scholarly journals Barriers and opportunities to increase PD incidence and prevalence: Lessons from a European Survey

2021 ◽  
pp. 089686082110349
Author(s):  
Ulrika Hahn Lundström ◽  
Alferso C Abrahams ◽  
Jennifer Allen ◽  
Karmela Altabas ◽  
Clémence Béchade ◽  
...  
Keyword(s):  
Case Vignette ◽  
Dialysis Modality ◽  
End Stage Kidney Disease ◽  
Home Based ◽  
Barriers And Opportunities ◽  
End Stage ◽  
Quality Of Structure ◽  
Unplanned Start ◽  
Do So

Introduction: Peritoneal dialysis (PD) remains underutilised and unplanned start of dialysis further diminishes the likelihood of patients starting on PD, although outcomes are equal to haemodialysis (HD). Methods: A survey was sent to members of EuroPD and regional societies presenting a case vignette of a 48-year-old woman not previously known to the nephrology department and who arrives at the emergency department with established end-stage kidney disease (unplanned start), asking which dialysis modality would most likely be chosen at their respective centre. We assessed associations between the modality choices for this case vignette and centre characteristics and PD-related practices. Results: Of 575 respondents, 32.8%, 32.2% and 35.0% indicated they would start unplanned PD, unplanned HD or unplanned HD with intention to educate patient on PD later, respectively. Likelihood for unplanned start of PD was only associated with quality of structure of the pre-dialysis program. Structure of pre-dialysis education program, PD program in general, likelihood to provide education on PD to unplanned starters, good collaboration with the PD access team and taking initiatives to enhance home-based therapies increased the likelihood unplanned patients would end up on PD. Conclusions: Well-structured pre-dialysis education on PD as a modality, good connections to dedicated PD catheter placement teams and additional initiatives to enhance home-based therapies are key to grow PD programs. Centres motivated to grow their PD programs seem to find solutions to do so.

scholarly journals Course of Encephalopathy in a Cirrhotic Dialysis Patient Treated Sequentially with Peritoneal and Hemodialysis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Suleyman Koz ◽  
Idris Sahin ◽  
Zafer Terzi ◽  
Sema Tulay Koz
Keyword(s):  
Peritoneal Dialysis ◽  
Hepatic Encephalopathy ◽  
Kidney Disease ◽  
Dialysis Patient ◽  
Dialysis Modality ◽  
End Stage Kidney Disease ◽  
Advanced Cirrhosis ◽  
Cirrhotic Patients ◽  
End Stage

End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.

Health-related quality of life and symptoms of conservative care versus dialysis in patients with end-stage kidney disease: a systematic review

2020 ◽  
Author(s):  
Wouter R Verberne ◽  
Iris D van den Wittenboer ◽  
Carlijn G N Voorend ◽  
Alferso C Abrahams ◽  
Marjolijn van Buren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Older Patients ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Conservative Care ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Abstract Background Non-dialytic conservative care (CC) has been proposed as a viable alternative to maintenance dialysis for selected older patients to treat end-stage kidney disease (ESKD). This systematic review compares both treatment pathways on health-related quality of life (HRQoL) and symptoms, which are major outcomes for patients and clinicians when deciding on preferred treatment. Methods We searched PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and PsycINFO from inception to 1 October 2019 for studies comparing patient-reported HRQoL outcomes or symptoms between patients who chose either CC or dialysis for ESKD. Results Eleven observational cohort studies were identified comprising 1718 patients overall. There were no randomized controlled trials. Studies were susceptible to selection bias and confounding. In most studies, patients who chose CC were older and had more comorbidities and worse functional status than patients who chose dialysis. Results were broadly consistent across studies, despite considerable clinical and methodological heterogeneity. Patient-reported physical health outcomes and symptoms appeared to be worse in patients who chose CC compared with patients who chose dialysis but had not yet started, but similar compared with patients on dialysis. Mental health outcomes were similar between patients who chose CC or dialysis, including before and after dialysis start. In patients who chose dialysis, the burden of kidney disease and impact on daily life increased after dialysis start. Conclusions The available data, while heterogeneous, suggest that in selected older patients, CC has the potential to achieve similar HRQoL and symptoms compared with a dialysis pathway. High-quality prospective studies are needed to confirm these provisional findings.

scholarly journals Peritoneal Dialysis at Ibn Sina Hospital in Rabat: 10 years’ experience

2020 ◽  
Vol 3 (1) ◽  
pp. 27-35
Author(s):  
Meryem Benbella ◽  
Aziza Guennoun ◽  
Mohamed Belrhiti ◽  
Tarik Bouattar ◽  
Rabia Bayahia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Retrospective Study ◽  
Infectious Complications ◽  
Dialysis Modality ◽  
Ibn Sina ◽  
End Stage Renal Failure ◽  
End Stage

Introduction:  The choice of dialysis modality has become an important decision that affects not only the country's health policy in the management of chronic end stage renal failure, but also the quality of life of patients and their survival. Peritoneal dialysis is an alternative for the treatment of these patients. The objective of our work is to report the epidemiological, clinical and biological results in the unit of PD, UHC of Rabat and to clarify the obstacles to the development of PD in Morocco.  Material and Methods:  We conducted a descriptive retrospective study in our PD unit from July 2006 to July 2017, including all patients who were in PD by choice or necessity and enrolled in the French Peritoneal Dialysis Registry (RDPLF).  Results: In 10 years, 159 patients were placed in PD, with an average age of 50.44 +/- 17.42 years and a sex ratio of 1.36. The indication for placement of setting in PD was by choice in 34% of the cases, social in 52% and medical in 14% of cases. Mechanical complications were dominated by catheter migrations. Infectious complications were represented by peritonitis, caused by poor of hygiene in 42% of cases. Conclusion: The obstacles to the development of PD are the lack of knowledge of the technique by the patients, as well as the prejudices or myths about the technique.

scholarly journals Dialysis modality choice in diabetic patients with end-stage kidney disease: a systematic review of the available evidence

2014 ◽  
Vol 30 (2) ◽  
pp. 310-320 ◽  
Author(s):  
C. Couchoud ◽  
D. Bolignano ◽  
I. Nistor ◽  
K. J. Jager ◽  
J. Heaf ◽  
...  
Keyword(s):  
Systematic Review ◽  
Kidney Disease ◽  
Diabetic Patients ◽  
Dialysis Modality ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Quality Of Life And Health Related Quality Of Life Among End-Stage Kidney Disease Patients: Methodology Assessment

2020 ◽  
Vol 6 (3) ◽  
pp. 1-11
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
End Stage ◽  
The Impact

End-Stage Kidney Disease (ESKD) is a serious and irreversible condition. Understanding the impact of ESKD and its treatment on an individual's Quality of Life (QoL) is important.

scholarly journals End stage kidney disease in the elderly: Hope for the best

2021 ◽  
Vol 34 (4) ◽  
Author(s):  
Patrícia Valério ◽  
◽  
Ana Farinha ◽  
Keyword(s):  
Kidney Disease ◽  
The Elderly ◽  
End Stage Kidney Disease ◽  
Disease Trajectory ◽  
Technological Advances ◽  
Care Of Elderly ◽  
End Stage ◽  
Symptomatic Control ◽  
Taking Care

With an increased number of aged chronic kidney disease (CKD) patients, along with medical and technological advances, the options to approach end‑stage kidney disease (ESKD) have multiplied. Nephrologists should be aware that taking care of elderly patients is different from taking care of younger ones. The spectrum of choices is as wide as the functional status of these patients. For fit ones, the main goal should be to restore function as much as possible and to rehabilitate. On the other hand, for frail patients, the expectations should be realistic in terms of survival, disease trajectory and symptomatic control, because while kidney replacement therapies can prolong life, they do not cure. The issue is complex due to its multidimensional perspective, so decisions must take into account the patient’s options, respecting his/her autonomy, dignity and quality of life. This text aims to review the particularities of geriatric CKD patients’ assessment towards options to care for ESKD, in a specific population which is growing in our practice.

Effect of a Home Exercise Program Based on Tai Chi in Patients with End-Stage Renal Disease

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 99-103 ◽  
Author(s):  
Kin-wa Ling ◽  
Flora S.Y. Wong ◽  
Wing-ki Chan ◽  
Shuk-yin Chan ◽  
Eric P. Y. Chan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
Exercise Program ◽  
Well Being ◽  
Home Based ◽  
Stage Renal Disease ◽  
End Stage ◽  
Minute Walk

Objective Previous reports have documented the benefits of exercise on the well-being of renal patients. However, fewer than 50% of our end-stage renal disease (ESRD) patients engage in regular exercise. To promote exercise, we implemented a home-based exercise program. The aim of the program was to reduce barriers to exercise by helping patients to exercise at their convenience and without the need to travel. The effect of the program was evaluated 3 months after implementation. Patients and Methods Each study participant received a videotape that demonstrated 30 minutes of low-capacity aerobic exercise. Participants were advised to exercise by following the demonstration on the videotape. Encouragement was given over the telephone. Self-reports on practice were recorded in a log book that was also provided. The effect of the program was evaluated by comparing outcomes data before, and 3 months after, implementation of the program. Outcomes assessment included functional mobility (timed “Up & Go” test), muscle flexibility (“Sit & Reach” test), physical capacity (“Six-Minute Walk”), and quality of life [Kidney Disease Quality of Life Short Form (KDQOL-SF)]. Results The program began with 72 participants. Over time, 39 dropped out. The remaining 33 participants included 11 men and 22 women with a mean age of 52.8 ± 9.8 years. They exercised 3 – 7 times weekly. Significant improvements were observed in the timed “Up & Go” ( p = 0.003) and “Sit & Reach” ( p < 0.001) tests. Improvements in the “Six-Minute Walk” ( p = 0.130) and in KDQOL-SF scores for emotional well-being ( p = 0.456), pain ( p = 0.100), burden of kidney disease ( p = 0.061), and general health ( p = 0.085) were statistically insignificant. Conclusions Physically, patients with ESRD benefit from home-based low-capacity aerobic exercise. A home-based program provides an alternative to outdoor and group exercise. In view of a high drop-out rate, intensive promotion and encouragement should be considered to achieve a positive outcome.

P0843EFFECT OF GROUP PSYCHO SOCIAL SUPPORT ON QUALITY OF LIFE AND MORTALITY WITH END STAGE KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Zara Nisar ◽  
Hassan Sajjad ◽  
Nisar Anwar
Keyword(s):  
Quality Of Life ◽  
Group Therapy ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
Group A ◽  
Group B ◽  
End Stage

Abstract Background and Aims The patients of end stage renal disease suffer a lot of psychological trauma as well as feel a lot of social burden. They mostly show psychological distress in different forms, be it impaired quality of life, depression or anxiety. The aim of our study was to find out the effect of supportive-expressive group therapy in end stage kidney disease patients in the outcome of better health related quality of life and survival. Method 181 patients were recruited in the study after consent between June 2012-June 2017. They were then assigned randomly to Group A supportive-expressive group therapy or to a Group B control group (no intervention). It was a double blinded randomized control trial. 115 patients were assigned to Group A and 66 were assigned to group B. The primary outcome was the effect on health related quality of life. Secondly, if it had any impact on survival. Significant predictors of survival were not analysed. Analysis was done by intention to treat. Results The patients of group A showed decrease in physical pain(p=0.002), mood elevation (p=0.04), compliance with treatment (p=0.001), reduced hopelessness (p=0.004), newly diagnosed depressive disorders (p=0.01) and better social life (p=0.003). Group A had 97% survival rate as compared to group B with 77%. Conclusion Supportive-expressive group therapy to patients with end stage kidney disease improves health related quality of life. It also has an effect on survival maybe because of compliance with treatment. We would like to further explore the role of Supportive-expressive group therapy in survival. Support groups should be provided to patients in developing countries like the setup of ours because it has a great impact on the betterment of the patient.

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