scholarly journals An Exploratory Qualitative Study of Patient and Caregiver Perspectives of Ambulatory Kidney Palliative Care

2021 ◽  
pp. 104990912098612
Author(s):  
Alycia A. Bristol ◽  
Sobaata Chaudhry ◽  
Dana Assis ◽  
Rebecca Wright ◽  
Derek Moriyama ◽  
...  
Keyword(s):  
Palliative Care ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
The United States ◽  
Qualitative Description ◽  
Disease Stage ◽  
Structured Interviews ◽  
Care Clinic ◽  
Clinical Model

Objectives: The ideal clinical model to deliver palliative care to patients with advanced kidney disease is currently unknown. Internationally, ambulatory kidney palliative care clinics have emerged with positive outcomes, yet there is limited data from the United States (US). In this exploratory study we report perceptions of a US-based ambulatory kidney palliative care clinic from the perspective of patient and caregiver attendees. The objective of this study was to inform further improvement of our clinical program. Methods: Semi-structured interviews were conducted to elicit the patient and caregiver experience. Eleven interviews (8 patients with chronic kidney disease stage IV or V and 3 caregivers) were analyzed using qualitative description design. Results: We identified 2 themes: “Communication addressing the emotional and physical aspects of disease” and “Filling gaps in care”; Subthemes include perceived value in symptom management, assistance with coping with disease, engagement in advance care planning, program satisfaction and patient activation. Significance of Results: Qualitative analysis showed that attendees of an ambulatory kidney palliative care clinic found the clinic enhanced the management of their kidney disease and provided services that filled current gaps in their care. Shared experiences highlight the significant challenges of life with kidney disease and the possible benefits of palliative care for this population. Further study to determine the optimal model of care for kidney palliative care is needed. Inclusion of the patient and caregiver perspective will be essential in this development.

scholarly journals Analysof Reticulocyte Hemoglobin Equivalent Levels in Patients with Chronic Kidney Disease Stage IV and V

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Agri Febria Sari ◽  
Rikarni Rikarni ◽  
Deswita Sari
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Status ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Disease Stage ◽  
Cross Sectional ◽  
Iron Storage ◽  
Laboratory Installation ◽  
Ckd Stage

Reticulocyte hemoglobin equivalent (RET-He) represents hemoglobin content in reticulocyte. Reticulocyte hemoglobin equivalent test can be used to asses iron status of chronic kidney disease (CKD). Iron deficiency happens in 40% CKD and could lead to anemia manifestation. Level of RET-He gives real-time assesment of iron availability for hemoglobin production and the level will getting lower when iron storage for erythropoiesis decreasing. Reticulocyte hemoglobin equivalent is more stabil than feritin and transferin saturation in assessing iron status. Aim of this study is to determine RET-He level in patients with CKD stage IV and V. This study is  a cross sectional descripstive study. Subjects were 96 CKD stage IV and V patients that met inclusion and exclusion criterias. Subjects conducted blood tests at Central Laboratory Installation Dr. M. Djamil Hospital Padang from July to September 2020. Examination of RET-He level was analyzed by Sysmex XN-1000 flowcytometry fluorescense method. Data was presented in frequency distribution table. The RET-He level below cutoff (<29,2 pg) indicates the need for iron suplementation therapy for CKD stage IV and V patients. Samples with RET-He level below cutoff were 48 (50%) and 48 (50%) were above cutoff.

scholarly journals Immunogenicity and safety of quadrivalent human papillomavirus types 6/11/16/18 recombinant vaccine in chronic kidney disease stage IV, V and VD

2016 ◽  
pp. gfv444 ◽  
Author(s):  
Kearkiat Praditpornsilpa ◽  
Pornchai Kingwatanakul ◽  
Tawatchai Deekajorndej ◽  
Pornpimol Rianthavorn ◽  
Paweena Susantitaphong ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Human Papillomavirus ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Recombinant Vaccine ◽  
Disease Stage

The role of hepcidin as a biomarker for iron status in patients with chronic kidney disease (stage IV and V) with negative virology

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy M El Sharkawy ◽  
Heba W Elsaid ◽  
Lina E Khedr ◽  
Ahmed M Ibraheem
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Significant Positive Correlation ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Disease Stage ◽  
Positive Correlation ◽  
Stage 4 ◽  
Ckd Stage ◽  
Serum Hepcidin

Abstract Background Anemia is a severe complication of chronic kidney disease (CKD) that is seen in more than 80% of patients with impaired renal function. Hepcidin, an acute phase reactant protein produced in the liver, is a key regulator of iron homeostasis. Aim of the Work to assess hepcidin level in 45 non-dialysis patients (CKD stage IV and V with negative virology) and its relation to iron parameters. Patients and Methods A cross sectional study was conducted at Nasser Institute for Treatment and Research on 45 patients with chronic kidney disease stage IV and V. All patients included in this study were subjected to the following: Careful history taking, full clinical examination and proper laboratory investigations. Results A statistically significant difference was found between CKD stage 4 and stage 5 according to Hb., iron, TIBC, Frerretin, serum and CRP. Also, there was a significant positive correlation of serum hepcidin with serum ferretin and hsCRP, while Hb and iron were significantly negatively correlated with hepcidin. We found statistically significant decrease in Hb level, serum Iron level, and TIBC in CKD stage 5 less than stage 4. We found statistically significant increase in Hepcidin level, serum ferritin, and hsCRP in CKD stage 5 more than stage 4. We found statistically significant Positive correlation between serum hepcidin with serum ferretin among patients with CKD stage 4 and 5. We found statistically significant Positive correlation between serum hepcidin with hsCRP among patients with CKD stage 4 and 5. We found statistically significant negative correlation between serum hepcidin with Hb among patients with CKD stage 4 and 5. A statistically significant Positive correlation between serum hepcidin with serum Iron among patients with CKD stage 4 and 5. Also we reported a statistically non-significant negative correlation between serum hepcidin and TIBC. Conclusion Elevated hepcidin can predict the need for parenteral iron to overcome hepcidin-mediated iron-restricted erythropoiesis and need for relatively higher rhEPO doses to suppress hepcidin in CKD patients with negative viral markers.

The effect of lanthanum carbonate on metabolic acidosis in patients with chronic kidney disease stage IV, V and V-D

2015 ◽  
Vol 47 (7) ◽  
pp. 1165-1171 ◽  
Author(s):  
William Beaubien-Souligny ◽  
Sarah Bezzaoucha ◽  
Vincent Pichette ◽  
Jean-Philippe Lafrance ◽  
Robert Bell ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Metabolic Acidosis ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Lanthanum Carbonate ◽  
Disease Stage

Internet-Based Tools to Assess Diet and Provide Feedback in Chronic Kidney Disease Stage IV: A Pilot Study

2013 ◽  
Vol 23 (2) ◽  
pp. e33-e42 ◽  
Author(s):  
Sameer Murali ◽  
Lenore Arab ◽  
Roberto Vargas ◽  
Anjay Rastogi ◽  
Alfonso Ang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Pilot Study ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Disease Stage

scholarly journals Síntomas, comorbilidad y estado funcional de los pacientes con enfermedad renal crónica estadio 5 en manejo renal conservador

2021 ◽  
Vol 20 (3) ◽  
pp. 33-54
Author(s):  
Daniel Gutiérrez Sánchez ◽  
Juan P. Leiva-Santos
Keyword(s):  
Chronic Kidney Disease ◽  
Palliative Care ◽  
Kidney Disease ◽  
Barthel Index ◽  
Chronic Kidney Disease Stage ◽  
Functional Decline ◽  
Symptom Burden ◽  
Disease Stage ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Objetivos: Determinar la prevalencia e intensidad de síntomas pacientes con Enfermedad Renal Crónica estadio 5 en manejo renal conservador y analizar su asociación con la comorbilidad y el estado funcional. Método: Estudio descriptivo, correlacional, de corte transversal. Para la evaluación de síntomas se utilizó la versión española modificada de la Palliative care Outcome Scale-Symptoms Renal. La comorbilidad fue evaluada con el índice de comorbilidad de Charlson modificado. Para la evaluación del estado funcional y grado de dependencia se utilizó el índice de Barthel. Resultados: 60 pacientes fueron incluidos en este estudio. Más del 50% de los pacientes presentaron debilidad, dolor, dificultad para dormir, poco apetito y problemas en la boca, encontrándose el dolor y la debilidad entre los síntomas más intensos. Las principales condiciones comórbidas fueron: diabetes, cardiopatía isquémica, enfermedad vascular periférica y neoplasias. La media del índice de Barthel fue 88±14,2. No se encontró asociación entre la comorbilidad y la sintomatología (p=0,43). El deterioro del estado funcional se asoció con la carga de síntomas (p=0.001).Conclusiones: Los pacientes con Enfermedad Renal Crónica estadio 5 en manejo renal conservador sufren una elevada carga de síntomas. La debilidad fue síntoma más frecuente en esta población. La carga sintomática se asoció con el deterioro del estado funcional. Futuros estudios sobre el impacto de los síntomas en estos pacientes, así como las intervenciones necesarias para su óptimo manejo deberían ser considerados. Objective: To determine the prevalence and severity of symptoms of patients with Chronic Kidney Disease Stage 5 managed conservately, and their association with the comorbidities and functional status. Methods: A cross-sectional, descriptive, and correlational design was used. Symptom data were collected using the Spanish modified version of Palliative care Outcome Scale-Symptoms Renal. Comorbidity was collected and scored according to the modified Charlson Comorbidity Index. For the evaluation of functional status, the Barthel index was used.Results: 60 patients were included in this study. More than 50% of patients described weakness, pain, difficulty for sleeping, poor appetite and mouth problems. Diabetes, coronary artery disease, and peripheral vascular disease, and tumor, were the main comorbid conditions of these patients. The mean score of Barthel index was 88±14.2. There was no significant correlation between comorbidities and symptoms (p=0.43). There was a significant correlation between symptoms and functional decline (p=0.001).Conclusions: Patients with Chronic Kidney Disease Stage 5 experience a high level of symptom burden. Weakness was the most prevalent symptom in this sample population. Symptom burden correlated with functional decline. Further longitudinal studies are needed that analyse the impact of symptoms and their management in this population.

scholarly journals EXPEDIENCY USING OF LOW-PROTEIN UKRAINIAN DISHES AND KETO/AMINO ACIDS IN THE TREATMENT OF CHRONIC KIDNEY DISEASE STAGE IV-V

2017 ◽  
pp. 42-45
Author(s):  
T. D. Nykula ◽  
V. O. Moyseyenko ◽  
O. O. Naumova
Keyword(s):  
Chronic Kidney Disease ◽  
Amino Acids ◽  
Kidney Disease ◽  
Food Processing ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Dietary Treatment ◽  
Disease Stage ◽  
Dietary Interventions ◽  
Low Protein

Through the analysis of literature, the results of own research and development, 48-year-old experience in the nephrologìcal clinic outlines the dietary treatment of chronic kidney disease (CKD). Common issues with dietary interventions in CKD, optimal protein diet lowprotein quota must provide, culinary food processing of dietary interventions in patients with CKD. Particular attention is drawn to the use of Ukrainian low-protein dishes, which were developed by the author, and their combination with ketoacids including Ketosteril.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

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