“Dialysis and medical tourism. Investigating patients’ perceptions in Greece”

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vasiliki Traouda ◽  
Panagiotis Mpogiatzidis
Keyword(s):  
Renal Failure ◽  
Kidney Disease ◽  
Quantitative Research ◽  
Medical Tourism ◽  
Renal Dialysis ◽  
Artificial Kidney ◽  
Daily Routine ◽  
Content Type ◽  
The Right ◽  
End Stage

Purpose The purpose of this paper is to explore the possibilities and the growth prospects of medical tourism in Greece, while particularly focusing on the dialysis process. Patients with end-stage renal failure have the right to any treatment deemed necessary during their journey to another city or country away from the place where their treatment normally takes place. Design/methodology/approach The survey has been conducted among 193 kidney disease patients that underwent extra-renal dialysis in two public and three private artificial kidney units in Thessaloniki. The study population consists of patients with end-stage chronic renal failure (CRF) that undergo dialysis. For the purpose of this study, quantitative research was carried out via a structured and anonymous questionnaire. The design and structure of the study were based upon questionnaires from two relevant questionnaires. The questionnaires were modified appropriately to respond to the subject in question. Finally, for the analysis of the data, the SPSS software has been used. Findings One of the most obvious results is that patients on dialysis treatment have limited both the frequency and the duration of their vacation. The 8.3% of patients that did not use to travel increased to 37.8%, whereas only 22.3% continue to travel 2–4 times a year. Patients that keep on going on vacation frequently claim that a break from the daily routine improves their quality of life. Most of the participants (up to 36.3%) claim they feel healthier, while 34.2% stated they experience a normal life when they escape their everyday life and travel far from home. The 69.9% claim that Greece has the potentials to be a popular medical tourism destination. However, a well-structured and government-financed assistance programme is absent. The processing of data has revealed a positive correlation between age and tourism behaviour. Additionally, according to the research results, younger patients tend to be better informed regarding medical tourism in comparison with older ones. Social implications Considering the patients to be potential travellers facilitates the development, realization and promotion of medical tourism. Originality/value This study attempts to investigate, for the first time, the tourism behaviour of chronic kidney disease patients. The study highlights a sensitive issue, patients’ right to treatment without geographical or distance-related obstacles.

scholarly journals Evaluation of the Usage of Erythropoietin in Patients with End-Stage Chronic Kidney Disease Dialysis Cycle in Hanoi Nephrology Hospital

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Do Thi Hoa ◽  
Nguyen Thi Tuyet Trinh ◽  
Nguyen Thi Lien Huong ◽  
Phan Tung Linh
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Kidney Disease ◽  
General Hospital ◽  
Renal Dialysis ◽  
The United States ◽  
Artificial Kidney ◽  
Health Official ◽  
End Stage

Treatment and control of anemia plays an important role in improving the quality and effectiveness of artificial kidney. The study was conducted on 61 patients who met the selection and were not included in the excluded criteria group. Collecting data from medical records using retrospective, descriptive, vertical follow-up method for 6 months. Data were processed using Microsoft Excel Office 2010 and R. The results showed that patients used both EPO alpha and EPO beta simultaneously. Rate of usage’s EPO beta accounted for 23%, alpha EPO was 77%. Lyophilized form (EPO alpha) is most commonly used. Starting from T3, Hb. averages treat. There were no abnormalities in blood pressure, white blood cell, platelets, and electrolytes. Keywords Hanoi Kidney Hospital, EPO (erythropoietin), Hb, efficacy and safety. References [1] L.A. Szczech, W. Harmon, T.H. Hostetter et al, World Kidney Day 2009: Problem and Challenges in the Emering Epidemic of Kidney Disease, J Am Soc Nephrol 20 (2009) 453-455. https://doi.org/10.1681/ASN.2009010041.[2] D.T. Gilbertson, J. Liu et al, Projecting the Number of Patient with End Stage Renal Disease in the United States to the Year 2015, J Am Soc Nephrol 16 (2005) 3736-3741. https://doi.org/10.1681/ASN.2005010112.[3] A.E. Gaweda, G.R. Aronoff et al, Individualized anemia management reduces hemoglobin variability in hemodialysis patients, J Am Soc Nephrol 25(1) (2014) 159-66. https://doi.org/10.1681/ASN.2013010089.[4] Do Thi Thu Hien, Evaluation of the usage of erythropoietin in the treatment of anemia in patients with chronic renal failure on dialysis at Thai Binh Provincial General Hospital, Master of Pharmacy thesis, Hanoi University of Pharmacy, 2015 (in Vietnamese).[5] Trieu Thi Tuyet Van, Evaluation of the usage of erythropoietin in the treatment of anemia in patients with chronic renal failure on dialysis at the artificial kidney department - Bach Mai Hospital, Master of Pharmacy thesis, Hanoi University of Pharmacy, 2009 (in Vietnamese).[6] Nguyen Thi Uyen, Investigating the effectiveness and safety of Erythropoietin use in dialysis patients at artificial kidney monotherapy Sanit Paul Hospital, Graduation thesis of Pharmacist, Hanoi University of Pharmacy, 2016 (in Vietnamese).[7] Bui Thi Tam, Evaluation the effectiveness of anemia treatment with Erythropoietin in patients with chronic renal failure receiving dialysis at Dien Bien Provincial General Hospital, Graduation thesis of Pharmacist Specialist 2, Hanoi University of Pharmacy, 2011 (in Vietnamese).[8] Drug Administration of Vietnam - Ministry of health, Official dispatch number 4764/QLD-ĐK, 2014 (in Vietnamese).[9] The Vietnam Urology & Nephrology Association, Guidelines for treatment of anemia in chronic kidney disease, The Vietnam Urology & Nephrology Association, 2013 (in Vietnamese).[10] KDIGO, KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease, Kidney International Supplement, 2013, pp.1-150.[11] Lam Thanh Vung, Study on the characteristics of anemia and the effectiveness of Erythropoietin β combination with intravenous iron in patients with chronic renal dialysis by dialysis, Thesis Specialized level 2 Medical and Pharmaceutical University, Hue University, 2013.  

Assessing the prevalence of malnutrition in chronic kidney disease patients undergoing hemodialysis in Kushtia District, Bangladesh

2018 ◽  
Vol 48 (1) ◽  
pp. 150-164
Author(s):  
Hasan Mahfuz Reza ◽  
Suvasish Das Shuvo ◽  
Tanvir Ahmad
Keyword(s):  
Renal Failure ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Hemodialysis Patients ◽  
Anthropometric Measurement ◽  
Dialysis Unit ◽  
Men And Women ◽  
Content Type ◽  
Significant Difference ◽  
End Stage

Purpose The purpose of this study is to evaluate the nutritional status of patients with end-stage kidney disease undergoing hemodialysis. Design/methodology/approach End-stage renal failure outpatients on hemodialysis were selected using simple random sampling technique from the dialysis unit of Sono Hospital Limited, Kushtia, Bangladesh. The nutritional status of 142 participant, of age 18-65 years, was screened. A direct method of nutritional assessment including anthropometric measurement, biochemical measurement, clinical assessment and dietary method was conducted. A logistic regression was applied to estimate the prevalence of malnutrition in hemodialysis patients. Findings In total 69.0 per cent participants were men and 31.0 per cent were women, whereas about 65.5 and 16.9 per cent patients of this study had a BMI of less than 23 kg/m2 and 18.5 kg/m2 (p < 0.05) where malnutrition was significantly prevalent. Mean ± SD hemoglobin level of both men and women participants was below the normal level which might increase the risk of malnutrition (p < 0.05). Of the total number of participants, 97.2 per cent were anemic, 66.9 per cent had anorexia, 63.4 per cent complained of nausea, 58.5 per cent complained of vomiting and 26.1 per cent complained of diarrhea, factors that can increase the risk of malnutrition in hemodialysis patients (p < 0.05). The creatinine and urea levels were higher in both men and women participants (p < 0.05). Results show significant difference in albumin levels among men and women (p < 0.05). The bicarbonate level was lower in both men and women, and the participants were suffering from metabolic acidosis (p < 0.05). About 87.3 per cent participants were taking inadequate amounts of protein which was a significant risk factor of malnutrition in hemodialysis patients (p < 0.01). Originality/value The result shows that renal failure is prevalent more in men than in women. The majority of patients on hemodialysis were at a risk of malnutrition including being underweight. Most of the patients were anemic. Malnutrition is related to low nutrient intake.

METABOLIC SYNDROME IN DIALYSIS PATIENTS

2016 ◽  
pp. 7-11
Author(s):  
Vinh Phu Hoang ◽  
Tam Vo ◽  
Van Tien Le ◽  
Thi Hoai Huong Vo
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Artificial Kidney ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Average Value ◽  
The Metabolic Syndrome ◽  
End Stage

Objective: To review disorders elements of the metabolic syndrome in patients with end-stage chronic renal failure on dialysis cycle. Materials and methods: A cross sectional descriptive study of 85 patients including end-stage chronic renal failure in dialysis cycle from 5/2015 - 9/2016 at the Department of Artificial Kidney, Hue Central Hospital. Results: The prevalence of metabolic syndrome in dialysis patients was 37.65%. The prevalence of abdominal obesity was 30.6%; The prevalence of hypertension was 72.9%, the average value systolic blood pressure and diastolic blood pressure were 142.24 ± 27.53, 80.35 ± 12.48 mmHg; The prevalence of hyperglycemia was 28%, the average value blood glucose was 4.9 ± 1.19 mmol/l; The prevalence of triglyceride increase was 34.1%, the average value triglyceride was 1.59 ± 0.84 mmol/l. The prevalence of HDL-C increase was 47.1%, the average value HDL-C was 1.24 ± 0.33 mmol/l. Conclusion: The prevalence of metabolic syndrome in dialysis patients is very high, in which hypertension and HDL disturbances are the highest. Key words: chronic renal failure, dialysis, metabolic syndrome

Country perspective on medical tourism: the Malaysian experience

2015 ◽  
Vol 28 (1) ◽  
pp. 43-56 ◽  
Author(s):  
Noor Hazilah Abd Manaf ◽  
Husnayati Hussin ◽  
Puteri Nemie Jahn Kassim ◽  
Rokiah Alavi ◽  
Zainurin Dahari
Keyword(s):  
Medical Tourism ◽  
Destination Country ◽  
Kuala Lumpur ◽  
Policy Makers ◽  
Main Method ◽  
Content Type ◽  
Five Dimensions ◽  
Future Intention ◽  
The Right ◽  
Self Administered Questionnaire

Purpose – The study seeks to explore the perception of international patients on Malaysia as a medical tourism destination country, as well as overall patient satisfaction, perceived value and future intention for repeat treatment and services. Design/methodology/approach – Self-administered questionnaire was the main method of data collection. The survey covered major private hospitals in medical tourists’ states in the country, namely, Penang, Melaka, Selangor and Kuala Lumpur. Convenience sampling was used due to the condition of patients as respondents. Findings – Indonesian patients formed the largest majority of international patients in the country. Five dimensions of medical tourism in Malaysia was identified, namely, hospital and staff, country factor, combining tourism and health services, cost saving and insurance and unavailability of treatment. Of these, hospital and staff was found to be the most important factor for the patients. Perception of value, overall satisfaction and intention for future treatment was also found to be high. This indicates that Malaysia is on the right footing in this burgeoning industry. Practical implications – Findings from the study will enable policy-makers to better position Malaysia as a medical tourist destination country. Originality/value – Medical tourism is a recent phenomenon and very little empirical research has been carried out at the patient level. This study is one of the first few studies which seek to explore medical tourism from the perspective of the patients themselves.

Management of Chronic Kidney Disease and its Complications

2018 ◽  
Author(s):  
Joshua S. Hundert ◽  
Ajay K Singh
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Filtration Rate ◽  
Stage Renal Disease ◽  
End Stage

Management of early renal failure helps in the reduction or prevention of end-stage renal disease. The monitoring of renal function is discussed, and the chapter includes a table that shows commonly used methods for monitoring. Risk factors for chronic renal failure include stroke and cardiac disease. Risk factors for renal disease progression are diabetes mellitus, hypertension, proteinuria, smoking, protein intake, and hyperlipidemia. Complications of chronic renal failure that are addressed include sodium and water imbalance, potassium imbalance, acidosis, calcium and phosphorus imbalance, and anemia. There is also a section that discusses the case for early referral to a nephrologist. Tables present the equations used to estimate the glomerular filtration rate (GFR); stages of chronic kidney disease and the appropriate steps in their management; risk factors for chronic kidney disease in which the testing of proteinuria and estimation of GFR are indicated; appropriate diet for patients who have chronic kidney disease; and guidelines for diagnosing and treating anemia resulting from chronic kidney disease. An algorithm outlines the steps in management of calcium and phosphate in patients with kidney disease. This review contains 3 figures, 10 tables and 50 references Key Words End-stage renal disease, chronic kidney disease, glomerular filtration rate, Modification of Diet in Renal Disease, Proteinuric renal disease, Hyperuricemia

Management of acute kidney injury and chronic kidney disease

2017 ◽  
pp. 1087-1096
Author(s):  
Natalie Ebert ◽  
Elke Schaeffner
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Staging System ◽  
Kidney Damage ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Both acute and chronic states of kidney disease have considerable healthcare impact as they can produce enormous disease burden and costs. To classify chronic kidney disease into the CKD staging system, glomerular filtration rate as an index of kidney function, as well as albuminuria as a marker of kidney damage have to be assessed as correctly as possible. Misclassification is a serious concern due to the difficulties in precise GFR assessment and correct interpretation of results. Differentiating between pure senescence and true disease among older adults can be a delicate issue. To find the right renal replacement option for individuals that progress to end-stage renal disease can be challenging, and some older patients may even benefit from conservative care without dialysis. To prevent acute kidney injury as a frequent and potentially life-threatening complication, clinicians need to develop an understanding of the common vulnerability to kidney damage among older adults.

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