scholarly journals Exploring Self-Regulation of Patients with Chronic Kidney Disease Undergoing Hemodialysis

2021 ◽  
Vol 48 (2) ◽  
pp. 1
Author(s):  
Belinda Belinda ◽  
Zahrasari Lukita Dewi

Patients with chronic kidney disease (CKD) undergoing hemodialysis often experience residual impacts of the treatment on their physical, economic, social, and psychological, to an extent that CKD is considered a barrier for individuals to fully participate and enjoy life. It is crucial for CKD patients self-regulate their cognitive, social and emotional health in order to function optimally. This research aimed to explore the self-regulation process of CKD patients. This research adopted a qualitative exploratory utilizing in-depth interview as a data collection technique. There were three participants in the research recruited through convenience sampling, two men and one female aged 50-60 years and undergoing hemodialysis within 6-10 months.  The analysis process used thematic analysis guided by a common-sense model of self-regulation. Findings showed that at an initial stage patients perceived CKD and its treatment emotionally, but this was changed over time to be more positive. Two participants had adequate coping strategies and received support from the closest relatives to assist in the evaluation, while, one participant was more emotionally harboring and lacked social support. The evaluation process could encourage participants to seek information and understand CKD better. Further research suggested that sampling techniques could involve participants with a more diverse age range in order to have more varied data that can be used by other CKD patients with diverse age range.

PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e66543 ◽  
Author(s):  
Miklós Palkovits ◽  
Katarína Šebeková ◽  
Kristina Simon Klenovics ◽  
Anton Kebis ◽  
Gholamreza Fazeli ◽  
...  

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia


2021 ◽  
Vol 71 (1) ◽  
pp. 261-65
Author(s):  
Muhammad Sajid Hussain ◽  
Qasim Raza ◽  
Muhammad Omer Aamir ◽  
Nadia Murtaza ◽  
Sadia Naureen ◽  
...  

Objective: To determine the effect of subcutaneous recombinant human erythropoietin on blood pressure in predialysis chronic kidney disease (CKD) patients. Study Design: Case-series descriptive study. Place and Duration of Study: Combined Military Hospital Peshawar, from Mar 2016 to Sep 2016. Methodology: A total of 100 cases were enrolled. Inclusion criteria was patients of 18 to 60 years of both gender & estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2 having Hb <10g/dL and pre-dialysis while Exclusion Criteria was pregnancy or lactation, BP more than 140/90 mmHg, patients on Haemodialysis and worsening renal function. Baseline BP, body weight and eGFR of anaemic chronic kidney disease patients were recorded prior to EPO Alpha therapy. Erythropoiesis-stimulating agents (ESAs) i.e. EPO Alpha (50-100 Units/kg thrice or once weekly) was administered subcutaneously. Subsequent blood pressure, body weight and eGFR monitoring was done after 2 and 4 weeks post EPO Alpha injection. Results: Mean age range was 46.71 years with range of 20-60 years, 73 (73%) were male while 27 (27%) werefemales. Mean ± SD for other quantitative variables like eGFR was 23.12 ± 5.28, Hb levels (g/dL) was 8.62 ± 0.85,Weight (kg) was 56.66 ± 6.62 and duration of CKD was 9.87 ± 4.02. Frequency of Hypertension (post EPO) was 2(2%) and p-value was 0.453. Conclusion: We concluded that the frequency of hypertension in pre-dialysis patients with chronic kidney disease (CKD) receiving recombinant human erythropoietin (rhEPo) subcutaneously (SC) in low doses, is very low, so rhEPo can be used subcutaneously......................


2020 ◽  
Vol 10 (5) ◽  
pp. 353-361
Author(s):  
Mirela Bojan ◽  
Laurence Pieroni ◽  
Cristian Mirabile ◽  
Marc Froissart ◽  
Damien Bonnet

Background: The onset of chronic kidney disease (CKD) is an important prognostic factor in young adults with congenital heart disease (CHD). Although it is likely that CKD is manifest early in CHD patients, the prevalence among adolescents is still unknown. The National Kidney Foundation’s Kidney Disease Improving Global Outcomes guidelines 2012 recommend new equations for the estimated glomerular filtration rate (eGFR) and highlight the importance of albuminuria for CKD screening. The objective of the present study was to estimate the prevalence of CKD in CHD adolescents. Methods: This observational cross-sectional study included 115 patients aged 10–18 years attending the cardiologic outpatient clinic at our institution as a follow-up after cardiac surgery in infancy related to various CHDs. CKD assessment used the CKD criteria 2012, including eGFR equations based on serum creatinine and cystatin C, and measurement of albuminuria. Results: No patient had an eGFR <60 mL min–1 1.73 m–2. However, 28.7% of all patients (95% CI 20.7–37.9) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the bedside Schwartz creatinine-based equation,and 17.4% (95% CI 11.2–24.1) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the Zappitelli equation, combining creatinine and cystatin C. Of all patients, 20.0% (95% CI 12.1–26.7) had orthostatic proteinuria, and none had persistent albuminuria. Conclusions: There was no evidence of CKD in the present population aged 10–18 years. The significance of an eGFR between 60 and 90 mL min–1 1.73 m–2 is not concordant for this age range and requires further investigations.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sebastian Cabrera ◽  
Ruben Torres ◽  
Leticia Elgueta ◽  
Erico Segovia ◽  
Maria Eugenia Sanhueza ◽  
...  

Abstract Background and Aims Diabetic nephropathy is one of the main causes of chronic kidney disease (CKD) in the world. In the past years new studies using SGLT-2 inhibitors in diabetic patients have shown benefit in both mortality and progression of CKD. However, these works show heterogeneity between studies regarding the severity of CKD of patients included. All above complicates the interpretation of the benefits of SGLT-2 inhibitors. Method We did a systematic search of the literature in PUBMED, EMBASE, Cochrane CENTRAL trials database and in references of the selected studies. Terms used for the search were Canaglifozin, Dapaglifozin, Ertuglifozin, Empaglifozin, diabetes, mortality and CKD. Search included studies in all languages. We selected only randomized and controlled studies that reported mortality and relevant renal outcomes (doubling serum creatinine or decrease in eGFR&gt; 40%, need for renal replacement or renal death). We included studies until September 30, 2019. For the meta-analysis, a Mantel-Haenszel model of random effects was used. The software Review Manager, Version 5.3 The Cochrane Collaboration, 2014 was used. Results We obtained results from 142 studies, fifteen studies met the selected criteria, but only four reported mortality and renal outcomes (EMPA-REG, CANVAS, CREDENCE AND DECLARE-TIMI 58). A total of 38,721 patients (SGTL2 inhibitors n = 21,264 and control n = 17,457) were included for the analysis. The EMPA-REG study used Empaglifozin, the CANVAS and CREDENCE studies used Canaglifozin and the DECLARE-TIMI 58 used Dapaglifozin. All studies were funded by pharmaceutical laboratories.The average age range of the studies was between 62 to 67 years. The percentage of patients with eGFR &lt;60ml/min were 26%, 20%, 60% and 7% for the EMPA-REG, CANVAS, CREDENCE and DECLARE-TIMI 58 studies respectively.Mortality was lower in patients who used SGTL2 inhibitors OR 0.86 (CI 0.80-0.94) Figure 1. Renal outcomes were also lower in patients who used SGTL-2 inhibitors OR 0.69 (CI 0.60-0.78) Figure 2. We assessed whether the effect was related to the severity of the CKD taking out the work with patients with more severe CKD (CREDENCE study), the effect on mortality did not change OR 0.87 (CI 0.80-0.95) as well as renal outcome OR 0.66 (CI 0.52- 0.83). Conclusion The SGTL-2 inhibitors decrease mortality and improve renal outcomes in patients with diabetic nephropathy. These benefits remain in patients with less severe CKD.


Author(s):  
Elena Hunter ◽  
Benita Percival ◽  
Zeeshan Ahmad ◽  
Ming-Wei Chang ◽  
John A. Hunt ◽  
...  

AbstractChronic kidney disease (CKD) is a renal dysfunction that can lead to high rates of mortality and morbidity, particularly when coupled with late diagnosis. CKD has become a major health problem due to its challenging detection at early stages when clear symptoms are yet to be presented. Thus, CKD is likely to be identified when the substantive conditions of the disease are manifest. In order to address the development of the disease and provide necessary treatments at the initial stage, the investigation of new biomarkers and metabolites associated with early detection of CKD are needed. Identified metabolites could be used to confirm the presence of the disease, obtain information on its mechanism and facilitate the development of novel pharmaceutical treatments. Such metabolites may be detected from biofluids and tissues using a range of analytical techniques. There are a number of metabolites that have been identified by mass spectrometry at high sensitivities, whilst the detection of metabolites directly from biofluids using NMR could present a more rapid way to expand our understanding of this disease. This review is focused on NMR-based metabolomics associated with CKD in humans and animals.


e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia


2021 ◽  
Vol 4 (1) ◽  
pp. 38-45
Author(s):  
Siti Nurhayati Utami ◽  
Hanna Marsinta Uli ◽  
Indri Seta Septadina

Chronic kidney disease is a condition in which there is destruction of the kidneys along with structural or functional abnormalities, with or without decreased glomerular filtration rate for more than 3 months. The common treatment for this condition is hemodialysis, however, it may cause complications, specifically cardiovascular and non-cardiovascular system dysfunctions that can be observed through thorax imaging. This study aims to observe pathologic thorax imaging findings on chronic kidney disease patients undergoing hemodialysis at RSUP Dr. Mohammad Hoesin Palembang. This study is a descriptive study using a cross-sectional design. The data is gathered from medical records from the Medical Records & Radiology Department of RSUP Dr. Mohammad Hoesin Palembang that have passed the inclusion and exclusion criteria. The data is processed using the SPSS application version 25. The results of this study indicate that, based on risk factors, patients are generally in the 55-64 age range (41%), female (60%), and with a normal BMI/normal weight (52%). Based on the patients’ comorbid diseases, patients mostly have hypertension (59%), followed by diabetes mellitus (46%). Analysis of the chest radiographs indicate that (70%) of patients have cardiomegaly; (22%) of patients have grade 1, (15%) have grade 2, (7%) have grade 3 aortic arch calcification; (49%) have pulmonary edema; (31%) have unilateral pleural effusion, and (14%) have bilateral pleural effusion.  The majority of chronic kidney disease patients undergoing hemodialysis at RSUP Dr. Mohammad Hoesin Palembang are in the 55-64 age range, female, and with normal BMI. The most common comorbid conditions are hypertension and diabetes mellitus. Analysis of the chest radiographs indicate that the majority of patients have cardiomegaly; grade 1, 2, and 3 aortic arch calcification; pulmonary edema; unilateral and bilateral pleural effusion.


2018 ◽  
Vol 72 (4) ◽  
pp. 287-293 ◽  
Author(s):  
Mark Canney ◽  
Donal J Sexton ◽  
Neil O’Leary ◽  
Martin Healy ◽  
Rose Anne Kenny ◽  
...  

BackgroundCystatin C has been proposed as a confirmatory test of chronic kidney disease (CKD). This is most applicable to older individuals with CKD, the majority of whom have a creatinine-based estimated glomerular filtration rate (eGFR) of 45–59 mL/min/1.73 m2 (CKD stage 3a). We sought to examine the utility of cystatin C as a confirmatory test of CKD across the age range in the general population of older adults.MethodsCross-sectional analysis of 5386 participants from The Irish Longitudinal Study on Ageing, a cluster-sampled national cohort of community-dwelling adults aged ≥50 years. Cystatin C and creatinine were measured simultaneously using standardised assays. Using generalised additive models, we modelled the distributions of creatinine and cystatin C per year of age from four distributional parameters: location, dispersion, skewness, kurtosis. Among participants with CKD stage 3a, we estimated the predicted probability of cystatin C eGFR <60 mL/min/1.73 m2 (‘confirmed CKD’) as a function of age.ResultsMedian age was 62 years, 53% were female and median cystatin C eGFR was 80 mL/min/1.73 m2. We observed progressive variability in cystatin C with increasing age. Compared with creatinine, cystatin C levels rose sharply beyond the age of 65. Among participants with CKD stage 3a (n=463), the predicted probability of ‘confirmed CKD’ increased steadily with age, from 15% at age 50 to 80% at age 80.ConclusionsThe clinical utility of cystatin C may be maximised in middle-aged individuals, in whom the distribution of cystatin C is less variable than older adults, and the pretest probability of confirming CKD is lower.


2021 ◽  
Vol 15 (7) ◽  
pp. 2330-2333
Author(s):  
Rashid Ahmad ◽  
Khalil Ullah ◽  
Ghazala Shaheen ◽  
Muhammad Ikram Shah ◽  
Muazzam Fuaad ◽  
...  

Background and Aim: Premature atherosclerosis and increased prevalence of cardiovascular mortality are significantly associated with chronic kidney disease (CKD). The CKD risk factors contribute to cardiovascular and atherogenesis disease. Anemia, inflammation, vascular calcification, lack of physical activity, lipid disorders, endothelial dysfunction, and oxidative stress are various risk-induced factors for CKD patients. The aim of the present study was to evaluate or assess the lipid profile in chronic kidneys disease. Place and Duration of Study: Conducted at Medicine department of Lady Reading hospital, Peshawar and Pak International Medical College, Peshawar for duration of six months between November 2020 and April 2021. Materials and Methods: This cross-sectional study was carried out on 70 patients with chronic kidney disease (CKD) with an age range of 18 and 65 years. The male to female ratio was 1.3:1. A Control group of 70 patients of similar age and sex were enrolled in this study. Lipid profile and collection of blood specimen were managed from both groups were taken. Other parameters such as PPBS, creatinine, FBS, and blood urea results were compared for both groups. Results: The overall mean age of the study group patients was 42.4±11.5 years while the control group's mean age was 51.6±9.8 years. The prevalence of CKD patients was high 17 (24%) in the age range of 30-40 years. The prevalence of Dyslipidemia parameters such as High TC, High TG, High VLDL-C, HIGH LDL-C and low HDL-C was 49.8%, 66.7%, 67%, 42.5%, and 72.9% respectively. Overall dyslipidemia prevalence was 81.7%. Significant decrease in HDL-C while the increase in TG and VLDL-C was reported. On comparing hypertension comorbid conditions with triglyceride, HDL, and VLDL statistical significance was found. SPSS version 24 was used for data analysis. Conclusion: A significant amount of dyslipidemia is found in CKD patients. As a result, treating dyslipidemia will reduce mortality in CKD patients. Patients with CKD are predisposed to accelerated atherosclerosis, which increases the risk of CVD. The presence of an atherogenic lipid profile in CKD is confirmed by this study. Keywords: CKD, Lipid Profile, Hypertension, Dyslipidemia


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