Providing counseling through home pharmacy care (HPC) for hemodialysis patients with hypertension in lowering blood pressure

2021 ◽  
Vol 32 (4) ◽  
pp. 459-465
Author(s):  
Rahmiyati Daud ◽  
Bambang Subakti Zulkarnain ◽  
Ivan Virnanda Amu
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Diastolic Blood Pressure ◽  
Hemodialysis Patients ◽  
Patient Medication ◽  
Counseling Group ◽  
Hemodialysis Unit ◽  
Quasi Experimental ◽  
Stage Renal Disease ◽  
End Stage

Abstract Objectives Hypertension is one of the main factors in increasing the risk of cardiovascular disease with 51% reported cause of death in chronic kidney disease (CKD) patients with end-stage renal disease (ESRD). It is a comorbid that needs to be managed properly and gets special attention from various health disciplines including a pharmacist. Methods This was a quasi experimental study with pretest–posttest intervention using home pharmacy care (HPC) counseling both on the counseling and the noncounseling group. Initial data collection and informed consent was done at the Hemodialysis Unit Aloei Saboe and Toto Kabila Hospital, Gorontalo. The parameters in the study were patients’ compliance to their medication using the Medication Adherence Questionnaire (MAQ) and Pill Count Adherence (PCA) questionnaires and the patient’s blood pressure. Results Fifty-eight patients met the inclusion criteria and were divided into two groups (the counseling group and the noncounseling group). Based on MAQ and PCA, the level of patient medication adherence increased significantly in the counseling group compared to the noncounseling group with a significance value of p<0.05. Increasing adherence was correlated with patients’ outcome of lowering blood pressure. More patients in the counseling group showed decrease in systolic and diastolic blood pressure compared to the noncounseling group (86.2 vs. 17.2% for systolic BP and 69 vs. 10.3% for diastolic blood pressure (BP). Following adjusted confounding variables, counseling through HPC provided a chance of decreasing systolic blood pressure 32 times (95% CI: 7.198–144.550) and diastolic blood pressure 42 times (95% CI: 6.204–286.677). Conclusions HPC affects the improvement of patient medication adherence and reduction of blood pressure in hemodialysis patients with hypertension.

scholarly journals RELATIONSHIP BETWEEN INTERDIALYTIC WEIGHT GAIN AND PRE HEMODIALYSIS BLOOD PRESSURE IN HEMODIALYSIS PATIENTS

2020 ◽  
pp. 169-171
Author(s):  
M Manasa ◽  
Aravind Reddy. Gangula
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Water Retention ◽  
Salt Intake ◽  
Hemodialysis Patients ◽  
Interdialytic Weight Gain ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Interdialytic weight gain in patients with hemodialysis depends on fluid, salt intake in interdialytic period and compliance of dialysis patients. In end stage renal disease(ESRD) patients due to decreased and absent residual urine output there is salt and water retention in body which leads to interdialytic weight gain. Overhydration and IDWG is assumed to be the main cause of pre hemodialysis raised blood pressure(BP) in ESRD patients. Here the relationship between IDWG and pre HD blood pressure is studied in 40 hemodialysis patients. We recorded pre HD BP and IDWG in four subsequent hemodialysis sessions for each patient during the period of 2 weeks in patients who are on twice weekly hemodialysis. so, in total we studied 160 hemodialysis sessions. Mean of four pre HD BP is compared with mean of four IDWG for each patient. Then correlation between 40 mean IDWG and 40 mean pre HD BP is studied and also correlation between IDWG and pre HD blood pressure during 160 hemodidlysis sessions studied individually.

scholarly journals Comparison of the efficacy of using paclitaxel-eluting balloon and plain balloon angioplasty for arteriovenous fistula in hemodialysis patients

2019 ◽  
Vol 6 (5) ◽  
pp. 3151-3155
Author(s):  
Alireza Rai ◽  
Mohammadreza Sobhiyeh
Keyword(s):  
Success Rate ◽  
Balloon Angioplasty ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Hemodialysis Patients ◽  
Group 13 ◽  
Quasi Experimental ◽  
Stage Renal Disease ◽  
End Stage ◽  
To Receive

Introduction: Arteriovanous (AV) access failure is one of the main problems in patients with end stage renal disease (ESRD), who receive hemodialysis. Balloon angioplasty is a favorable method for managing vascular access failure. The purpose of this study was to compare the six-month efficacy of paclitaxel-eluting balloon and plain balloon angioplasty in failed AV access cases among hemodialysis patients. Methods: In this quasi-experimental study (http://en.irct.ir/trial/35333), 50 hemodialysis patients with failure of AV access (stenosis > 50%), who were candidates for angioplasty, were included. They were divided to receive either paclitaxel-eluting balloon (25 patients) or plain balloon (25 patients) angioplasty. Patients were followed up for six months with color Doppler ultrasonography and clinical examination for the hemodynamic success rate of angioplasty. Results: After six months, 19 patients (76%) in paclitaxel-eluting balloon angioplasty group achieved hemodynamic success, which was significantly higher than plain balloon angioplasty group (13 patients, 52%) (P = 0.012). Age, gender, diabetes mellitus, hypertension, and location of AVF (snuff box, forearm, and antecubital fossa) did not associate with hemodynamic success rate in any group. Conclusion: The use of angioplasty with paclitaxel-eluting balloon was superior to plain balloon angioplasty for failed AV access cases in hemodialysis patients. It is recommended to use paclitaxeleluting balloon angioplasty in patients with failure of AV access and requirement for balloon angioplasty.  

Long-Term Oral Calcium Supplementation Reduces Diastolic Blood Pressure in End Stage Renal Disease. A Randomized, Double-Blind, Placebo Controlled Study

1994 ◽  
Vol 17 (1) ◽  
pp. 37-40 ◽  
Author(s):  
L.J. Petersen ◽  
M. Rudnicki ◽  
J. Højsted
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Calcium Supplementation ◽  
Controlled Study ◽  
Double Blind ◽  
Oral Calcium ◽  
Calcium Supply ◽  
Stage Renal Disease ◽  
End Stage

Previous studies suggest that oral calcium supply reduces blood pressure in patients with mild to moderate hypertension. The aim of this study was to determine whether oral calcium supply reduces blood pressure in patients undergoing haemodialysis. The study was randomized, double-blind, and placebo controlled. Eleven patients received two grams of calcium per day and 12 patients received placebo. Three patients (one from the calcium group and two from the placebo group) dropped out within the first month. The groups were comparable at inclusion regarding blood pressure, weight, and serum values. Blood pressure measurements were auscultatory with a mercury manometer and diastolic blood pressure was measured as Korotkoff phase V. At inclusion a significant positive correlation between serum phosphate and blood pressure was found. After a study period of six months a significant reduction in diastolic blood pressure was found between the two groups (p < 0.05), but no difference was found in systolic blood pressure. The reduction in diastolic blood pressure was 6.9 mmHg of the pretreatment level in the calcium group. In conclusion, the treatment of secondary hyperparathyroidism with oral calcium gives good benefits in the regulation of diastolic blood pressure. A well controlled phosphate homeostasis may also be of importance for the control of blood pressure in haemodialysis patients.

scholarly journals Concerns of hemodialysis patients

2020 ◽  
Vol 6 (2) ◽  
pp. 56
Author(s):  
Sofia Benetou ◽  
Stavros Tsirigotis ◽  
Evangelos Dousis ◽  
Victoria Alikari ◽  
Eleni Evangelou ◽  
...  
Keyword(s):  
Social Life ◽  
Hemodialysis Patients ◽  
Psychological State ◽  
Categorical Variables ◽  
Patient Centered ◽  
Convenience Sample ◽  
Hemodialysis Unit ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis, which is the most common treatment in individuals with end stage renal disease, includes a series of limitations and modifications in daily life that adversely affect patients' physical and psychological state. Eliciting and addressing patients’ concerns is a key aspect of patient-centered treatment.  Unaddressed concerns may lead to lower satisfaction and   lower quality of medical care.Aim: To explore  concerns of hemodialysis patients. Method and material: A Descriptive study on a convenience sample of  patients undergoing hemodialysis in dialysis centers in Athens. Data was collected by the completion of a questionnaire which included the patients' concerns. Categorical variables are presented by absolute and relative frequencies (percentages).Results: In the present study were enrolled 100 patients, of whom 73% were male, 55% were>60 years old, 66% were married and 30% of primary level of education. Regarding patients' concerns, 36% of participants were bothered to spend time on dialysis center, 65% and 49% were concerned about a possible discontinue of fistula and hemodialysis machine respectively, while 59% were concerned about restrictions  in social life, 39% in their role as a spouse,  71% about fluid restrictions, 55% about diet restrictions and  53% were concerned about transport "to and from" hemodialysis unit. In terms of limitations due to hemodialysis,  30% reported limitation in clothes, 69% in going for holidays and 67% in sexual life.Conclusions: Expanding nurses knowledge about patients' concerns  is essential to implement individualized effective therapeutic strategies.

scholarly journals Association Between Systolic and Diastolic Blood Pressure Variability and the Risk of End-Stage Renal Disease

Hypertension ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 880-887 ◽  
Author(s):  
Eun Hui Bae ◽  
Sang Yup Lim ◽  
Kyung-Do Han ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
Diastolic Blood Pressure ◽  
End Stage Renal Disease ◽  
Blood Pressure Variability ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Application of regularized regression to identify novel predictors of mortality in a cohort of hemodialysis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stanislas Werfel ◽  
Georg Lorenz ◽  
Bernhard Haller ◽  
Roman Günthner ◽  
Julia Matschkal ◽  
...  
Keyword(s):  
Statistical Learning ◽  
Cox Regression ◽  
Serum Levels ◽  
Hemodialysis Patients ◽  
Derivation Cohort ◽  
Predictors Of Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Study Participants ◽  
Related Mortality

AbstractCohort studies often provide a large array of data on study participants. The techniques of statistical learning can allow an efficient way to analyze large datasets in order to uncover previously unknown, clinically relevant predictors of morbidity or mortality. We applied a combination of elastic net penalized Cox regression and stability selection with the aim of identifying novel predictors of mortality in a cohort of prevalent hemodialysis patients. In our analysis we included 475 patients from the “rISk strAtification in end-stage Renal disease” (ISAR) study, who we split into derivation and confirmation cohorts. A wide array of examinations was available for study participants, resulting in over a hundred potential predictors. In the selection approach many of the well established predictors were retrieved in the derivation cohort. Additionally, the serum levels of IL-12p70 and AST were selected as mortality predictors and confirmed in the withheld subgroup. High IL-12p70 levels were specifically prognostic of infection-related mortality. In summary, we demonstrate an approach how statistical learning can be applied to a cohort study to derive novel hypotheses in a data-driven way. Our results suggest a novel role of IL-12p70 in infection-related mortality, while AST is a promising additional biomarker in patients undergoing hemodialysis.

Depression in end-stage renal disease hemodialysis patients

2006 ◽  
Vol 2 (12) ◽  
pp. 678-687 ◽  
Author(s):  
Daniel Cukor ◽  
Rolf A Peterson ◽  
Scott D Cohen ◽  
Paul L Kimmel
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Stage Renal Disease ◽  
End Stage
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