The Relationship  Between Dialysis Adequacy And Fatigue In  Patients On Maintenance Hemodialysis

Fatigue and inadequacy dialysis are common problem in hemodialysis patients. The dialysis inadequacy can cause an increased progression of impaired renal function, as well as the increased morbidity and mortality, and declining productivity of hemodialysis patients. Fatigue prevalence ranged from 44,7- 97% from mild to severe. Fatigue is a common complaint of hemodialysis patients that can lower physical function and life quality. To determine the correlation between adequacy and the fatigue level of the patients with End Stage Renal Disease (ESRD) undergoing hemodialysis. This study used a descriptive analytic and cross sectional approach involving 75 respondents and the FACIT-G Questionnaire was used to collect the data. The inclusion criteria are male and female patients aged 18 -70, undergoing hemodialysis for more than 3 months with a frequency of 2 times at least 4 hours, composmentis patients. The adequacy hemodialysis was assessed using the Kt/V formula. All data were collected during the session of hemodialysis. Pearson Product moment test wes used to analyze the data. The mean dialysis adequacy was 1.43±0.380, 57(76%) only 13 (17.3%) patients had adequate dialysis (minimum laboratory standard Kt / v = 1.8) and inadequate were 62 (82.7%) patients. The mean of fatigue was 20.07 and 62 (82.7%) respondents experienced severe fatigue. There was no significant correlation between adequacy and the fatigue level of the patients with ESRD undergoing hemodialysis with p value 0.504 (α> 0.05). Mostly patients had inadequate dialysis, both adequate and inadequate dialysis patients had experience fatigue from mild to severe. Multiple individuale and personnel factors affect dialysis adequacy directly or conversely.

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Assessing the Adequacy of Hemodialysis Patients via the Graph-Based Takagi-Sugeno-Kang Fuzzy System

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/9036322 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Aiyan Du ◽

Xiaofen Shi ◽

Xiaoyi Guo ◽

Qixiao Pei ◽

Yijie Ding ◽

...

Keyword(s):

Clinical Practice ◽

Fuzzy System ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Dialysis Adequacy ◽

Feasible Method ◽

Body Weights ◽

Stage Renal Disease ◽

End Stage ◽

Takagi Sugeno

Maintenance hemodialysis is the main method for the treatment of end-stage renal disease in China. The K t / V value is the gold standard of hemodialysis adequacy. However, K t / V requires repeated blood drawing and evaluation; it is hard to monitor dialysis adequacy frequently. In order to meet the need for repeated clinical assessments of dialysis adequacy, we want to find a noninvasive way to assess dialysis adequacy. Therefore, we collect some clinically relevant data and develop a machine learning- (ML-) based model to predict dialysis adequacy for clinical hemodialysis patients. We collect 250 patients, including gender, age, ultrafiltration (UF), predialysis body weight (preBW), postdialysis body weights (postBW), blood pressure (BP), heart rate (HR), and blood flow (BF). An efficient graph-based Takagi-Sugeno-Kang Fuzzy System (G-TSK-FS) model is proposed to predict the dialysis adequacy of hemodialysis patients. The root mean square error (RMSE) of our model is 0.1578. The proposed model can be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice. Our G-TSK-FS model could be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice.

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Frequency of anemia in patients with increased level of parathyroid hormone among patients on maintenance hemodialysis.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.4272 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1255-1258

Author(s):

Saad Muzaffar Azeem ◽

Anita Haroon ◽

Ishtiaque Alam ◽

Sadia Azeem ◽

Mahrukh Sultana ◽

...

Keyword(s):

Parathyroid Hormone ◽

Renal Disease ◽

End Stage Renal Disease ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

Number Of Patients ◽

Study Results ◽

The Mean ◽

Stage Renal Disease ◽

End Stage

Objectives: One of the most frequently occurring complication of end stage renal disease is anemia. It can be defined as decrease in red blood cells with hemoglobin concentration less than 12 g/dl in women and less than 13 g/dl in men. Parathyroid hormone levels are also raised among patients with end stage renal disease to maintain serum calcium levels. The objective of this study is to evaluate the degree of anemia in patients with end stage renal disease currently on maintenance hemodialysis and have raised PTH levels. Study Design: Cross-sectional study. Setting: Kidney Center, Karachi. Period: November 2015 to July 2016. Material & Method: Patients undergoing maintenance hemodialysis during the study duration with PTH levels greater than 300 ng/L were included in the study. Patients with other co-morbid conditions like chronic liver disease and hypersplenism were excluded from the study. Results: The total number of patients on maintenance hemodialysis in the kidney center that matched our inclusion criteria was 110. Amongst them there were 47.3% (n=52) males and 52.7% (n=58) females. The mean age of patients in our study is 50.15 ± 12.92 years. The mean PTH level of patients was found to be 642 ± 405.9U. Since all the participants of the study are on maintenance dialysis, the mean duration of hemodialysis was found to be 4.2 ± 3.19 months. The mean hemoglobin level of patients was found to be 9.75 ± 1.47 g/dl. Conclusion: Patients with hyperparathyroidism and undergoing maintenance hemodialysis frequently develops anemia. Many factors account for this including raised PTH levels causing bone marrow fibrosis, decreased production of erythropoietin and resistance of produced erythropoietin are some factors responsible for the anemia.

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Clinicodemographic Profile and Outcome of Maintenance Hemodialysis Patients in a Tertiary Hospital of Central Nepal, Chitwan

Kathmandu University Medical Journal ◽

10.3126/kumj.v18i1.33338 ◽

2020 ◽

Vol 18 (1) ◽

pp. 9-14

Author(s):

M. Ghimire ◽

S. Vaidya ◽

H.P. Upadhyay

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Volume Overload ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

P Value ◽

Stage Renal Disease ◽

End Stage ◽

Maintenance Hemodialysis Patients

Background Maintenance hemodialysis is a popular treatment modality of renal replacement therapy for end stage renal disease patients; however their mortality seemed to be rising in our centre. There were no previous studies regarding the clinicodemographic profile and outcome of maintenance hemodialysis patients from this region. Objective This study was carried out with an objective to know the clinicodemographic profile and outcome of maintenance hemodialysis patients in our centre. Method This study was a hospital based prospective observational study carried out over a period of three year, from May 2016 to April 2019, in the hemodialysis unit of the department of nephrology. All the consecutive end stage renal disease patients on maintenance hemodialysis were included in the study. The patient’s demographic profile and outcome were studied and analysed using appropriate statistical tools. Result A total of 156 patients were enrolled in the study. Males were 96(61.5%) and females were 60(38.5%). The mean age of the patient was 52.2±15.6 years. The commonest causes of end stage renal disease and reasons for admission were Type 2 diabetes mellitus 68(43.6%) and volume overload with heart failure 101(64.7%) respectively. At the end of three years, 39(25%) were expired, 14(8.9%) were transferred to other centre and four (2.6%) underwent kidney transplantation. The average duration of hemodialysis was 20.3± 17.5 months. Majority of the patients 154(98.7%) had repeat admission ranging from 1 time 21(13.5%) to 10 times two (1.3%). There was a significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively). Conclusion The commonest cause of end stage renal disease and the reason of admission were Type 2 diabetes mellitus 68 (43.6%) and volume overload with heart failure 101 (64.7%) respectively. The overall mortality was 39 (25%) and the commonest cause of mortality was sepsis/health care associated pneumonia 30 (76.9%). There was significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively).

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Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1935 ◽

2022 ◽

Vol 71 (12) ◽

pp. 2761-2765

Author(s):

Lubna Ghazi ◽

Murtaza Dhrolia ◽

Aamna Hamid ◽

Ruqaya Qureshi ◽

Kiran Nasir ◽

...

Keyword(s):

Nutritional Status ◽

Global Assessment ◽

Practical Method ◽

Hemodialysis Patients ◽

Normal Weight ◽

Maintenance Hemodialysis ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Subjective Global Assessment ◽

Cross Sectional

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment. Continuous...

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Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v5i1.324 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Muhammad Nadeem ◽

Mansoor Abbas Qaisar ◽

Ali Hassan Al Hakami ◽

Fateh Sher Chattah ◽

Muhammad Muzammil ◽

...

Keyword(s):

Mean Arterial Pressure ◽

Arterial Pressure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Age Group ◽

Calcium Phosphorus ◽

The Mean ◽

Stage Renal Disease ◽

End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

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Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

Journal of Nepal Medical Association ◽

10.31729/jnma.358 ◽

2012 ◽

Vol 52 (187) ◽

Author(s):

R K Agrawal ◽

S Khakurel ◽

R Hada ◽

D Shrestha ◽

A Baral

Keyword(s):

Renal Failure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Tertiary Care ◽

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Care Hospital ◽

Cross Sectional ◽

Stage Renal Disease ◽

End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

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Clinical Utility of Potassium-Sparing Diuretics to Maintain Normal Serum Potassium in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2016.00022 ◽

2017 ◽

Vol 37 (1) ◽

pp. 63-69 ◽

Cited By ~ 6

Author(s):

Tibor Fülöp ◽

Lajos Zsom ◽

Betzaida Rodríguez ◽

Sabahat Afshan ◽

Jamie V. Davidson ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Serum Potassium ◽

Residual Renal Function ◽

Normal Serum ◽

Dialysis Adequacy ◽

Cross Sectional ◽

Laboratory Variables ◽

Stage Renal Disease ◽

End Stage ◽

Vexing Problem

BackgroundHypokalemia is a vexing problem in end-stage renal disease patients on peritoneal dialysis (PD), and oral potassium supplements (OPS) have limited palatability. Potassium-sparing diuretics (KSD) (spironolactone, amiloride) may be effective in these patients.MethodsWe performed a cross-sectional review of 75 current or past (vintage > 6 months) PD patients with regard to serum potassium (K+), OPS, and KSD utilization. We reviewed charts for multiple clinical and laboratory variables, including dialysis adequacy, residual renal function, nutritional status and co-existing medical therapy.ResultsThe cohort was middle-aged with a mean age of 49.2 years (standard deviation [SD] = 14.7) and overweight with a body mass index of 29.5 (6.7) kg/m2. Of all the participants, 57.3% were female, 73.3% African-American, and 48% diabetic with an overall PD vintage of 28.2 (24.3) months at the time of enrollment. Weekly Kt/V was 2.12 (0.43), creatinine clearance was 73.5 (33.6) L/week/1.73 m2with total daily exchange volume of 10.8 (2.7) L. Residual urine output (RUO) measured at 440 (494) mL (anuric 30.6%). Three-month averaged serum K+measured at 4 (0.5) mmol/L with 36% of the participants receiving K+supplements (median: 20 [0;20] mmol/day) and 41.3% KSD (spironolactone dose: 25 – 200 mg/day; amiloride dose: 5 – 10 mg/day). Serum K+correlated positively with weekly Kt/V (r = 0.239; p = 0.039), PD vintage (r = 0.272; p = 0.018) but not with PD modality, daily exchange volume, RUO, or KSD use. However, KSD use was associated with decreased use of OPS (r = -0.646; p < 0.0001).ConclusionsPotassium-sparing diuretics were effective in this cohort of PD patients and decreased the need for OPS utilization.

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Pengaruh Edukasi Pendekatan Spiritual Berbasis Video terhadap Kepatuhan Pembatasan Cairan Klien ESRD yang Menjalani Hemodialisa

Jurnal Keperawatan Silampari ◽

10.31539/jks.v1i2.97 ◽

2018 ◽

Vol 1 (2) ◽

pp. 17-31

Author(s):

Andri Kusuma Wijaya ◽

Busjra Busjra ◽

Rohman Azzam

Keyword(s):

Weight Gain ◽

Health Education ◽

Family Support ◽

Sampling Method ◽

P Value ◽

Fluid Restriction ◽

Post Test ◽

The Mean ◽

Stage Renal Disease ◽

End Stage

The purpose of this research to know effect of health education with spiritual approach based video toward adherence fluid restriction or interdialysis weight gain of patients undergoing hemodialysis. This is a pre experimental onegroup pretest post test. Using total sampling method 22 patients. The mean of samples interdialysis weight gain total score after education was significantly decrease than before education p value 0.011. While proved there was significantly between the adherence fluid restriction patients undergoing hemodialysis will be increas after health education spiritual approach with video based controlled by family support p value 0, 047 while proved was no significantly between the ages of p value 0.364, education level alue 0.949 to interdialysis weight gain of patients undergoing hemodialysis. Health education with spiritual approach to improve adherence fluid restriction in patients undergoing hemodialysis, which is expected to implemented in order clinic especially patients who undergoing hemodialysis therapy who experienced non-compliance restrictions fluid. Keywords : Spiritual Based Video, End Stage Renal Disease

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Hubungan Lama Menjalani Kemoterapi Dengan Kualitas Hidup Penderita Kanker Payudara Di RSUD Ulin Banjarmasin

DINAMIKA KESEHATAN JURNAL KEBIDANAN DAN KEPERAWATAN ◽

10.33859/dksm.v10i1.455 ◽

2020 ◽

Vol 10 (1) ◽

pp. 253-265

Author(s):

Mahmuddin Mahmuddin ◽

Dhian Ririn Lestari ◽

Ichsan Rizani

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Side Effect ◽

Life Quality ◽

P Value ◽

Symptom Scale ◽

Cross Sectional ◽

European Organization ◽

The Mean

Latar Belakang: Kanker payudara adalah keganasan sel yang menyerang payudara dan merupakan penyebab kematian kedua pada wanita. Frekuensi kemoterapi menimbulkan gangguan pada fungsi dan gejala kanker payudara yang dapat mempengaruhi kualitas hidup. Kualitas hidup merupakan keadaan yang menyatakan kepuasan batin dan kenyamanan hidup seseorang. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan lama menjalani kemoterapi dengan kualitas hidup penderita kanker payudara di RSUD Ulin Banjarmasin Metode: Penelitian ini merupakan penelitian analitik dengan pendekatan cross sectional menggunakan accidental sampling didapatkan 47 responden, penilaian kualitas hidup menggunakan European Organization of Research and Treatment of Cancer (EORTC) BR23. Uji Analisa menggunakan korelasi spearman. Hasil: Hasil rata-rata lama penderita menjalani kemoterapi sebanyak 4,53 kali dan rata-rata kualitas hidup penderita kanker payudara berada di 65, 5% . Kesimpulan: dari Hasil analisis didapatkan ada hubungan antara lama menjalani kemoterapi dengan kualitas hidup penderita kanker payudara di RSUD Ulin Banjarmasin (P Value=0,000,01) dengan arah hubungan positif yakni semakin lama menjalani kemoterapi semakin tinggi nilai kualitas hidup penderita kanker payudara. Kualitas hidup yang paling tinggi dilihat dari function scale adalah sexs enjoyment yakni 72,0 sedangkan dari symptom scale adalah side effect dengan skor 582,6 Kata kunci : kanker payudara, kemoterapi, kualitas hidup.Long Relationship Undergo Chemotherapy with Quality of Life of Breast Cancer Patients in Ulin Hospital BanjarmasinAbstractBackground: Breast cancer is a malignancy cells that attack breast and it is also the second leading cause of death among women. Frequency of chemotherapy may have detrimental function and symptom can make affect for patient’s quality of life. Quality of life is defined as condition to which individual reports inner satisfaction and comfort in life. Aim:The study to identify correlation between duration of chemotherapy and quality of life in patients with breast cancer RSUD Ulin Banjarmasin Method: This Research use Analitic Method with design was cross sectional and involved 47 patients, all of whom were selected through accidental sampling. European Organization of Research and Treatment of Cancer (EORTC) BR23 was applied to measure patient’s quality of life. Anlyssis test using spearman correlation. Result: The mean of chemotherapy duration among participants was 4.53 times and the mean of QoL of patients with breast cancer was 73.31%. Conclusion: The analysis revealed a significant correlation between duration of chemotherapy and quality of life in patients with breast cancer in Ulin public hospital of Banjarmasin (p value = 0.000.01) with positive direction of association indicating that the longer the duration of make increase the score life quality of patients with breast cancer. The highest quality of life seen from the function scale is sex enjoyment, namely 72.0 while the symptom scale is a side effect with a score of 582.6. Key words: breast cancer, chemotherapy, quality of life

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Effects of Arterial Needle Placement in Arteriovenous Fistula on Dialysis Adequacy of End-Stage Renal Disease Patients Undergoing Maintenance Hemodialysis

Journal of Nursing & Healthcare ◽

10.33140/jnh/01/02/00010 ◽

2016 ◽

Vol 1 (2) ◽

Keyword(s):

Blood Flow ◽

Arteriovenous Fistula ◽

Intervention Group ◽

Maintenance Hemodialysis ◽

Control Group ◽

Needle Placement ◽

Dialysis Adequacy ◽

Significant Difference ◽

Stage Renal Disease ◽

End Stage

Objective: The arterial needle placement in arteriovenous fistula (AVF) can either be antegrade (in the direction of blood flow or pointing towards the heart) or retrograde (against the direction of blood flow) while venous needle placement should always be in the same direction as the blood flow. This study determined the effects of arterial needle placement in the arteriovenous fistula on dialysis adequacy of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis in United Candelaria Doctors Hospital - Nephro Synergies Inc. (UCDHNSI) Hemodialysis Center. Methods: A randomized controlled trial design was used in the study. A total of 20 non-diabetic, non-cardiac patients on maintenance hemodialysis for more than 6 months were randomized either to the intervention group (patients’ AVF were cannulated in a retrograde manner) or the control group (patients’ AVF were cannulated in an antegrade manner). Urea reduction ratio (URR) and Kt/V as well as access recirculation percentage were used to determine dialysis adequacy. Pre-dialysis, in the first 30 minutes of dialysis initiation and post-dialysis blood samples were obtained in each patient in 6 succeeding hemodialysis considering dialyzer reuse up to fifth reuse. Means were compared by independent t-test. Results: The findings of the study revealed that the mean URR and Kt/V of the subjects cannulated in retrograde manner and antegrade manner were 69.35% and 1.45, and 74.65% and 1.70, respectively. The mean access recirculation percentage of the subjects was 4.65% in the intervention group and 3.02% in the control group. There was a significant difference on URR and Kt/V of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. There was no significant difference on access recirculation percentage of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. Conclusions: Antegrade arterial needle placement provides more adequate hemodialysis than retrograde arterial needle placement in terms of URR and Kt/V values among non-diabetic, non-cardiac patients undergoing maintenance hemodialysis in 6 succeeding hemodialysis sessions. The directions of the arterial needle either retrograde and antegrade did not have significant effects on access recirculation.

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