Marriage and End-Stage Renal Disease: Implications for African Americans

2010 ◽  
Vol 31 (9) ◽  
pp. 1230-1249
Author(s):  
Emily F. Shortridge ◽  
Cara V. James
Keyword(s):  
African Americans ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Well Being ◽  
Lifestyle Changes ◽  
Treatment Modalities ◽  
Dialysis Facilities ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

African Americans are disproportionately represented among patients with end-stage renal disease (ESRD). ESRD is managed with a strict routine that might include regular dialysis as well as dietary, fluid intake, and other lifestyle changes. In a disease such as this, with such disruptive treatment modalities, marriage, specifically, and its ties to well-being have the potential to significantly affect adherence to medical treatment and lifestyle recommendations as well as downstream health outcomes such as disease progression and mortality. The authors used data from the Dialysis Morbidity and Mortality Study, Wave 2, of the U.S. Renal Data System Database, a prospective study of 4,000 ESRD patients selected from a random sample of 25% U.S. dialysis facilities, to investigate these research questions. They found that married African American ESRD patients had marginally better outcomes on several clinical and psychosocial measures, which they hypothesize may be attributable to the instrumental and emotional support conferred by marriage.

scholarly journals Lived Experiences of End Stage Renal Disease Patients Undergoing Continuous Ambulatory Peritoneal Dialysis Therapy

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
M. Hanif Prasetya 'Adhi ◽  
Yanny Trisyani ◽  
Etika Emaliyawati
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Lived Experiences ◽  
Final Diagnosis ◽  
Treatment Modalities ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End stage renal disease (ESRD) is a serious chronic disease that resulted from complications of chronic renal failure and a final diagnosis that requires treatment modalities such as dialysis or continuous ambulatory peritoneal dialysis (CAPD). However, CAPD is rarely selected as renal replacement therapy by ESRD patients in Indonesia. Therefore, the phenomenon associated with patients undergoing CAPD is unclear, especially in Indonesia. The purpose of this study was to explore the lived experiences of ESRD patients undergoing CAPD therapy. The research method employed qualitative descriptive phenomenology. The participants in this study were 10 ESRD patients with CAPD. Data collection utilized semi-structured interviewed and data was analyzed using the Colaizzi approach. The result of the study was explained through 6 themes. These are: 1) Condition improved with CAPD, 2) Freedom of activity, 3) Between feeling better and bored 4) Health is increased, 5) It is sustained life, 6) Resignation to accept illness. In conclusion, the patients with CAPD felt  significant positive changes in their life and CAPD is considered life-sustaining for the participants, as the majority of the symptoms was decreased significantly. Therefore, the partisipants felt their conditions improved better. The unpleasant sides of CAPD are feeling bored. The support  of the family  is important as it  produced strength and passion for patients in undergoing CAPD.

scholarly journals Nurse’s Experience As Educator in Hemodialysis Care to End Stage Renal Disease Patient in Hospital X: a Phenomenology Study

2019 ◽  
Author(s):  
Karolus Yosef Woitila Wangi ◽  
Dessy Permata Sela ◽  
Christina Evi Ambarsar
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Lifestyle Changes ◽  
Future Research ◽  
Ethical Perspective ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End Stage Renal Disease (ESRD) is progressive and irreversible damage to kidney function,which can reduce the quality of life of patients and death due to accumulation of uremia toxins in the blood. Hemodialysis is a temporary therapy used to prolong the life of the patient. The uncertainty of the treatment provides a unique response which became an interesting phenomenon for researchers to conduct research Sethe qualitative strategy for explore the nurses’ experience and to describe it especially in the nurses’ role as educator in hemodialysis care to ESRD patient in Hospital X.Aim of this study to provide an overview of nurse’s experience as educator in ESRD patients during hemodialysis therapy in the Hemodialysis Unit Hospital X. this research used a qualitative method with a phenomenological approach has been conducted. The data collection technique used was using in-depth interviews. A purposive sampling was used to recruited the participant and, namely ten nurses were involded in this study with inclusion critearia as follows: (1) work as an executive nurse in HD unit, (2) have minimum Diploma III as basic education level. Data analysis using Colaizzi’s method and then using thematic analysis. Four themes were found in this study: lifestyle changes, uncooperative patients, responsive patients, and patients do not want to stop dialysis. Future research can be conduct in fourth theme concerning withdrawal dialysis in ESRD patients in various perspectives including: ethical perspective and decision making for futile treatment, health coverage policies, and palliative care.

Increased Red Cell Phosphatidylserine Exposure Correlates with Enhanced Thrombin Generation In Sickle Trait Patients with End Stage Renal Disease

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2665-2665 ◽  
Author(s):  
Julia Brittain ◽  
Vimal K. Derebail ◽  
Micah J. Mooberry ◽  
Kenneth I. Ataga ◽  
Abhijit Kshirsagar V. ◽  
...  
Keyword(s):  
African Americans ◽  
Renal Disease ◽  
Sickle Cell ◽  
End Stage Renal Disease ◽  
Thrombin Generation ◽  
Coagulation Activation ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Abstract Abstract 2665 Introduction: Phosphatidylserine (PS) exposure by red blood cells (RBCs) is increased in sickle cell disease, where it is thought to contribute to anemia, inflammation and activation of coagulation. RBCs from subjects with sickle cell trait (SCT) may also express more PS compared to controls. We recently reported a high prevalence of SCT in African Americans with end-stage renal disease (ESRD) - a state marked by anemia, profound inflammation and coagulation activation. No study has yet examined RBC PS exposure, inflammation or coagulation activation in African Americans patients with SCT and ESRD. Objective: To determine whether RBC PS exposure is elevated in ESRD patients with SCT receiving hemodialysis compared to patients with normal hemoglobin genotype, and whether markers of coagulation activation and inflammation are similarly elevated. The relationship between RBC PS exposure, thrombin generation and inflammation was also examined. Methods: We performed a cross sectional study of 10 patients with documented SCT and 9 race-matched controls. Both groups were receiving in center hemodialysis. The percentage of RBCs demonstrating PS exposure was determined by annexin-V binding and flow cytometry detection. Plasma thrombin/anti-thrombin (TAT) complexes and C-reactive protein (CRP) levels were determined by ELISA. Mann-Whitney U tests were used to examine differences between these variables among the groups. Medians and interquartile ranges (IQR) are shown. Spearman's correlation coefficient was used to assess the relationship among the variables tested. Results: Consistent with previous reports in ESRD patients, we found markedly elevated RBC PS exposure among both groups; however, patients with SCT had significantly elevated PS exposure compared to those without SCT (6.65%, [IQR: 5.1, 8.8] vs. 3.0%, [IQR: 2.1,4.2], p = 0.002). Furthermore, patients with SCT had higher TAT levels compared to those without SCT (16.1 ng/L [IQR: 11.9, 28.4] vs. 5.5 ng/L [IQR: 3.8, 8.6], p<0.0001). We also noted increased plasma CRP levels in those patients with SCT compared to control (33.7 mg/L [IQR: 22.8, 62.8] vs. 11.2 mg/L [IQR: 2.2, 19.5], p = 0.016). In patients with SCT, there was a striking correlation between PS exposure and TAT levels (r = 0.897, p<0.0001), but no correlation was noted between PS exposure and levels of CRP (r=-0.17, p = 0.63). Conclusions: These data suggest that patients with SCT trait in ESRD may be subject to an increased risk of thrombotic complications related to increased PS exposure on RBCs. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Associations of Family Functioning, General Well-Being, and Exercise with Mental Health among End-Stage Renal Disease Patients

2020 ◽  
Vol 17 (4) ◽  
pp. 356-365
Author(s):  
Qi Wang ◽  
Hongjian Liu ◽  
Zheng Ren ◽  
Wenjing Xiong ◽  
Minfu He ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Family Functioning ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Linear Regression Analysis ◽  
General Health Questionnaire ◽  
Well Being ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Objective This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress. Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioning and psychological distress.Methods Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item General Health Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzed using multiple linear regression analysis and path analysis.Results The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factors of psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by general well-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated by exercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029).Conclusion The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercise were associated with psychological distress. Family functioning could affect psychological distress partially by affecting general well-being. Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.

Epidemiology, detection, and management of tuberculosis among end-stage renal disease patients

2018 ◽  
Vol 39 (11) ◽  
pp. 1367-1374 ◽  
Author(s):  
Reiko C. Okada ◽  
Pennan M. Barry ◽  
Jacek Skarbinski ◽  
Amit S. Chitnis
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Incidence Rates ◽  
Skin Tests ◽  
Treatment Practices ◽  
Dialysis Facilities ◽  
Latent Tb Infection ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

AbstractTuberculosis (TB) remains an important problem among end-stage renal disease (ESRD) patients. We reviewed the epidemiology of TB and ESRD, investigations of TB exposures in US dialysis facilities, and published guidelines to inform screening and treatment practices among US ESRD patients. Compared to TB in the general population, ESRD patients have 6–25-fold higher TB incidence rates, and mortality during treatment is 2–3-fold higher. Most TB cases among ESRD patients (~90%) occur among non–US-born persons, and an analysis of genotyping data suggests that 80% of all cases result from latent TB infection (LTBI) reactivation. Published TB contact investigations in dialysis facilities have reported cases among ESRD patients and healthcare workers. However, transmission of TB is rare: there were no reports of secondary cases of TB because of exposure to an index-case patient and there were few TB infections, which was demonstrated by low occurrence of newly positive tuberculin skin tests (12%–16%) and conversions (8%–17%) among contacts. Targeted TB education, screening, and treatment for ESRD patients at highest risk for TB exposure (eg, non–US-born persons), using interferon-gamma release assays and short course LTBI regimens (ie, isoniazid-rifapentine weekly for 12 weeks or rifampin daily for 4 months) may be an effective overall strategy for reducing TB burden in ESRD patients.

Adipokines and Gut Hormones in End-Stage Renal Disease

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peptide Yy ◽  
Gut Hormones ◽  
Poor Quality ◽  
Mortality And Morbidity ◽  
Novel Therapeutic Strategies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

Fibrin clot structure in patients with end-stage renal disease

2007 ◽  
Vol 98 (08) ◽  
pp. 339-345 ◽  
Author(s):  
Johannes Sidelmann ◽  
Mikkel Brabrand ◽  
Robert Pedersen ◽  
Jørgen Pedersen ◽  
Kim Esbensen ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Healthy Controls ◽  
Structure Characteristics ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Fibrin Structure ◽  
Plasma Markers ◽  
Fibrin Clots

SummaryFibrin clots with reduced permeability, increased clot stiffness and reduced fibrinolysis susceptibility may predispose to cardiovascular disease (CVD). Little is known, however, about the structure of fibrin clots in patients with end-stage renal disease (ESRD).These patients suffer from a high risk of CVD in addition to their chronic low-grade inflammation. Using permeability, compaction and turbidity studies in 22 ESRD patients and 24 healthy controls, fibrin clots made from patient plasma were found to be less permeable (p<0.001), less compactable (p<0.001), and less susceptible to fibrinolysis (p<0.001) than clots from controls.The maximum rate of turbidity increase was also higher for the patients than controls (p<0.001), and scan-ning electron microscopy revealed higher clot density of fibrin fibers in clots from patients than clots from controls (p<0.001). Patients had higher plasma concentrations of fibrinogen, C-reative protein and interleukin 6 than controls.These plasma markers of inflammation correlated significantly with most of the fibrin structure characteristics observed in the patients. In contrast, plasma markers of azothemia showed no such correlations. The results suggest that in ESRD patients fibrin clots are significantly different from healthy controls, and that the fibrin structure characteristics in the patients are associated primarily with the inflammatory plasma milieu rather than with level of azothemia.

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