scholarly journals Psychosocial factors among end-stage kidney disease patients receiving hemodialysis treatment in Kumasi, Ghana

2021 ◽  
Vol 5 (1) ◽  
pp. 014-019
Author(s):  
Amoako Thomas Nti ◽  
Owusu-Ansah Frances Emily

Background: End-Stage Kidney Disease and its maintenance hemodialysis treatment force patients to make several lifestyle changes to cope with this debilitating illness. These changes often trigger the onset of notable psychological distress and depressive symptoms. Furthermore, these negative psychological experiences can undermine the effectiveness of the treatment and consequently worsening the health and quality of life of patients. Objective: The study assessed the psychological well-being among hemodialysis patients in Kumasi Metropolis. Further, it explored the relationship between these psychosocial factors and demographic characteristics. Materials and Methods: 30 hemodialysis patients were recruited from two dialysis units in Kumasi, Ghana. Participants were aged 18 and above and had been on hemodialysis treatment for more than three months. The Hospital Anxiety and Depression scale (HADS) was used to assess depression and anxiety whiles the Multidimensional Scale of Perceived Social Support was used to assess perceived social support of participants. Results: The majority of respondents were males (60%), relative to females. The study revealed that 80% were severely depressed, 20% met the criteria for severe anxiety. Some participants reported moderate social support 53.3%; perceived social support being inversely correlated with both depression (r = -0.41; n = 30; p < 0.05) and anxiety (r = -0.59; n = 30; p < 0.05). Income levels were inversely correlated with depression (r = -0.41, n = 30; p < 0.05). Conclusion: Findings of the study suggest that the psychological wellbeing of hemodialysis patients is compromised. Social support appears to alleviate depression and anxiety. Implications for patient treatment are discussed.

Author(s):  
Micaella Sotera Hansen ◽  
Wubshet Tesfaye ◽  
Beena Sewlal ◽  
Bharati Mehta ◽  
Kamal Sud ◽  
...  

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 289
Author(s):  
Adamasco Cupisti ◽  
Piergiorgio Bolasco ◽  
Claudia D’Alessandro ◽  
Domenico Giannese ◽  
Alice Sabatino ◽  
...  

The retention of uremic toxins and their pathological effects occurs in the advanced phases of chronic kidney disease (CKD), mainly in stage 5, when the implementation of conventional thrice-weekly hemodialysis is the prevalent and life-saving treatment. However, the start of hemodialysis is associated with both an acceleration of the loss of residual kidney function (RKF) and the shift to an increased intake of proteins, which are precursors of uremic toxins. In this phase, hemodialysis treatment is the only way to remove toxins from the body, but it can be largely inefficient in the case of high molecular weight and/or protein-bound molecules. Instead, even very low levels of RKF are crucial for uremic toxins excretion, which in most cases are protein-derived waste products generated by the intestinal microbiota. Protection of RKF can be obtained even in patients with end-stage kidney disease (ESKD) by a gradual and soft shift to kidney replacement therapy (KRT), for example by combining a once-a-week hemodialysis program with a low or very low-protein diet on the extra-dialysis days. This approach could represent a tailored strategy aimed at limiting the retention of both inorganic and organic toxins. In this paper, we discuss the combination of upstream (i.e., reduced production) and downstream (i.e., increased removal) strategies to reduce the concentration of uremic toxins in patients with ESKD during the transition phase from pure conservative management to full hemodialysis treatment.


2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Magdalene M. Assimon ◽  
Lily Wang ◽  
Patrick H. Pun ◽  
Wolfgang C. Winkelmayer ◽  
Jennifer E. Flythe

Background The rate of sudden cardiac death in the hemodialysis population exceeds that of the general population by >20‐fold. Hemodialysis patients may be particularly susceptible to sudden cardiac death provoked by drug‐induced QT prolongation because of their substantial cardiovascular disease burden, exposure to electrolyte shifts during dialysis, and extensive polypharmacy. However, population‐specific data regarding the frequency and patterns of QT prolonging medication use are limited. Methods and Results We conducted a descriptive drug utilization study using 3 administrative databases, the United States Renal Data System, MarketScan, and Medicare claims. We characterized the extent and patterns of QT prolonging medication use by adult hemodialysis patients and individuals without end‐stage kidney disease annually from 2012 to 2016. We also identified instances of high‐risk QT prolonging medication use among hemodialysis patients. In total, 338 515 hemodialysis patients and 40.7 million individuals without end‐stage kidney disease were studied. Annual utilization rates of QT prolonging medications with known torsades de pointes risk in hemodialysis patients were ~1.4 to ~2.5 times higher than utilization rates in individuals without end‐stage kidney disease. Hemodialysis patients with demographic and clinical risk factors for drug‐induced QT prolongation were exposed to medications with known torsades de pointes risk more often than patients without risk factors. Conclusions Hemodialysis patients use QT prolonging medications with known torsades de pointes risk more extensively than individuals without end‐stage kidney disease. Given the widespread use and instances of high‐risk prescribing, future studies evaluating the cardiac safety of these drugs in the hemodialysis population are needed.


2019 ◽  
Vol 23 (6) ◽  
pp. 534-541
Author(s):  
Yusuke Kawai ◽  
Masataka Banshodani ◽  
Misaki Moriishi ◽  
Tomoyasu Sato ◽  
Sadanori Shintaku ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sima Sadat Hejazi ◽  
Meimanat Hosseini ◽  
Abbas Ebadi ◽  
Hamid Alavi Majd

Abstract Background Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients’ quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients’ disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers’ perspective. Methods In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas’ method. Results A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). Conclusion Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients’ quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients’ quality of life and even reduce the caregivers’ burden.


1993 ◽  
Vol 16 (9) ◽  
pp. 659-661 ◽  
Author(s):  
V. Stefanović ◽  
M. Bogićević ◽  
M. Mitić

Increased serum myoglobin levels were previously found in patients with chronic renal failure. In this report we have studied the effects of dialysis on myoglobin elimination in patients on CARD, IPD, cuprophan and polyacrylonitrile (PAN) membrane hemodialysis. Peritoneal dialysis removed a significant amount of myoglobin, CAPD 480 ± 65 μg/day, IPD 270 ± 25 μg/12 h treatment, while with cuprophan dialysis none, and with PAN dialysis only an insignificant amount of myoglobin. The serum myoglobin levels were 250 ± 18 and 264 ± 14 μg/l on cuprophan and a 3 month dialysis on PAN membrane, respectively. Markedly increased serum levels were also found in CAPD and IPD patients on peritoneal dialysis, 227 ± 25 and 286 ± 32 μg/l respectively. This study has shown that there is an increased serum myoglobin concentration in end-stage kidney disease patients on dialysis. Although peritoneal membrane is permeable to myoglobin, a relatively small amount is removed, and the serum level in CAPD and IPD patients was not significantly different from the serum myoglobin concentration in hemodialysis patients. Furthermore myoglobin could not be removed by hemodialysis membrane and an analysis of its important extrarenal catabolism level points were analyzed.


2021 ◽  
Vol 11 (1) ◽  
pp. 131-142
Author(s):  
Omer Toprak ◽  
Emel Aslan Bozyel ◽  
Burak Alp

End-stage kidney disease patients who require hemodialysis for more than 3 months have a small chance of leaving dialysis unless they have a kidney transplant. Educating the patient about lifestyle changes can play a major role in improving kidney function. Therefore, we created a patient education program according to our nephrology experiences. Herein, we show an end-stage kidney disease patient who underwent hemodialysis for 6 months. Afterwards, dialysis was terminated with patient care, and the patient was then followed up for 9 years without dialysis. To date, there have been no reports regarding the termination of long-term dialysis with a kidney care program and the ensuing 9-year follow-up without renal replacement therapy.


Author(s):  
Katia Berkache ◽  
Zohra Bengharez ◽  
Bastien Poitier ◽  
Djamila Ouabdesslam ◽  
Abdelkrim Guerinik ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document