scholarly journals Pengaruh Relaksasi Dzikir terhadap Tingkat Kecemasan Pasien Gagal Ginjal Kronis yang Menjalani Hemodialisa

1970 ◽  
Vol 3 (1) ◽  
Author(s):  
Iin Patimah ◽  
Suryani S ◽  
Aan Nuraeni
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Rating Scale ◽  
Nursing Intervention ◽  
Anxiety Level ◽  
Pharmacological Intervention ◽  
Purposive Sampling ◽  
Before And After ◽  
The Impact ◽  
Hamilton Anxiety

Salah satu permasalahan psikologis yang paling sering ditemukan pada pasien gagal ginjal kronis (GGK) yang menjalani hemodialisis yaitu cemas. Kecemasan yang tidak diatasi dapat mengakibatkan dampak negatif untuk pasien. Salah satu intervensi nonfarmakologis untuk mengurangi kecemasan, yaitu dengan teknik relaksasi. Teknik relaksasi yang digunakan dalam penelitian ini adalah relaksasi dzikir, yaitu suatu metode yang memadukan antara relaksasi dan dzikir dengan fokus latihan pada relaksasi dan kata yang terkandung di dalam dzikir yang dapat memunculkan respon relaksasi. Tujuan penelitian ini adalah untuk melihat pengaruh relaksasi dzikir terhadap kecemasan pada pasien GGK yang menjalani hemodialisis di RSUD dr. Slamet Garut. Metode penelitian menggunakan pre experimental one group pre and post test design dengan jumlah sampel 17 responden yang diambil berdasarkan teknik purposive sampling. Penelitian ini mengukur skor kecemasan menggunakan instrument HAM-A (Hamilton Anxiety) sebelum dan sesudah intervensi relaksasi dzikir. Relaksasi dzikir dilaksanakan dua kali dalam sehari selama 2 hari, selanjutnya data dianalisa menggunakan uji t. Hasil penelitian menunjukan terdapat perbedaan yang bermakna antara tingkat kecemasan sebelum dan sesudah intervensi (p<0.005). Relaksasi dzikir berdampak positif dalam menurunkan tingkat kecemasan pasien GGK yang menjalani hemodialisis. Penggunaan relaksasi dzikir dapat dipertimbangkan sebagai salah satu intervensi keperawatan untuk mengatasi kecemasan pada pasien GGK yang menjalani hemodialisis di RSUD dr. Slamet Garut. Kata kunci: Dzikir, gagal ginjal kronis, hemodialisis, kecemasan, relaksasi. The Impact of Dzikir to The Level of Anxiety of Chronic Renal Failure Patient Undergoing Hemodialysis AbstractAnxiety disorder can be adversely impacting to the chronic renal failure (CRF) patients undergoing hemodialysis. Untreated anxiety could affect negatively both physiological and psychological and exacerbate the disorder. Dzikr relaxation is a methode that combines relaxation and repetitious of prayer (dzikr) which focused on relaxation technique and the words contained in the dzikr can be a non-pharmacological intervention to reduce anxiety with leading relaxation respons. Thus, the purpose of this study was to examine the effect of dzikr relaxation intervention to the anxiety level of CRF patients undergoing hemodialysis in dr. Slamet Garut Hospital. Method and Design this research involving 17 participants, taken through purposive sampling, completed dzikr relaxation twice a day for two days period. Hamilton Anxiety Rating Scale (HAM-A) was used to assess anxiety level both before and after treatment. Current study used One-group pretest-posttest design and T-test was used for the analysis by the time all data have been completely gathered. The result showed there was a significant contrast of anxiety level for all participants before and after dzikr intervention (P<0.005). The average of participant anxiety scores is 18 (mild to moderate anxiety) before treatment whereas found 13 point (mild) in average for anxiety score post treatment. The anxiety scores decreased 3 to 6 points from initial scoring subsequent to participants completed dzikr relaxation. Dzikr relaxation can be considered as one of nursing intervention in mitigating anxiety disorder for CRF patients during hemodialysis treatment in dr. Slamet Garut Hospital.Key words: Anxiety, Chronic Renal Failure, dzikr, hemodialysis, relaxation.

scholarly journals KOMUNIKASI TERAPEUTIK PERAWAT DENGAN TINGKAT KECEMASAN KELUARGA PASIEN DI RUANG INTENSIVE CARE UNIT

2017 ◽  
Vol 4 (1) ◽  
pp. 30
Author(s):  
Ismi Maulida Rezki ◽  
Dhian Ririn Lestari ◽  
Anggi Setyowati
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rating Scale ◽  
Nursing Intervention ◽  
Anxiety Level ◽  
P Value ◽  
Therapeutic Communication ◽  
Coefficient Corrélation ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

ABSTRAKKomunikasi terapeutik adalah alat dasar yang digunakan untuk membentuk hubungan antara perawat dan keluarga pasien. Keluarga pasien merasa interaksinya dengan perawat merupakan kesempatan menyampaikan perasaan yang mengganggu sehingga sangat diperlukan untuk mengatasi kecemasan. Tujuan penelitian adalah Menganalisis hubungan komunikasi terapeutik perawat dengan tingkat kecemasan keluarga pasien. Metode penelitian ini adalah observasional analitis dilakukan pada 30 keluarga pasien di ruang Intensive Care Unit (ICU) Rumah Sakit Umum Daerah (RSUD) Ratu Zalecha Martapura. Instrumen yang digunakan yaitu kuesioner komunikasi terapeutik perawat dan Hamilton Anxiety Rating Scale (HARS). Hasil penelitian didapatkan komunikasi terapeutik perawat baik sebanyak 83,4%, komunikasi terapeutik perawat cukup sebanyak 16,7%. Tidak terdapat kecemasan sebanyak 33,3%, kecemasan ringan sebanyak 33,4%, kecemasan sedang sebanyak 16,6%, kecemasan berat 16,7%. Hasil uji korelasi spearmandidapatkan p value= 0,000 dan koefisien korelasi spearman (r)= -0,816. p value 0,000 <0,05. Komunikasi terapeutik perawat berhubungan dengan tingkat kecemasan keluarga pasien. Komunikasi terapeutik perawat dapat dijadikan intervensi keperawatan oleh perawat kepada keluarga pasien di ruang ICU.Kata-kata kunci: komunikasi terapeutik perawat, kecemasan keluarga pasien.ABSTRACTTherapeutic communication is a base tool used for making correlation between nurse and patient family. Patient family feels that their interaction with nurse is oppurtunity to explain feel which disturb so need for anxiety solving. Aim of this research to analyze correlation therapeutic communication of nurse with patient family anxiety level. Method of This research observational analysis with total respondent were 30 patients family in Intensive Care Unit (ICU) General Hospital (RSUD) Ratu Zalecha Martapura between 28 November to 7 December 2015. This research instruments used Therapeutic Communication of Nursing questionnaire and Hamilton Anxiety Rating Scale (HARS) questionnaire. Results of this research is communication of nurse good were 83,4%, therapeutic comunication of nurse enough were 16,7. There were no anxiety 33,3%, low anxiety were 33,4%, middle anxiety were 16,6%, high anxiety were 16,7%. Result of corelation spearman statistic p value= 0,000 and coefficient correlation spearman (r)= -0,816. p value 0,000<0,05. Communication therapeutic of nurse related with patient family anxiety level. Communication therapeutic of nurse can be used as nursing intervention by nurse to patient family in ICU.Keywords: communication therapeutic of nurse, patient family anxiety.

scholarly journals Hubungan Self Efficacy Dengan Tingkat Kecemasan Pasien Pre Operasi

2020 ◽  
pp. 1-6
Author(s):  
Dian Nugroho ◽  
Agus Sarwo Prayogi ◽  
Ana Ratnawati ◽  
Tri Arini
Keyword(s):  
Significant Relationship ◽  
Self Efficacy ◽  
Rating Scale ◽  
Sampling Technique ◽  
Anxiety Level ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Hamilton Anxiety Rating Scale ◽  
General Self Efficacy ◽  
Hamilton Anxiety

Kecemasan menyebabkan  kekhawatiran yang tidak jelas dan menyebar, yang berkaitan dengan perasaan yang tidak pasti dan tidak berdaya. Kecemasan pada pasien pre operasi harus diatasi, karena dapat menimbulkan perubahan-perubahan fisiologis yang akan menghambat dilakukannya tindakan operasi. Salah satu faktor untuk menurunkan tingkat kecemasan seseorang ketika menghadapi situasi dan kondisi tertentu yaitu dengan self efficacy. Tujuan penelitian ini adalah mengetahui hubungan self efficacy dengan tingkat kecemasan pasien pre operasi. Jenis penelitian deskriptif kuantitatif dengan pendekatan cross sectional. Teknik sampel menggunakan purposive sampling sebanyak 71 pasien pre operasi. Instrumen pengambilan data menggunakan kuesioner general self efficacy dan Hamilton Anxiety Rating Scale (HARS) yang telah baku. Analisa data menggunakan uji korelasi kendall-tau dengan taraf signifikan 5%. Self efficacy pasien dengan kategori tinggi (57,7%), sedang (36,7%) dan kurang (5,6%). Kecemasan pasien pre operasi pembedahan dengan kategori tidak cemas (25,4%), cemas ringan (54,9%), cemas sedang (19,7%) dan cemas berat serta panik (0%). Hasil uji statistik menunjukkan besarnya koefisien korelasi Kendall-Tau yaitu 0,317 dengan signifikasi 0,002. Hal ini menunjukkan bahwa nilai p < 0,05 berarti bahwa terdapat hubungan positif dan signifikan antara self efficacy dengan tingkat kecemasan pasien pre operasi pembedahan. Terdapat hubungan positif dan signifikan antara self efficacy dengan tingkat kecemasan pasien pre operasi pembedahan dengan nilai p < 0,05   Anxiety causes unclear and diffuse concerns, which are associated with feelings of uncertainty and helplessness. Anxiety in preoperative patients must be overcome because it can cause physiological changes that will hinder the operation. One of the factors to reduce one's anxiety level when facing certain situations and conditions is self-efficacy. The objective of this study is to find out the relationship between self-efficacy and the patient's anxiety level preoperatively. Type of quantitative descriptive research with the cross-sectional approach. The sampling technique used purposive sampling as many as 71 patients pre-surgery. The data collection instruments used the standard general self-efficacy and Hamilton Anxiety Rating Scale (HARS) questionnaire. Data analysis used the Kendall Tau-correlation test with a significant level of 5%. Self-efficacy of patients with high categories (57.7%), moderate (36.7%) and less (5.6%). The anxiety of preoperative patients with the category of not anxious (25.4%), mild anxiety (54.9%), moderate anxiety (19.7%) and severe anxiety and panic (0%). The statistical test results show the magnitude of the Kendall-Tau correlation coefficient, which is 0.317 with a significance of 0.002. This shows that the value of p <0.05 means that there is a positive and significant relationship between self-efficacy and the level of anxiety of patients preoperative surgery. There is a positive and significant relationship between self-efficacy and the patient's anxiety level in preoperative surgery with a value of p <0.05

scholarly journals PERBEDAAN PENGETAHUAN SEBELUM DAN SESUDAH PENDIDIKAN KESEHATAN TENTANG TERAPIDIET CAIRAN DAN HEMODIALISIS TERHADAP KELUARGA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 2 (2) ◽  
pp. 115
Author(s):  
Emiliana Tawuru May ◽  
Abdul Wakhid ◽  
Yunita Galih Yudanari
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Health Education ◽  
Kidney Failure ◽  
Chronic Kidney Failure ◽  
Diet Therapy ◽  
Experimental Designs ◽  
P Value ◽  
Purposive Sampling ◽  
Before And After

Pendidikan kesehatan pasien atau keluarga merupakan kegiatan dalam perencanaan pulang pasien yang ditujukan untuk meningkatkan pengetahuan keluarga dalam memberikan perawatan selanjutnya dirumah. Tujuan penelitian ini untuk mengetahui perbedaan pengetahuan sebelum dan sesudah pendidikan kesehatan tentang terapi diet cairan dan hemodialisis terhadap keluarga pasien gagal ginjal kronik yang menjalani hemodialisis. Desain penelitian ini pre-experimental designs dengan pendekatanOne-Group-Pretest-Posttest Design. Populasi penelitian ini yaitu pasien gagal ginjal kronik yang menjalani hemodialisis dengan sampel 15 orang diambil menggunakan metode purposive sampling. Alat pengambilan data menggunakan kuesioner. Analisis data menggunakan program komputer. Analisis bivariat menggunakan ujit-Test Dependent. Pengetahuan keluarga pasien gagal ginjal kronik yang menjalani hemodialisis sebelum diberikan pendidikan kesehatan tentang terapi diet cairan dan hemodialisis sebagian besar kategori kurang (53,4%), dan sesudah pendidikan kesehatan sebagian besar kategori baik (86,7%). Ada perbedaan yang bermakna pengetahuan tentang terapi diet cairan dan hemodialisis sebelum dan sesudah pendidikan kesehatan pada keluarga pasien gagal ginjal kronik yang menjalani hemodialisis, dengan p-value = 0,000< 0,05.Ada peningkatan pengetahuan sesudah pendidikan kesehatan tentang terapi diet cairan dan hemodialisis terhadap keluarga pasien gagal ginjal kronik yang menjalani hemodialisis. Keluarga pasien gagal ginjal kronik yang menjalani hemodialisis sebaiknya meningkatkan pengetahuan tentang terapi diet cairan dan hemodialisis dengan aktif menggali informasi dengan aktif berkonsultasi dengan tenaga kesehatan yang berkompeten. Kata kunci: Terapi diet cairan dan hemodialisis, pengetahuan keluarga,gagal ginjal kronik DIFFERENCES OF KNOWLEDGE BEFORE AND AFTER HEALTH EDUCATION ABOUT THERAPIDYET LIQUID AND HEMODIALYSIS OF FAMILY OF CHRONIC KIDNEY PATIENTS WHO HAVE DONE HEMODIALISIS ABSTRACTHealth education of patient or family is an activity in planning a patient's return aimed at increasing family knowledge in providing further care at home.Objective of this study was to determine the knowledge differences before and after health education about fluid diet therapy and haemodialysis on families with patients with chronic renal failure undergoing haemodialysis. The design of this study was pre-experimental designs by using the One-Group-Pretest-Posttest Design approach. The population of this study were chronic kidney failure patients who underwent haemodialysis with sample of 15 people taken by using a purposive sampling method. The data collection tool used a questionnaire. Data analysis used computer program. Bivariate analysis used the t-Test Dependent. The family knowledge of patients with chronic renal failure who underwent haemodialysis before being given health education about fluid diet therapy and haemodialysis is mostly in poor category (53.4%), and after health education is mostly in good category (86.7%). There is significant differences in knowledge about fluid diet therapy and haemodialysis before and after health education in families of patients with chronic renal failure undergoing haemodialysis, with p-value = 0.000 <0.05. There are increased knowledge after health education about dietary fluid therapy and haemodialysis on families of patients with chronic renal failure undergoing haemodialysis. Families of patients with chronic kidney failure who undergo haemodialysis should increase their knowledge of fluid diet therapy and haemodialysis by actively digging up information and consulting with competent health professionals. Keywords: Fluid diet therapy and haemodialysis, family knowledge, chronic kidney failure

scholarly journals Gambaran Tingkat Kecemasan pada Warga yang Tinggal di Daerah Rawan Longsor di Kelurahan Ranomuut Kota Manado

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Nikhita F. A. Mamesah ◽  
Hendri Opod ◽  
Lydia David
Keyword(s):  
Rating Scale ◽  
Sampling Technique ◽  
Anxiety Level ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Prone Area ◽  
Hamilton Anxiety Rating Scale ◽  
Physical Changes ◽  
Severe Anxiety ◽  
Hamilton Anxiety

Abstract: Anxiety is a normal reaction that helps human to deal with danger or tough situation. Anxious people feel afraid, worry, and have physical changes such as increased blood pressure. This condition can happen especially among people who live in the landslide-prone area. They always feel worried and anxious when rain as well as earthquake or any condition that can trigger landslide occurs. This study was aimed to determine the anxiety level among residents living in the landslide prone-area Ranomuut Manado. This was a descriptive study with a cross sectional approach. Samples were obtained by using the purposive sampling technique. Respondents were residents of Ranomuut Lingkungan IV Manado. The anxiety level was measured with Hamilton Anxiety Rating Scale (HAR-S) questionnaire. The results showed that there were 43 respondents who participated in this study; 22 females (51.1%) and 21 males (48.9%). The anxiety levels were mild anxiety in 11 respondents (25.6%), moderate anxiety in 22 respondents (51.1%), severe anxiety in 8 respondents (18.6%), and no anxiety in 2 respondents (4.7%). Conclusion: Most residents in landslide prone-area had anxiety, and the most common anxiety was moderate anxiety.Keywords: anxiety, landslide prone-area, Hamilton Anxiety Rating Scale (HAR-S) Abstrak : Kecemasan adalah reaksi normal yang membantu manusia menghadapi situasi yang berbahaya atau sulit. Kecemasan merupakan suatu perasaan yang sifatnya umum, dimana seseorang merasa ketakutan, memiliki pikiran yang khawatir, dan perubahan fisik seperti tekanan darah yang meningkat. Keadaan ini dapat terjadi khusunya bagi orang yang tinggal di daerah rawan longsor yang akan selalu waspada dan juga merasa cemas disaat hujan, gempa atau hal-hal yang dapat memicu terjadinya longsor. Penelitian ini bertujuan untuk mengetahui gambaran tingkat kecemasan pada warga yang tinggal di daerah rawan longsor di Kelurahan Ranomuut, Kota Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang. Teknik pengambilan sampel menggunakan purposive sampling. Responden penelitian ialah warga Kelurahan Ranomuut Lingkungan IV. Tingkat kecemasan diukur menggunakan kuesioner Hamilton Anxiety Rating Scale (HAR-S). Hasil penelitian mendapatkan bahwa responden yang mengikuti penelitian berjumlah 43 orang, terdiri dari perempuan 22 orang (51,1%) dan laki-laki 21 orang (48,9%). Tingkat kecemasan yang didapatkan ialah kecemasan ringan sebanyak 11 orang (25,6%), kecemasan sedang sebanyak 22 orang (51,1%), kecemasan berat sebanyak 8 orang (18,6%), dan yang tidak memiliki kecemasan sebanyak 2 orang (4,7%). Simpulan: Sebagian besar masyarakat yang berdiam di daerah rawan longsor mengalami kecemasan, terutama kecemasan sedang.Kata kunci: kecemasan, daerah rawan longsor, Hamilton Anxiety Rating Scale (HAR-S)

scholarly journals An Anxiety Case Report with Murotal Alqur’an Approach in Woman Who Got Hemodialysis in Universitas Sumatera Utara Hospital, Medan

2019 ◽  
Vol 7 (16) ◽  
pp. 2695-2697
Author(s):  
Agusmita Agusmita ◽  
Elmeida Efffendy
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Chronic Renal Failure ◽  
Rating Scale ◽  
Psychological Impact ◽  
Hemodialysis Patients ◽  
Anxiety Level ◽  
Irreversible Damage ◽  
Islamic Religion ◽  
North Sumatra

BACKGROUND: Chronic renal failure (CRF) is a term used to describe a decrease in kidney function caused by irreversible damage. Until now, hemodialysis is the main alternative to replacement therapy for renal function in patients with chronic renal failure because of its lower cost and lower risk of bleeding when compared to peritoneal dialysis. The effects that are felt when undergoing hemodialyses, such as muscle cramps, hypotension, headache, nausea, and vomiting. The psychological impact felt by patients is anxiety. To overcome anxiety in patients undergoing hemodialysis, we need to provide relaxation therapy, one of which is murottal Al-Qur'an. The aim is to find out whether there is an effect of giving Murottal Al-Qur'   to the anxiety level of hemodialysis patients in North Sumatra Hospital Medan. The instrument in the form of the Hamilton Rating Scale for Anxiety (HRS A). The conclusion, in this case, is that there is the effect of giving Murottal Al-Qur'an therapy to the anxiety level of hemodialysis patients in North Sumatra Hospital Medan. CASE REPORT: Mrs R 48-year-old female, Javanese tribe, Islamic religion, patient complains of palpitations, neck pain and a feeling of suffocation in the chest, anxiously felt by patients almost every day, even throughout the day, patients experience complaints when going through hemodialysis therapy, and the patient cannot cope so that the patient feels very agitated and uneasy, has difficulty sleeping at night and often wakes up, this complaint is experienced by patients 1 month and burdensome in the past 2 weeks. CONCLUSION: Overall, this case has several unique features, the problem of anxiety in patients undergoing hemodialysis and there is an effect of giving Murottal Al-Qur'an therapy to the anxiety level of hemodialysis patients at Medan North Sumatra Hospital.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

The impact of hemodialysis on retinal and choroidal thickness in patients with chronic renal failure

2021 ◽  
Author(s):  
Fariba Shaikhi Shoshtari ◽  
Sasan Biranvand ◽  
Leila Rezaei ◽  
Nader Salari ◽  
Nasrin Aghaei
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Choroidal Thickness ◽  
The Impact

Renal Osteodystrophy in Children with Chronic Renal Failure: An Unexpectedly Common and Incapacitating Complication

PEDIATRICS ◽  
1982 ◽  
Vol 70 (5) ◽  
pp. 742-750 ◽  
Author(s):  
Anthony C. Hsu ◽  
Sang Whay Kooh ◽  
Donald Fraser ◽  
William A. Cumming ◽  
Victor L. Fornasier
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Osteodystrophy ◽  
Age At Onset ◽  
Growth Zone ◽  
Growth Patterns ◽  
Bone Lesions ◽  
Older Children ◽  
Before And After ◽  
End Stage

The incidence, age at onset, and progression of the biochemical, radiographic, and histologic characteristics of renal osteodystrophy were studied in 50 children in whom chronic renal failure had been recently diagnosed. During a ten-year observation period, 19 patients progressed to end-stage renal failure and radiographic signs of renal osteodystrophy developed in 15 of these (79%). Renal osteodystrophy developed in all nine patients whose chronic renal failure was diagnosed before 3 years of age and in six of the ten children with later onset of failure. The mean interval from diagnosis of renal failure to development of osteodystrophy was 1.4 years. Radiographically, growth zone lesions predominated in the younger children, whereas cortical erosions were more prevalent in the older children. Histologic examination, performed in 38 patients, showed both defective mineralization and excessive resorption and was a more sensitive diagnostic index than radiography. Noticeable deformities developed in one third of the patients with osteodystrophy, despite medical treatment including vitamin D2 therapy. Deformities were particularly frequent and Severe in patients whose renal failure developed in infancy. In all 13 patients whose growth patterns were studied before and after osteodystrophy developed, the onset of bone lesions was associated with a deterioration of growth, indicating that osteodystrophy plays a major role in causing the growth retardation commonly observed in children with chronic renal failure.

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