scholarly journals Patient and provider factors associated with enrolment in the pre-end-stage renal disease pay-for-performance programme in Taiwan: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031354
Author(s):  
Hsiao-Yun Hu ◽  
Feng-Xuan Jian ◽  
Yun-ju Lai ◽  
Yung-Feng Yen ◽  
Nicole Huang ◽  
...  
Keyword(s):  
Health Insurance ◽  
End Stage Renal Disease ◽  
Pay For Performance ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

ObjectiveThe incidence and prevalence of end-stage renal disease (ESRD) in Taiwan have been ranked the highest worldwide. Therefore, the National Health Insurance Administration has implemented the pre-ESRD pay-for-performance (P4P) programme since November 2006, which had significantly reduced the incidence of dialysis and all-cause mortality. This study aimed to identify the factors associated with the enrolment in the pre-ESRD P4P programme.DesignCross-sectional study.SettingThe National Health Insurance research database 2007–2012 in Taiwan.ParticipantsPatients with prevalent pre-ESRD aged more than 18 years between January 2007 and December 2012 were enrolled. Patient demographics and hospital characteristics between P4P and non-P4P groups were compared. A logistic regression model was used to analyse the factors associated with P4P enrolment, and a generalised estimating equation was used to verify the results.Primary outcome measureEnrolment in the pre-ESRD P4P programme.ResultsIn total, 82 991 patients were enrolled in the programme, with a 45.6% participation rate. Patients who were males (adjusted OR (AOR)=0.89, 95% CI=0.86 to 0.91) and employed (AOR=0.95, 95% CI=0.92 to 0.97) had a significantly lower probability to be enrolled in the programme. Older patients (66–75 years old, AOR=1.23, 95% CI=1.14 to 1.33) and those with higher Charlson Comorbidities Index (CCI 5+, AOR=4.01, 95% CI=3.55 to 4.53) tended to be enrolled in the programme, while those in the 76+ years age group were not (AOR=1.03, 95% CI=0.95 to 1.13). Hospitals located in the central (AOR=1.48, 95% CI=1.05 to 2.08) and Kao-Ping regions (AOR=1.62, 95% CI=1.18 to 2.22) also tended to enrol patients in the pre-ESRD P4P programme. Enrolment rates increased over time.ConclusionPre-ESRD patients of the female gender, greater age and more comorbidities were more likely to be enrolled in the pre-ESRD P4P programme. Healthcare providers and health authorities should focus attention on patients who are male, younger and with less comorbidities to improve the healthcare quality and equality for all pre-ESRD patients.

scholarly journals Bone mineral density in Palestinian patients with end-stage renal disease and the related clinical and biochemical factors: Cross-sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241201
Author(s):  
Zaher Nazzal ◽  
Shahd Khader ◽  
Hiba Zawyani ◽  
Mazen Abdallah ◽  
Osama Sawalmeh ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction End-Stage Renal Disease (ESRD) is the ultimate result of chronic kidney disease (CKD). In Palestine, the prevalence of ESRD was 240.3 PMP which is comparable with the nearby countries. Accelerated bone loss among ESRD patients is attributed to abnormal bone turn over that leads to osteoporosis and osteopenia. The risk of fractures is increased four-fold in men and women on hemodialysis, which explains the importance of assessing the bone mineral density among these population. The goals of this study were to find the prevalence of osteoporosis in ESRD patients as determined by bone mineral density (BMD) at different sites and to determine whether BMD correlates with many other clinical parameters. Methods A cross-sectional study of 194 ESRD patients were recruited from the dialysis unit in An-Najah National University Hospital, Nablus, Palestine. The patients were on regular hemodialysis or peritoneal dialysis. BMD was measured at the lumbar spine and the hip using the dual-energy X-Ray absorptiometry (DEXA) and the value is expressed as T-score. The data were analyzed using SPSS, version 26. The relationship between BMD and the clinical and biochemical parameters among the ESRD patients was assessed. Results We found that 42.8% of ESRD patient had osteoporosis and 40.2% had osteopenia. There were significantly higher proportions of osteoporosis and osteopenia among patients >60 years of age (p<0.005). Patients with osteoporosis and osteopenia had significantly higher serum levels of PTH (792.9 and 469.7) (p<0.05). BMD decreases as the duration of dialysis (39.0 months Vs. 56.8 months), (p<0.05). We found no significant difference between patients on hemodialysis or peritoneal dialysis. Conclusion This study showed that Palestinian patients with ESRD have low BMD at the hip and spine. The observed high serum level of PTH was associated with low BMD. Those patients should be closely monitored especially those with more than one risk factor. Moreover, more attention should be paid for these category of patients to decrease the incidence of falling down and the resulting fractures that might lead to mortality and morbidity.

scholarly journals Quality of Life in Patients With End-Stage Renal Disease on Hemodialysis: A Cross-Sectional Study in Sudan

2020 ◽  
Author(s):  
Marwah Mohamed
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease (CKD) when renal replacement therapy (RRT) is necessary for sustaining life. Assessment of QoL of ESRD patients has become an essential tool to measure how the disease affects patients’ lives, and to develop better plans of care. Little is known about QoL in patients with CKD before RRT. This study aims to examine the various socio-demographic and other factors that affect the daily QoL of ESRD patients on haemodialysis (HD).Methods: A cross-sectional study was conducted at Dr Selma Dialysis Center, Khartoum, Sudan from September to December 2018. A total of 138 adult patients on chronic dialysis were recruited in this observational study. The QoL was assessed using the Kidney Disease Quality of Life-Short Form questionnaire (KDQoL-SF™).Results: Out of 138 enrolled patients, there were 105 patients (76.1%) had a good QoL and 33 patients (23.9%) had a poor QoL.Patients with a poor QoL had an average age of 42.8 ± 12.9 years. The good-QoL group had an average age of 46.9 ± 14.9 years. The total score of KDQoL-SF was 61.6%, while the scores for the physical and mental components were 39.3 ± 9.6 and 50.0 ± 10.6 respectively.Conclusion: This study indicated that the main factors that have a significant impact on the QoL were social status, origin, employment status, duration of the CKD, family history of kidney disease, time on HD, and Hypertension.

scholarly journals Diabetic nephropathy as a cause of end-stage renal disease in Egypt: a six-year study

2004 ◽  
Vol 10 (4-5) ◽  
pp. 620-626 ◽  
Author(s):  
A. Afifi ◽  
M. El Setouhy ◽  
M. El Sharkawy ◽  
M. Ali ◽  
H. Ahmed ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Large Scale ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The prevalence of diabetic nephropathy as a cause of end-stage renal disease [ESRD] in Egypt has been examined in small cross-sectional studies, with conflicting results. The need for a large-scale study prompted us to perform this 6-year multiple cross-sectional study. A sample of ESRD patients enrolled in the Egyptian renal data system was evaluated during the period 1996-2001 for the prevalence of diabetic nephropathy. Prevalence gradually increased from 8.9% in 1996, to 14.5% in 2001. The mean age of patients with diabetic nephropathy was significantly higher than that of patients with ESRD from other causes. Mortality was also significantly higher in diabetic patients with ESRD

scholarly journals Outcome of Cuffed Tunneled Dialysis Catheters for Hemodialysis Patients at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Kajan Raj Shrestha ◽  
Dinesh Gurung ◽  
Uttam Krishna Shrestha
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Severe Bleeding ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Arteriovenous fistula is the most common vascular access for patients requiringhemodialysis, but it is not always possible or practical hence cuffed tunneled dialysis cathetercomes into play. The aim of the study was to determine the outcome of cuffed tunneled dialysiscatheter used for hemodialysis at a teaching hospital. Methods: A descriptive cross-sectional study was conducted between January 2014 and December2019 on 103 chronic dialysis patients with end-stage renal disease presenting to a tertiary carehospital. Ethical approval was received from the institutional review board (2/(6-11) E2/076/77).Whole sampling was done. Data entry and analysis were done in Microsoft Excel 10. Results: The study included 103 patients with 117 cuffed tunneled dialysis catheters placed forhemodialysis. On assessing the outcome of the catheters, the primary and secondary patencyrates of the catheters were 5.85±4.87 and 1.21±3.77 months. Thirty-one (30.1%) patients requiredone intervention, and 11 (10.68%) catheters required 3 or more interventions to maintain patency.Eighteen (17.48%) patients presented with catheter dysfunction while in 11 (10.68%) cases, thecatheter was kinked or malpositioned at the notch. In one patient, procedure was abandoned dueto severe bleeding and in 2 (1.94%) patients dialysis catheters could not be negotiated into the rightatrium and left in brachiocephalic junction. Conclusions: Cuffed tunneled dialysis catheter is effective for maintenance hemodialysis in patientswith the end-stage renal disease if used with proper care during dialysis even in our setup. Theresults and outcomes of the procedure are at par with standards.

scholarly journals Adherence to Hemodialysis and Associated Factors among End Stage Renal Disease Patients at Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Marie Claire Mukakarangwa ◽  
Geldine Chironda ◽  
Busisiwe Bhengu ◽  
Godfrey Katende
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Health Concern ◽  
Public Health Concern ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction. Worldwide, End Stage Renal Disease (ESRD) has become a public health concern increasing the number of patients maintained on hemodialysis prior to renal transplantation. Nonadherence to hemodialysis continues to impact on the care of ESRD patients, causing high increase in morbidity and mortality. Purpose of the Study. The purpose of this study was to determine the level of adherence to hemodialysis and the associated factors among End Stage Renal Disease (ESRD) patients in selected nephrology units in Rwanda. Methods. This was a descriptive cross-sectional design involving 41 participants. Participants were recruited using a purposive sampling technique. Demographic and adherence to hemodialysis data were collected with the use of structured interview schedules. Descriptive statistics were used to describe the demographic variables and the level of adherence to hemodialysis. Inferential statistics of chi-square was used to establish factors associated with adherence to hemodialysis. Results. Twenty-one (51%) of ESRD participants adhered highly (scores < 80%) to HD. Seventeen (42%) adhered moderately (70–79%) to HD while three (7%) had low level of adherence to HD (below 70%). The factors associated with adherence to hemodialysis were age (mean = 27; 95% CI 26.76–29, 17; p = 038) and religion (95% CI 26.29–60.12, p = 003). Frequencies of education of health care workers about the importance of not missing dialysis (95% CI 26.71–42.56, p = .000), perceived relative importance of hemodialysis (95% CI 20.44–27.76, p = .020), and experiencing difficulties during the procedure (95% CI 20.80–28.36, p = .004) were significantly associated with adherence to hemodialysis. Conclusion. Adherence to hemodialysis is still a public health concern in Rwanda. Health care providers and particularly nurses should continue to advocate for adherence to HD for better health outcomes. Further research is needed to identify the barriers to HD in Rwanda.

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