Identification and Management of Chronic Kidney Disease Complications by Internal Medicine Residents: A National Survey

2011 ◽  
Vol 18 (3) ◽  
pp. e40-e47 ◽  
Author(s):  
Varun Agrawal ◽  
Mohit Agarwal ◽  
Amit K Ghosh ◽  
Michael A Barnes ◽  
Peter A McCullough
2015 ◽  
Vol 2 ◽  
pp. 88 ◽  
Author(s):  
Helen H. L. Chiu ◽  
Navdeep Tangri ◽  
Ognjenka Djurdjev ◽  
Brendan J. Barrett ◽  
Brenda R. Hemmelgarn ◽  
...  

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Jesinta Kaparang ◽  
Emma Sy Moeis ◽  
Linda Rotty

Abstract : Bacground: Stadium V Chronic Kidney Disease is less than 15 ml/mnt GFR, there is an accumulation of toxin uremia in blood that could harm the survival of patient, it is required a substitute therapy for the kidney,which is called hemodialysis. Hemodialisis needs anticoagulation, so blood clotting in circuit extracorporeal does not occur. In its development, have been tried several kinds of anticoagulation technique and anticoagulant which is made based on the state of the patient such as heparin, but in its using it can cause side effects. The work of heparin as anticoagulant dependents on anti thrombin (AT-III) that is an inhibitor of various factor of clotting. Heparin can cause changing of homeostasis because of its effect to the function of thrombosis ( thrombosis aggregation ) even to reduce the number of thrombosis ( Heparin Induced Thrombocytopenia ) . Purpose: To know and to study about the value of thrombosis in CKD patient who endure hemodialysis in unit hemodialisis Department of Internal Medicine BLU RSUP Prof. Dr.R.D. Kandou Manado.Method : Descriptive retrospective, using secondary data medic record in unit hemodyalisis Department of Internal Medicine BLU RSUP Prof. DR .R. D. Kandou Manado. Result: The thrombocytopenia patient increased on HD > 96 X, most of them are men in range 51 – 60 years old. Conclusion: CKD patient who endure hemodyalisis generally have normal thrombosis value, number of thrombocytopenia case is 25,45 % and number of most occurrence is commonly to men Keywords: chronic kidney disease, hemodialysis, thrombocytopenia.   Abstrak: Latar Belakang: Penyakit ginjal kronik stadium V yaitu LFG kurang dari 15 ml/mnt terdapat akumulasi toksin uremia dalam darah yang dapat membahayakan kelangsungan hidup pasien, sehinga di perlukan terapi penganti ginjal, terapi pengganti ginjal tersebut berupa hemodialisis. Pada hemodialisis diperlukan antikoagulasi supaya tidak terjadi pembekuan darah didalam sirkuit ekstrakorporeal. Dalam perkembangannya telah dicoba beberapa macam teknik antikoagulasi dan antikoagulan yang dibuat berdasarkan keadaan pasien,seperti heparin tetapi dalam pengunaanya heparin dapat memberikan efek samping Kerja heparin sebagai antikoagulasi bergantung pada antitrombin (AT-III) yaitu suatu inhibitor dari berbagai faktor pembekuan. Heparin menyebabkan perubahan hemostasis karena efeknya terhadap fungsi trombosit (agregasi trombosit) bahkan menurunkan jumlah trombosit (Heparin Induced Thrombocytopenia). Tujuan:Mengetahui dan mempelajari nilai trombosit pada pasien PGK yang menjalani hemodialisis di unit hemodialisis bagian/SMF Ilmu Penyakit Dalam BLU RSUP. Prof.Dr.R.D.Kandou manado. Metode Penelitian: Deskriptif retospektif dengan mengunakan data sekunder rekam medik di unit Hemodialisis Bagian/SMF Ilmu Penyakit dalam BLU RSUP  Prof.DR. R. D. Kandou  Manado. Hasil: Pasien yang mengalami trombositopeni mengalami peningkatan pada Hemodialisis lebih dari 96 kali, terbanyak berjenis kelamin laki – laki pada kelompok umur 51 – 60 tahun. Simpulan: Pasien PGK yang menjalani hemodialisis pada umumnya mempunyai nilai trombosit normal, jumlah kasus trombositopeni 25,45%, dan angka kejadian terbanyak umumnya pada laki –laki. Kata Kunci: Penyakit ginjal kronik, hemodialisis, trombositopeni


Background: Delirium is the condition of an acute confusional state that disturbs both alertness and cognition. The problem is likely to happen with general internal medicine patients admitted in general wards. Objective: To identify delirium cases in the internal medicine In-Patient Department (IPD) by using the Thai Confusion Assessment Method for intensive care unit (CAM-ICU). Materials and Methods: The cross-sectional study was conducted between February and December 2018. The Thai version of the CAM-ICU was used as the evaluation form to detect delirium. The patients admitted to the IPD of internal medicine were freely randomized to be volunteers. Demographic data, systemic illnesses, neurology diseases, and current medications were recorded. Results: Three hundred fifty-six patients, 175 males (49.2%) and 181 females (50.8%), were included in the present study. The mean age was 61.52 years old. The development of acute confusion was significant in patients 50 years old and older (p<0.001). Multivariate analysis indicated the significant effect of substance abuse (p<0.05), chronic kidney disease (p<0.05), cerebrovascular disease (p<0.05), benzodiazepine usage (p<0.05), alcohol abuse (p<0.05), and age 50 years or older (p<0.001). Sixty-nine cases met the Thai CAM-ICU criteria for delirium of CAM-ICU, but the interns did not notice this problem (p<0.001). Conclusion: Chronic kidney disease, cerebrovascular disease, substance abuse, benzodiazepine use, alcohol abuse, and age 50 years or older are the factors associated with delirium in the present study. Hypoactive delirium is underdiagnosed by doctors but revealed by using CAM-ICU. Keywords: Delirium, CAM-ICU, Hypoactive delirium, RASS


2009 ◽  
Vol 14 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Benjamin D. Morrow ◽  
Ian J. Stewart ◽  
Eric W. Barnes ◽  
Casey L. Cotant

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