G. EL Bardai ◽  
N. Kabbali ◽  
M. Arrayhani ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Pediatric Age ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Weight ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is the most used renal replacement therapy for children in Morocco. The objective of this study was to determine the prevalence of patients who started hemodialysis in childhood and study their characteristics and specificities of their care. For this we conducted a multicentric descriptive cross-sectional study of all chronic hemodialysis patients who started dialysis in pediatric age, in hemodialysis centers in four of the sixteen regions of Morocco. We collected 2066 patients undergoing dialysis in 39 hemodialysis centers; from these, only 72 patients (3.48%) started hemodialysis in childhood. The average age of patients was 20.64 ± 6.5 years with a sex ratio of 1.9. Duration of dialysis was 78.2 ± 56 months. The cause of end stage renal disease was urological abnormalities in 18% of cases and glomerulopathy in 12.5% of cases; however, it remains unknown in half of the patients. Over 18 years, 74% of patients are without profession, it is active in 13% of cases, and pursuing studies are only in 13% of cases. Patients under 5 years and those with a low weight are rarely taken care of in chronic hemodialysis with little individualization of prescription. Greater attention should be paid to renal transplantation that is desired by the majority of these patients (92%).

A 3-day diary of dietary protein and calorie intake by serum phosphate concentration and binder use in hemodialysis patients

2017 ◽  
Vol 41 (2) ◽  
pp. 94-99
Author(s):  
Meiry J.S. Araújo ◽  
Luciana F. Silva ◽  
Maria T.S. Martins ◽  
Cacia M. Matos ◽  
Marcelo B. Lopes ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Serum Phosphate ◽  
Phosphate Binders ◽  
Calorie Intake ◽  
Maintenance Hemodialysis ◽  
Dietary Intakes ◽  
Cross Sectional ◽  
Low Serum

Introduction: The use of phosphate binders to control hyperphosphatemia may allow diets less restricted in protein and calories for maintenance hemodialysis (MHD) patients. The study compared intakes of protein, calorie and phosphate among MHD patients with different serum phosphate concentrations, taking into account binder use. The hypothesis was that low serum phosphate would be associated with low intakes of protein and calories only in patients not on binders. Methods: A cross-sectional study of 443 patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO) in Salvador, Brazil, with stratified sampling on serum phosphate: ≤3.0 (n = 41), 3.5-5.5 (n = 328) and ≥7.0 mg/dL (n = 74). A 3-day diet diary was used to determine dietary intakes. Results: Approximately 49.0% confirmed binder use. Covariate-adjusted linear regression showed that associations between dietary intakes and serum phosphate were modified by the binder use. In patients not on binders, protein intake was >20% lower for serum phosphate ≤3.0 mg/dL compared to higher concentrations. Also in those not on binders, calorie intake was >30% lower for serum phosphate ≤3.0 mg/dL compared to ≥7.0 mg/dL. Differences in dietary intakes by serum phosphate were virtually absent in patients on binders. Conclusions: The results are consistent with the hypothesis that low serum phosphate is associated with low protein and calorie intake only among MHD patients not on binders. This study supports recommendations to prevent hyperphosphatemia in MHD patients by adequate combination of binder use and selection of foods restricted in phosphors but not severely restricted in protein and calories.

scholarly journals Increased Neutrophil Extracellular Trap Formation in Uremia Is Associated with Chronic Inflammation and Prevalent Coronary Artery Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Jwa-Kyung Kim ◽  
Chang-won Hong ◽  
Mi Jin Park ◽  
Young Rim Song ◽  
Hyung Jik Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Acute Infection ◽  
Cross Sectional Study ◽  
Positive Control ◽  
Negative Control ◽  
Neutrophil Extracellular Trap ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Extracellular Trap ◽  
Stage Renal Disease

Background.Neutrophils are involved in the pathogenesis of atherosclerosis by neutrophil extracellular trap (NET) formation. We hypothesized that the NET formation of neutrophils might be changed in end-stage renal disease (ESRD) patients, explaining their higher incidence of coronary artery diseases (CAD).Method.A cross-sectional study was performed in 60 maintenance hemodialysis (MHD) patients, 30 age- and sex-matched healthy individuals (HV, negative control), and 30 patients with acute infection (positive control). Neutrophil activation and function were measured with reactive oxygen species (ROS) activity, degranulation, NET formation, and phenotypical changes.Result.Compared with HV, neutrophils extracted from MHD patients displayed significantly increased levels of basal NET formation, ROS production, and degranulation, suggesting spontaneous activation in uremia. Also, an increase in citrullinated histone H3 was detected in this group compared to the HV. And neutrophils from HV were normal CD16bright/CD62Lbrightcells; however, neutrophils from MHD were CD16bright/CD62Ldim, similar to those from patients with acute infections. Interestingly, multivariate analyses identified the prevalent CAD and neutrophil counts as independent determinants of baseline NET formation (β=0.323,p=0.016andβ=0.369,p=0.006, resp.).Conclusions.Uremia-associated-increased NET formation may be a sign of increased burden of atherosclerosis.

scholarly journals Anion Gap as a Determinant of Ionized Fraction of Divalent Cations in Hemodialysis Patients

2017 ◽  
Vol 13 (2) ◽  
pp. 274-281 ◽  
Author(s):  
Yusuke Sakaguchi ◽  
Takayuki Hamano ◽  
Keiichi Kubota ◽  
Tatsufumi Oka ◽  
Satoshi Yamaguchi ◽  
...  
Keyword(s):  
Divalent Cations ◽  
Cross Sectional Study ◽  
Anion Gap ◽  
Maintenance Hemodialysis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ionized Magnesium ◽  
The Mean ◽  
Circulating Levels ◽  
Total Magnesium

Background and objectivesCirculating levels of anions that bind to magnesium and calcium are often altered in patients with CKD. However, it is unknown how these alterations affect the ionized fraction of magnesium and calcium.Design, setting, participants, & measurementsThis cross-sectional study involved patients on maintenance hemodialysis and patients not on dialysis who visited the outpatient department of nephrology. We collected whole-blood samples to measure ionized magnesium and calcium concentrations. Adjusted anion gap was calculated as an integrative index of unmeasured anions.ResultsA total of 118 patients on hemodialysis and 112 patients not on dialysis were included. Although the prevalence of hypermagnesemia defined by total magnesium was much higher in patients on hemodialysis than in patients not on dialysis (69% versus 12%; P<0.001), the prevalence of hypermagnesemia defined by ionized magnesium did not differ significantly (13% versus 18%; P=0.28). Among patients on hemodialysis with high total magnesium, 83% had normal or low ionized magnesium. Consequently, the mean ionized fraction of magnesium in patients on hemodialysis was significantly lower than that in patients not on dialysis (51% versus 63%; P<0.001). Similarly, the mean ionized fraction of calcium in patients on hemodialysis was lower than that in patients not on dialysis (55% versus 56%; P<0.001). In patients on hemodialysis who had a higher adjusted anion gap than patients not on dialysis (mean [SD]: 14.1 [2.2] versus 5.1 [3.1]), the ionized fractions of magnesium and calcium were inversely associated with the adjusted anion gap. Furthermore, the anion gap significantly improved predictions of ionized magnesium and calcium in patients on hemodialysis.ConclusionsAnions that accumulate in patients on hemodialysis contribute to the lower ionized fraction of magnesium and calcium. Equations that incorporate the anion gap provide better predictions of ionized magnesium and calcium in patients on hemodialysis.

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