scholarly journals A simple, sustained and sufficient calcium regulation scheme during perioperative period for the secondary hyperparathyroidism

2020 ◽  
Author(s):  
WeiBin Zhang ◽  
Jia Dong ◽  
YunFei Wu ◽  
Bin Zheng ◽  
Jin Dai ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Secondary Hyperparathyroidism ◽  
Calcium Regulation ◽  
Perioperative Period ◽  
Control Group ◽  
Observation Group ◽  
Blood Calcium ◽  
Regulation Scheme ◽  
Significant Difference

Abstract Background: Patients of secondary hyperparathyroidism (SHPT) with chronic renal failure treated by long-term dialysis have received surgical treatment. The severe complications, especially convulsions caused by severe hypocalcemia, would endanger lives during perioperative treatment. Therefore, this study aims to explore a simple, sustained and sufficient calcium regulation scheme during perioperative period, which could stabilize blood calcium concentration and correct calcium deficiency, greatly reduce the occurrence of the complications.Methods: We reviewed the clinical data of 136 patients with chronic renal failure in uremic stage from Jinzhou Central Hospital and the Second Affiliated Hospital of Dalian Medical University, who received dialysis treatment for a long time and finally diagnosed as secondary hyperparathyroidism, from Jan 2017 to Dec 2019, were accepted different operations to treat hyperparathyroidism, were given corresponding calcium regulation therapy to avoid serious complications were, and were divided into the observation group and the control group according to the postoperative calcium regulation time of ≤7 days and > 7 days, which is defined by the mean time of postoperative calcium regulation, and by the time from the day of operation until the day when the patients have stable blood calcium levels and no obvious discomfort symptoms.Results: Compared with the control group, the observation group were elder (54.01±9.215, P<0.01), shorter preoperative dialysis time (5.05±2.855, P<0.01), significant difference in operation mode (P=0.026), positive preoperative oral calcium(c2=9.941, P=0.002), higher preoperative calcium value (t=4.795, P<0.001), lower preoperative Parathyroid Hormone(PTH) value (t=6.327, P<0.001), lower preoperative Alkaline phosphatase (ALP) value (t=3.527, P=0.001). Multivariate analysis showed that age, preoperative calcium value, preoperative PTH value and preoperative ALP value were independent risk factors for postoperative calcium regulation therapy. Those factors, Gender, preoperative dialysis mode, complications, preoperative Hemoglobin(HB) value, were not related to postoperative calcium regulation. There was no significant difference between the two groups (P>0.05).Conclusion: The simple, sustained and sufficient calcium regulation scheme can maintain a stable level of blood calcium in the dialytic CKD patients with secondary hyperparathyroidism, so as to avoid the occurrence of severe hypocalcemia and increase the curate.

Recommend a simple, sustained and sufficient perioperative calcium regulation therapy and analysis of related factors during perioperative period for secondary hyperparathyroidism

2020 ◽  
Author(s):  
WeiBin Zhang ◽  
Jia Dong ◽  
YunFei Wu ◽  
Bin Zheng ◽  
Jin Dai ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Secondary Hyperparathyroidism ◽  
Calcium Regulation ◽  
Control Group ◽  
Observation Group ◽  
Blood Calcium ◽  
Regulation Scheme ◽  
Preoperative Serum ◽  
Significant Difference

Abstract Background: Patients of secondary hyperparathyroidism (SHPT) with chronic renal failure treated by long-term dialysis have received surgical treatment. The severe complications, especially severe hypocalcemia, would endanger lives during perioperative treatment. Therefore, this study aims to recommend a simple, sustained and sufficient perioperative calcium regulation scheme, and analysis of preoperative related indicators, the patient's condition for a preliminary assessment, thus guiding the postoperative calcium regulation, to avoid the occurrence of serious complications.Methods: We reviewed the clinical data of 136 patients with chronic renal failure in uremic stage, who received dialysis treatment for a long time and finally diagnosed as SHPT, from Jan 2017 to Dec 2019, were accepted different operations to treat hyperparathyroidism, were given corresponding calcium regulation therapy to avoid serious complications, and were divided into the observation group and the control group according to the mean time of postoperative calcium regulation time.Results: According to the median time of adjusting the pump calcium(7.67 + 2.823)d, the patients were divided into two groups: the observation group (≤7d) and the control group (> 7d). Compared with the control group, the observation group were elder (54.01±9.215, P<0.01), shorter preoperative dialysis time (5.05±2.855, P<0.01), significant difference in operation mode (P=0.026), positive preoperative oral calcium(c2=9.941, P=0.002), higher preoperative calcium value (t=4.795, P<0.001), lower preoperative Parathyroid Hormone(PTH) value (t=6.327, P<0.001), lower preoperative Alkaline phosphatase (ALP) value (t=3.527, P=0.001). Multivariate analysis showed that age, preoperative calcium value, preoperative PTH value and preoperative ALP value were independent risk factors for postoperative calcium regulation therapy. Those factors, Gender, preoperative dialysis mode, complications, preoperative Hemoglobin(HB) value, were not related to postoperative calcium regulation. There was no significant difference between the two groups (P>0.05).Conclusion: The simple, sustained and sufficient calcium regulation scheme can maintain a stable level of blood calcium in SHPT, and be able to avoid the occurrence of severe hypocalcemia and increase the curate. Especially for the younger, the lower preoperative serum calcium, the higher blood PTH and ALP, should lengthen the calcium pump time appropriately, until the right time and stop the medicine. This is more safe.

scholarly journals Summary of  perioperative calcium regulation therapy and analysis of related factors in the treatment of secondary hyperparathyroidism

2020 ◽  
Author(s):  
XinSheng Zhang ◽  
weibin zhang ◽  
Jia Dong ◽  
YunFei Wu ◽  
Bin Zheng ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Clinical Data ◽  
Operation Mode ◽  
Calcium Regulation ◽  
Control Group ◽  
Observation Group ◽  
Related Factors ◽  
Blood Calcium ◽  
Regulation Scheme ◽  
Significant Difference

Abstract Background：Retrospectively register the clinical data of secondary hyperparathyroidism（SHPT）patients who received surgical treatment, summarize the postoperative calcium regulation scheme in details and analyze statistically related factors for guiding clinical early intervention and evaluating prognosis.Methods: Review the clinical data of 136 patients with chronic renal failure in uremic stage from Jinzhou Central Hospital and the Second Affiliated Hospital of Dalian Medical University, who received dialysis treatment for a long time and finally diagnosed as secondary hyperparathyroidism, from Jan 2017 to Dec 2019, were accepted different operations to treat hyperparathyroidism, were given corresponding calcium regulation therapy to avoid serious complicationswere, and were divided into the observation group and the control group according to the postoperative calcium regulation time of ≤7days and > 7days, which is defined as the time from the day of operation until the day when the patients have stable blood calcium levels and no obvious discomfort symptoms.Results: The difference between the two groups was statistically significant (P<0.001); Compared with the control group, the observation group were elder(54.01±9.215; P<0.01), shorter preoperative dialysis time (5.05±2.855; P<0.01); significant difference in operation mode (P=0.026); positive preoperative oral calcium(c2=9.941, P=0.002), higher preoperative calcium value (t=4.795; P<0.001), lower preoperative Parathyroid Hormone(PTH) value (t=6.327; P<0.001), lower preoperative Alkaline phosphatase(ALP) value (t=3.527; P=0.001); Multivariate analysis showed that age, preoperative calcium value, preoperative PTH value and preoperative ALP value were independent risk factors for postoperative calcium regulation therapy. Those factors, Gender, preoperative dialysis mode, complications, preoperative Hemoglobin(HB) value, were not related to postoperative calcium regulation. There was no significant difference between the two groups (P>0.05).Conclusion: Effective postoperative calcium regulation can maintain a stable level of blood calcium in the patients with secondary hyperparathyroidism, so as to avoid the occurrence of severe hypocalcemia.

PENGARUH KOMUNIKASI TERAPEUTIK TERHADAP HARGA DIRI KLIEN DENGAN GAGAL GINJAL KRONIS

2019 ◽  
Vol 1 (1) ◽  
pp. 28
Author(s):  
Juniyaska Hari Pratama ◽  
Ninuk Dwi Kurniati ◽  
Abu Bakar
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Treatment Group ◽  
Healing Process ◽  
Self Esteem ◽  
Communication Intervention ◽  
Rank Test ◽  
Control Group ◽  
Therapeutic Communication ◽  
Significant Difference

Introduction: Chronic renal failure is clinical syndrome caused by declining renal function, lasting progressively and irreversible. Physical change due to organ function decline will affect client psychologicaly and socially. These changes cause self esteem disorder where client tend to use maladaptive coping with manifestation of frequent irritating, angry, anxiety, and depression. Therapeutic communication between nurse and client that lead to client healing process which planned in conscious, purposive manner and this activity is centered on client. Method: This research used quasi experimental. Total sample in this research was 12 clients with chronic renal failure that meet inclusion criteria grouped in two groups: treatment group and control group. Independent variable was therapeutic communication while dependent variable was self esteem. In this research data analysis used was Wilcoxon Sign Rank Test with significance α ≤ 0,05 and Mann Whitney Test with significance α ≤0,05. Result: Result obtained after therapeutic communication intervention provided was p = 0,002 where there is significant difference on client self esteem before and after therapeutic communication intervention given. Result showed that there is significant difference between treatment group and comparative group with p = 0.026. Discussion: It is concluded that therapeutic communication has effect on improving self esteem in client with chronic renal failure. Therapeutic communication helps client to express his/her feeling and problems clients self esteem were improved.

scholarly journals CHRONIC RENAL FAILURE;

2017 ◽  
Vol 24 (10) ◽  
Author(s):  
Noor Un Nisa Memon ◽  
Santosh Kumar ◽  
Bhagwan Das
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Thyroid Hormone ◽  
Local Population ◽  
Antithyroid Drugs ◽  
Control Group ◽  
Hormone Levels ◽  
Significant Difference ◽  
Healthy Control ◽  
Thyroid Hormone Levels

Objectives: To compare thyroid hormone levels in apparently healthy individualsand un-dialyzed chronic renal failure patients in local population. Study Design: Crosssectional,descriptive, observational study. Setting: OPD patients in BMSI Biomedical ScienceInstitute of Medical Jinnah Medical Karachi. Period: June 2010 to December 2010 in BMSIJPMC, Karachi. Methods: Ninety individuals including 30 healthy control and 60 patients ofchronic renal failure were included in this study. Individuals were grouped based on severity ofdiseases (stages) as healthy (control) group and the diseased group. Patients with un-dialyzedCRF on conservative management, GFR < 60 ml/mint/1.73m2, age between 20 to 60 years inboth sexes were included in this study. Patients already taking thyroxine or antithyroid drugs,history of thyroid surgery and neck radiation and patients on maintenance haemodialysis wereexcluded. Measurement of thyroid hormone levels were done through Radio Imune Assay (RIA)method and GFR by Cock Craft Gualt formula. Results: Serum FT3 significantly low in patientswith CRF of stage III 1.27±0.12, stage IV 1.04±0.09 vs 2.80±0.09 in controls, p=0.001. TSHwas significantly high in patients of CRF as compared to control 4.41±0.87 and 3.3±0.34 vs1.97±0.16, P=0.001. No significant difference was seen in serum FT4 levels. Conclusion: Inlocal population thyroid hormone level of FT3 declines with the severity of Glomerular FiltrationRate as compare to healthy individuals. However, TSH level increases with this severity as alsoreported in other countries. Additionally, FT3 level is helpful for early detection and preventionof complications. Local population need awareness to prevent CRF by reporting to hospitalbefore stage 3.

scholarly journals PREVALENCE OF INTESTINAL PARASITISM AND ASSOCIATED SYMPTOMATOLOGY AMONG HEMODIALYSIS PATIENTS

2013 ◽  
Vol 55 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Frederico F. Gil ◽  
Maxlene J. Barros ◽  
Nazaré A. Macedo ◽  
Carmelino G. E. Júnior ◽  
Roseli Redoan ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Intestinal Parasites ◽  
Hemodialysis Patients ◽  
Parasitic Infections ◽  
Control Group ◽  
Community Group ◽  
Pathogenic Potential ◽  
Asymptomatic Patients ◽  
Significant Difference

Intestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF), we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively). Blastocystis was the most common infection in the control group (41.9%), however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38). The most common symptoms in this group were flatulence (36.4%), asthenia (30.0%) and weight loss (30.0%). In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703). A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p < 0.05). Comparing symptomatic with asymptomatic, there was no association in either group between symptoms or the prevalence of parasitic infection, nor with the type of parasite or with multiple parasitic infections. Patients with chronic renal failure are frequent targets for renal transplantation, which as well as the inherent immunological impairment of the disease itself, results in immunosuppression by medication. For this reason, carriers of intestinal parasites with pathogenic potential can develop serious clinical complications influencing the success of transplantation. This fact, coupled with the high prevalence of intestinal parasites and the dissociation between symptoms and infection in CRF patients, suggests that the stool test should be incorporated in routine propedeutics. Furthermore, preventive measures for the acquisition of parasites through the fecal-oral contamination route should be introduced.

scholarly journals Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients

2021 ◽  
Vol 18 (4) ◽  
pp. 1701
Author(s):  
Hyoyoung Kang ◽  
Youngran Chae
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Immune Function ◽  
Psychological Stress ◽  
Physiological Stress ◽  
Negative Emotion ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Significant Difference ◽  
Stress Levels

Background: Most hemodialysis patients may experience physiological and psychological stress. Exposure to nature has been reported to reduce psychological and physiological stress levels and improve immune function. This study aimed to investigate psychological and physiological effects of integrated indirect forest experience on chronic renal failure patients undergoing hemodialysis. Methods: As a quasi-experiment, this study employed a nonequivalent control group, repeated measurements, and a non-synchronized design. In total, 54 participants were included: 26 and 28 patients in the experimental and control groups, respectively. During hemodialysis, five types of forest therapy stimuli (visual, auditory, olfactory, tactile, and motor) were applied 3 times per week for 4 weeks during 15 min sessions. Results: Positive, but not negative, emotion measures differed between the groups after the intervention. Fatigue and physiological stress levels were significantly reduced in the experimental group, whereas no significant difference was found between the groups with respect to measures of psychological stress. Activation of both the parasympathetic and sympathetic nervous systems was similar in both groups, as was the number of natural killer cells. Conclusion: Integrated indirect forest experience may help increase positive emotions and reduce fatigue and stress levels during hemodialysis in patients with chronic renal failure.

scholarly journals Effects of Integrated Indirect Forest Therapy on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients

2020 ◽  
Author(s):  
Hyoyoung Kang ◽  
Youngran Chae
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Immune Function ◽  
Psychological Stress ◽  
Physiological Stress ◽  
Negative Emotion ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Significant Difference ◽  
Stress Levels

(1) Background: Most hemodialysis patients may experience physiological and psychological stress. Exposure to nature has been previously reported to reduce the measures of psychological and physiological stress, and immune function. This study aimed to investigate psychological and physiological effects of integrated indirect forest therapy on chronic renal failure patients undergoing hemodialysis. (2) Methods: As a quasi-experiment, this study employed a nonequivalent control group, repeated measurements, and a non-synchronized design. A total of 54 participants were included: 26 and 28 in the experimental and control groups, respectively. During hemodialysis, five types of forest therapy stimuli (visual, auditory, olfactory, tactile, and motor) were applied 3 times per week for 4 weeks during 15-minute sessions. (3) Results: Positive but not negative emotion measures differed between the groups after the intervention. Fatigue and physiological stress levels were significantly reduced in the experimental group, whereas no significant difference was found between the groups on the measures of psychological stress. Activation of both the parasympathetic and sympathetic nervous systems was similar in both groups, as was the number of natural killer cells. (4) Conclusion: Integrated indirect forest therapy may help increase positive emotions and reduce fatigue and stress levels during hemodialysis in patients with chronic renal failure.

scholarly journals The Effect of Chronic Renal Failure on Thyroid Hormones Specificity Measured fT3 in a Sample of Iraqi Patients

2018 ◽  
Vol 1 (3) ◽  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Thyroid Hormone ◽  
Serum Level ◽  
Control Group ◽  
Failure Group ◽  
Thyroid Gland Function ◽  
Significant Difference ◽  
Group B ◽  
Chronic Renal Failure Group

Background: Chronic renal failure (CRF) affects thyroid function in multiple ways, including low circulating thyroid hormone concentration, altered peripheral hormone metabolism, disturbed binding to carrier proteins, possible reduction in tissue thyroid hormone content, and increased iodine store. Objective: To evaluate of thyroid Gland Function in patients with chronic renal failure and an attempt to find a relationship between chronic renal failure and thyroid dysfunctions. Subjects and Methods: A total number of 96 subjects with age range from 15-67 years old (56 males and 40 females) were included in this study. Total number was divided into two groups according to their number Group A. Study group: haemodialysis (HD) consists of 48 patients and Group B. Control group: consists of 48 subjects. T3, T4, TSH, fT3, Urea, Creatinine, Albumin and TSP were measured in each of the two groups. Results: The results revealed statistically significant reduction serum level of tT3 , fT3 more than tT4 in Chronic Renal Failure group in comparison with normal levels in control group while there is no statistically significant difference seen between case and control groups in regard to TSH. Conclusion: There is a decrease serum level of tT3 , tT4 and fT3 but the decreased of tT3 and fT3 more than tT4 in Chronic Renal Failure group in comparison with normal levels in control group.

scholarly journals Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hong Lv ◽  
Ning Yang
Keyword(s):  
Tract Infection ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Control Group ◽  
Observation Group ◽  
Activity Time ◽  
Joint Function ◽  
Vein Thrombosis ◽  
Accelerated Rehabilitation

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.

Sign in / Sign up

Export Citation Format

Share Document