scholarly journals The Effectiveness of Roy’s Adaptation Model for Patients with Chronic Kidney Disease Undergoing Pre-Dialysis in Indonesia

Jurnal NERS ◽  
2019 ◽  
Vol 13 (2) ◽  
pp. 150
Author(s):  
Tri Hapsari Retno Agustiyowati ◽  
Ratna Sitorus ◽  
Agung Waluyo ◽  
Besral Besral

Introduction: Patients with chronic kidney disease (CKD) undergoing pre-dialysis requires a good self-management to control low protein intake and maintain kidney function. Adaptation to the existing stimulus through coping and adjustment mechanisms is important to maintaining good kidney function. However, few studies applied nursing theory based to guide intervention in helping the adaptation of patient CKD with their condition. The purpose of this study is to evaluate the effectiveness of Roy’s adaptation model towards physiological and psychological adaptation response among patients with CKD undergoing pre-dialysis.Methods: This study was conducted using a quasi-experiment to patients with CKD pre-dialysis, age over 18 years old. We modified Roy’s adaptation model for patients with CKD undergoing pre-dialysis.Results: A total of 70 subjects agreed to join the study, 38 subjects in intervention and 32 subjects in the control group. The mean of eGFR ranged from 26.3 to 26.6 mL/min/1.73 m2. We found that Roy’s adaptation model has significantly improved drinking behavior, reduce protein intake, blood creatinine, and psychosocial adaptation response after the intervention.Conclusion: These study findings suggested that Roy’s adaptation model is effective to help patients with CKD undergoing pre-dialysis improve their behavior and maintain kidneyfunction . Model dissemination, advocacy to related units, and application in nursing care in patients with chronic kidney disease pre-dialysis are necessary.

Author(s):  
V.G. Maidannyk ◽  
E.A. Burlaka ◽  
I.V. Bagdasarova ◽  
S.P. Fomina ◽  
V.M. Nepomnyaschiy

Aim of the study: to study the indicators of cellular hypoxia and apoptosis in pediatric patients with nephritic type of chronic glomerulonephritis. Material and methods: 52patients with active stage of nephrotic type ofChronic glomerulonephritis were inspected. All patients were divided into groups of Chronic Kidney Disease (CKD) by the level of glomerular filtration rate (GFR). Detection of the hypoxia–induced factor (HIF) and antiapoptotic factor Bcl–xL in serum performed using Western Blotting assay and immunohistochemically on material of kidney biopsies. Imaging was done using confocal laser microscopy. Results: it has been found that the disease course is accompanied by increased levels of hypoxia–induced factor HIF–1a and decreased expression of antiapoptotic factor Bcl–xL (in plasma and on biopsies). Detected changes significantly depended on the degree of proteinuria and declining of glomerular filtration rate. Dependence between the levels of hypoxia–induced damages and level of kidney function impairment was documented. In children with Chronic Kidney Disease (SKDIst.) HIF–1a was at level 128.6±2.3% (P<0.01, compared to Control group), in children with CKD II–III st. – 141.3±1.9% (P<0.01, compared to Control group and CKD I st.). Level of antiapoptotic defense in children with nephrotic type of Chronic glomerulonephritis was related to the level of kidney function impairment as well. In group of patient with CKDIst. Bcl–xL expression was down–regulated to 75.1±2.2%, in group with CKDII–IIIst. — to 60.1+1.8% (P<0.01 and P<0.001, compared to Control group, respectively). The level of evaluated changes has a dependence on levels ofproteinuria and kidney function impairment. Conclusion. Studied parameters might be used as predictors of unfavorable disease course.


2021 ◽  
Vol 9 (T4) ◽  
pp. 106-110
Author(s):  
Susanti Susanti ◽  
Difran Nobel Bistara

BACKGROUND: Chronic kidney disease (CKD) is a chronic illness with complex disease which could lead to other underlying diseases such as diabetes mellitus (DM), hypertension, and dyslipidemia. Urban population must manage their illness due to their occupation. Coaching support is an advanced method to help individuals manage their illnesses, especially chronic illness. Symptoms and complaints in early-stage renal disorders tend to be mild, making it difficult to diagnose only by clinical examination. Impaired kidney function can lead to progressive kidney damage. AIM: This study aimed was to analyze the effect of coaching support in maintaining kidney function in patients with CKD. METHODS: This research used quasi-experiment with pre-test and post-test with control group design. Respondents in this study were 40 CKD patients which were taken by consecutive sampling technique and divided into two groups, namely, control group and treatment group. Data were collected using blood urea nitrogen and creatinine values observation sheet. Coaching support was divided into four steps of therapy, identify the disturbance, identify based on experience, use a family support system, and evaluating the results. Data were analyzed using paired t-test and independent t-test with a significance of p < 0.05. RESULTS: This study found that there was a significant difference in kidney function between the control group and the treatment group (p = 0.000). Coaching support interventions were effective on kidney function in patients with CKD. The implementation of coaching support went well because respondents and families were proactive. CONCLUSION: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.


2021 ◽  
Vol 4 (2) ◽  
pp. 118
Author(s):  
Busyra Busyra ◽  
Yudha Nurhantari ◽  
Suhartini Suhartini ◽  
Maria Agnes Etty Dedy ◽  
Tri Ratnaningsih

Chronic kidney disease is a preventable high-burden disease. Several risk factors for impaired kidney function have been identified, including lifestyles, such as alcohol drinking and cigarette smoking. However, the evidence remains inconsistent. East Nusa Tenggara has the largest proportion of heavy alcohol drinking among all provinces in Indonesia. Genetic polymorphism of aldehyde dehydrogenase 2 (ALDH2) is related to alcohol drinking behavior through the inactivity of the ALDH2 enzyme, which leads to toxic acetaldehyde accumulation. This study aims to recognize the linkage of ALDH2 genotypes to kidney function among alcohol drinkers and cigarette smokers in East Nusa Tenggara. This study was a cross-sectional study of East Nusa Tenggara ethnicity, aged 18-60 years old. Demographic and lifestyle data were obtained via a questionnaire. DNA analysis was conducted with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Creatinine and BUN levels were measured with a chemistry analyzer. Afterward, the estimated glomerular filtration rate (eGFR) was calculated from creatinine value using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The association between kidney function status and alcohol drinking and cigarette smoking habits were analyzed using the chi-square test, then stratified based on genotype groups. Fifty-one subjects were included in this study, while the mean age was 26.33±1.33 years and the median age was 22 years. There were 37 (72.5%) alcohol drinkers and 14 (27.5%) non-drinkers; 28 (54,9%) cigarette smokers and 23 (45.1%) non-smokers. This study revealed no significant association between kidney function status and alcohol drinking habits. Cigarette smoking habits were inversely associated with eGFR decline and creatinine elevation in wild-type ALDH2 groups.


2017 ◽  
Vol 66 (3) ◽  
pp. 669-675 ◽  
Author(s):  
Qi-feng Liu ◽  
Jian-ming Ye ◽  
Li-xia Yu ◽  
Ao-lin He ◽  
Qiang Sun ◽  
...  

To investigate whether the soluble Klotho (s-Klotho) level in patients with chronic kidney disease (CKD) is related to kidney function and whether a low s-Klotho level can predict adverse renal outcomes or CKD progression in patients with advanced CKD. 112 patients with CKD stages 3–5 and 30 healthy volunteers were enrolled. Blood samples were collected to measure serum creatinine, calcium, phosphorus, intact parathyroid hormone, and hemoglobin. s-Klotho and fibroblast growth factor 23 (FGF23) were determined by ELISA. We first conducted a cross-sectional study to investigate correlations between s-Klotho and estimated glomerular filtration rate (eGFR) and other parameters. Patients were then followed prospectively for 20.1±10.1 months according to s-Klotho median level until serum creatinine doubled, or initiation of renal replacement therapy, or death. s-Klotho levels inpatients with CKD were significantly lower than that in the control group. For patients with CKD, there were no differences in age distribution among subgroups. However, s-Klotho level differed significantly across CKD stages, and it was lower in the advanced CKD group compared with the moderate CKD group. Correlation analysis revealed that s-Klotho was positively associated with eGFR, but inversely associated with FGF23. During the follow-up of 20.1±10.1 months, patients with higher s-Klotho levels showed a reduced risk of kidney adverse outcomes, including serum creatinine doubling and initiation of renal replacement therapy. Cox regression analysis revealed that low s-Klotho was an independent risk factor for CKD progression. s-Klotho level was closely correlated with kidney function, further, low s-Klotho level could predict adverse kidney disease outcomes in patients with progressive CKD.


2020 ◽  
pp. 985-992
Author(s):  
Sama S. Salih ◽  
Jabbar H. Yenzeel ◽  
Ali j. Alsaady

Chronic kidney disease (CKD) is a permanent loss of kidney function which is diagnosed when the glomerular filtration rate (GFR) is under 60 ml\min\1.73m2 for more than three months. The present study was conducted at Kidney Transplant and Dialysis Center in the Medical City in Baghdad from October 2018 to April 2019. Sixty CKD patients with an age ranged of 40 to 65 years and 25 healthy subjects were involved in this study. Blood samples were collected to evaluate the levels of kidney function parameters and thyroid hormones. The levels of urea, creatinine and uric acid showed highly significant (p ≤ 0.01) increases in CKD patient in comparison with the control group, while the values of GFR and creatinine clearance showed highly significant (p ≤ 0.01) decreases. The results of thyroid hormones showed highly significant (p < 0.01) decreases in the levels of T3 and T4 along with a highly significant (p < 0.01) increase in the level of TSH in the patients.


2018 ◽  
Vol 120 (7) ◽  
pp. 740-750 ◽  
Author(s):  
Aslaug Drotningsvik ◽  
Øivind Midttun ◽  
Adrian McCann ◽  
Per Magne Ueland ◽  
Ingmar Høgøy ◽  
...  

AbstractObesity increases the risk for developing kidney disease, and protection of kidneys through changes in diet should be investigated. Fish intake has been associated with reduced risk of developing kidney disease; therefore, we wanted to investigate whether cod protein intake could prevent or delay the development of kidney damage in an obese rat model that spontaneously develops proteinuria and focal segmental glomerulosclerosis. The aim of the study was to investigate any effects of cod protein intake on established markers of kidney function, amino acid composition, protein utilisation and growth in obese Zucker fa/fa rats in the early stage of decreased renal function. Male obese Zucker fa/fa rats (HsdOla:Zucker-Lepr) were fed cod muscle proteins in an amount corresponding to 25 % of dietary protein, with the remaining protein from a casein/whey mixture (COD diet). A control group was fed a diet with a casein/whey mixture as the only protein source (CAS diet). The intervention started when rats were 9–10 weeks old, and the rats were fed these diets for 4 weeks. At the end of the study, rats fed the COD diet had lower urine concentration of cystatin C, T-cell immunoglobulin mucin-1 (TIM-1), amino acids, carbamide, uric acid and ammonium and higher concentrations of creatine, trimethylamine N-oxide, 1-methylhistidine and 3-methylhistidine, lower kidney concentration of TIM-1 and showed better growth when compared with the CAS group. To conclude, cod protein may have the potential to delay the development of kidney damage in young obese Zucker rats and to improve protein utilisation and growth.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Basma Sultan ◽  
Hamdy Omar ◽  
Housseini Ahmed ◽  
Mahmoud Elprince ◽  
Osama Anter adly ◽  
...  

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.


Bone Research ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Guillaume Courbon ◽  
Connor Francis ◽  
Claire Gerber ◽  
Samantha Neuburg ◽  
Xueyan Wang ◽  
...  

AbstractBone-produced fibroblast growth factor 23 (FGF23) increases in response to inflammation and iron deficiency and contributes to cardiovascular mortality in chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL or lipocalin 2; LCN2 the murine homolog) is a pro-inflammatory and iron-shuttling molecule that is secreted in response to kidney injury and may promote CKD progression. We investigated bone FGF23 regulation by circulating LCN2. At 23 weeks, Col4a3KO mice showed impaired kidney function, increased levels of kidney and serum LCN2, increased bone and serum FGF23, anemia, and left ventricular hypertrophy (LVH). Deletion of Lcn2 in CKD mice did not improve kidney function or anemia but prevented the development of LVH and improved survival in association with marked reductions in serum FGF23. Lcn2 deletion specifically prevented FGF23 elevations in response to inflammation, but not iron deficiency or phosphate, and administration of LCN2 increased serum FGF23 in healthy and CKD mice by stimulating Fgf23 transcription via activation of cAMP-mediated signaling in bone cells. These results show that kidney-produced LCN2 is an important mediator of increased FGF23 production by bone in response to inflammation and in CKD. LCN2 inhibition might represent a potential therapeutic approach to lower FGF23 and improve outcomes in CKD.


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