Chronic Renal Failure: The Impact of Improved Medical Treatment Options on Rehabilitation

1996 ◽  
Vol 27 (1) ◽  
pp. 7-12
Author(s):  
Ruth Torkelson Lynch ◽  
Susan Gallagher-Lepak

The life quality potential and functional outcome status of individuals with chronic renal failure has been and will continue to be influenced by improved medical treatment options. Rehabilitation counselors are strongly urged to keep their knowledge up-to-date regarding developments in healthcare and technology in order to readjust their perspectives regarding rehabilitation possibilities. The progression of chronic renal failure is described followed by an update on current medical treatment options. Functional implications are presented with an emphasis on how specific treatment methods impact functional outcomes. Rehabilitation counseling practice guidelines are provided for assessment, counseling, and job placement.

2021 ◽  
Vol 10 (5) ◽  
pp. 1073
Author(s):  
Patricia Martínez-Botía ◽  
Ángel Bernardo ◽  
Andrea Acebes-Huerta ◽  
Alberto Caro ◽  
Blanca Leoz ◽  
...  

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.


Author(s):  
Fariba Shaikhi Shoshtari ◽  
Sasan Biranvand ◽  
Leila Rezaei ◽  
Nader Salari ◽  
Nasrin Aghaei

PEDIATRICS ◽  
1977 ◽  
Vol 60 (1) ◽  
pp. 46-50
Author(s):  
William A. Primack ◽  
Ira Greifer

A hemodialysis unit was established at a rural summer camp for children. Required medical treatment was planned so as to interfere as little as possible with normal camp programs. Campers who require dialysis were mixed fully into the population of normal campers. Twenty-two children participated during the first summer of operation. Our experience indicates that children on maintenance hemodialysis can be integrated with normal peers in a recreational program and can improve their self-image and self-confidence. The program also demonstrates that chronic pediatric hemodialysis can be safely performed in a rural satellite unit.


1983 ◽  
Vol 143 (1) ◽  
pp. 87-88
Author(s):  
John Kogeorgos

Regular, long term haemodialysis is a standard treatment of patients in chronic renal failure. Its psychiatric implications have been dealt with in a number of studies, most of which concentrate on purely psychological or social aspects, for example patients' perception of and response to illness (Pritchard, 1974), the relevance to outcome of basic personality (Kaplan De-Nour and Czaczkes, 1976), or the impact on the family of dialysis carried out at home (Farmer et al, 1979). There are two distinct psychiatric syndromes of importance which can be clinically recognized.


2012 ◽  
Vol 36 (5) ◽  
pp. 702 ◽  
Author(s):  
Do Yub Ku ◽  
Young Sook Park ◽  
Hyun Jung Chang ◽  
Sung Rok Kim ◽  
Jeoung Whan Ryu ◽  
...  

2019 ◽  
Vol 181 (4) ◽  
pp. R147-R153 ◽  
Author(s):  
Benjamin Lechner ◽  
Katharina Lechner ◽  
Daniel Heinrich ◽  
Christian Adolf ◽  
Finn Holler ◽  
...  

In patients with primary aldosteronism, specific treatment provides prognostic benefit over optimal antihypertensive therapy and is therefore crucial to reduce mortality and morbidity in this subgroup of patients with hypertension. Prognostic relevance has been shown for adrenalectomy in unilateral disease and for medical treatment with mineralocorticoid receptor antagonists in bilateral adrenal hyperplasia. Collectively, evidence points to the superiority of surgical treatment compared to medical treatment. The causal approach of removing the mineralocorticoid excess, as well as the often-accompanying glucocorticoid excess, might provide one biologically plausible explanation for the observation of slightly better outcomes with surgical therapy. However, in patients living with primary aldosteronism, medical treatment is often insufficient for three major reasons. First and foremost, no marker of sufficient aldosterone blockade has yet been established and therefore adequate treatment of the aldosterone excess is often dismissed as a treatment goal. Second, side effects often limit patient compliance. Third, as recommendations differ from other indications like heart failure, drug dosing is often inadequate. The aim of this review is first to provide an overview over medical treatment options and second to review potential markers for treatment surveillance in patients with primary aldosteronism.


2020 ◽  
Vol 14 (1) ◽  
pp. 101-109
Author(s):  
Indra Maulana ◽  
Iwan Shalahuddin ◽  
Taty Hernawaty

Psychosocial factors: The depression level  in patients with chronic kidney disease maintained on dialysisBackground: Chronic renal failure undergoing hemodialysis therapy in the world is almost 1.5 million people, and in Indonesia there are approximately 0.2 people with chronic renal failure undergoing hemodialysis therapy. The impact of hemodialysis on the physical that will occur in patients become weak tired in living their daily lives, against the psychological impact that will occur on sleep problems, impurity and depression, the impact on social and economic conditions that will occur to patients on social relationships, and on the environment the client will also have an impact on the social environment in which he lives. Therefore hemodialysis therapy will have an impact on the quality of life of patients.Purpose: To determine Psychosocial factors: the depression level  in patients with chronic kidney disease maintained on dialysisMethod: A descriptive correlational study by a cross sectional design approach. The sample used was 40 respondents, data collection techniques using questionnaires and direct observation with results calculated based on the total answers to questions given by respondents with criteria: score <17 = no sign of depression, score 18-24 = mild depression, score 25-34 = moderate depression and a score of 35-51 = severe depression, while the bivariate test used chi-squareResults: There was a relationship among factors such as: age, educational, sex, duration of maintaine of hemodialysis therapy and sleep patterns with the depression level in patients with chronic kidney disease under maintained on dialysis at Garut dr. Slamet Hospital.Conclusion: Health workers (nurses) to provide motivational and therapeutic informing in implementing hemodialysis therapy so that patients are more excited and better understand the importance of hemodialysis and to reduce the level of depression.Keywords: Depression level; Patients; Chronic kidney disease; DialysisPendahuluan: Penyakit gagal ginjal kronik yang menjalani terapi hemodialisis di dunia hampir sekitar 1,5 juta orang, dan di indonesi hampitr sekitar 0,2 jiwa penderita gagal ginjal kronik yang menjalani terapi hemodialisis. Dampak hemodialisis terhadap fisik yang akan terjadi pada pasien menjadi lemah lelah dalam menjalani kehidupan sehari-hari, terhadap psikologis dampak yang akan terjadi pada masalah tidur, kecemasaan dan depresi, dampak terhadap sosial dan ekonomi yang akan terjadi pada pasien pada hubungan sosialnya, dan pada lingkungan klien juga akan berdampak pada sosial lingkungan dimana dia tinggal. Maka dari itu terapi hemodialisis akan berdampak pada kualitas hidup pasien.Tujuan: Mengetahui faktor-faktor yang berhubungan dengan tingkat depresi pada pasien gagal ginjal kronis yang menjalani tindakan HemodialisaMetode: Menggunakan rancangan deskriptif korelasional dengan pendekatan desain cross sectional dengan sampel sebanyak 40 responden, teknik pengambilan data menggunakan kuesioner dan observasi langsung dengan hasil dihitung berdasarkan  total jawaban dari pertanyaan yang diberikan responden dengan kriteri skor <  17 = tidak ada depresi,  skor 18-24 = depresi ringan,  skor 25-34= depresi sedang dan skor 35-51= depresi berat                        sedangkan uji bivariat menggunakan chi-square.Hasil: Menunjukan adanya hubungan antara faktor : usia, pendidikan, jenis kelamin, lamanya periode menjalani terapi hemodialisa dan pola tidur. Semua faktor tersebut sangat  berhubungan dengan tingkat depresi pada pasien gagal ginjal kronik yang menjalani tindakan hemodialisa di Ruang Hemodialisa RSUD dr. Slamet Garut.Simpulan: Petugas kesehatan (perawat) agar memberikan motivasi dan terapeutik informing dalam pelaksanaan terapi hemodialisa agar pasien lebih bersemangat dan lebih memahami pentingnya hemodialisa serta untuk mengurangi tingkat depresi.


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