On Letting go: The Patient, Haemodialysis and Opting Out

1990 ◽  
Vol 24 (2) ◽  
pp. 268-275 ◽  
Author(s):  
William Cramond ◽  
Margaret Fraenkel ◽  
Lindsay Barratt
Keyword(s):  
Renal Failure ◽  
Renal Unit ◽  
End Stage Renal Failure ◽  
Opting Out ◽  
The Family ◽  
Letting Go ◽  
End Stage

The title of this article refers not only to the patient who decides to let go of life, the quality of which on dialysis is such that death is preferable, but also to the family and the renal unit staff who have to let go of the patient who makes this decision. One such case is described in detail since the problem is not one restricted to the treatment of end-stage renal failure alone, but occurs more and more frequently in other branches of medicine and surgery.

scholarly journals Peritoneal Dialysis at Ibn Sina Hospital in Rabat: 10 years’ experience

2020 ◽  
Vol 3 (1) ◽  
pp. 27-35
Author(s):  
Meryem Benbella ◽  
Aziza Guennoun ◽  
Mohamed Belrhiti ◽  
Tarik Bouattar ◽  
Rabia Bayahia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Retrospective Study ◽  
Infectious Complications ◽  
Dialysis Modality ◽  
Ibn Sina ◽  
End Stage Renal Failure ◽  
End Stage

Introduction:  The choice of dialysis modality has become an important decision that affects not only the country's health policy in the management of chronic end stage renal failure, but also the quality of life of patients and their survival. Peritoneal dialysis is an alternative for the treatment of these patients. The objective of our work is to report the epidemiological, clinical and biological results in the unit of PD, UHC of Rabat and to clarify the obstacles to the development of PD in Morocco.  Material and Methods:  We conducted a descriptive retrospective study in our PD unit from July 2006 to July 2017, including all patients who were in PD by choice or necessity and enrolled in the French Peritoneal Dialysis Registry (RDPLF).  Results: In 10 years, 159 patients were placed in PD, with an average age of 50.44 +/- 17.42 years and a sex ratio of 1.36. The indication for placement of setting in PD was by choice in 34% of the cases, social in 52% and medical in 14% of cases. Mechanical complications were dominated by catheter migrations. Infectious complications were represented by peritonitis, caused by poor of hygiene in 42% of cases. Conclusion: The obstacles to the development of PD are the lack of knowledge of the technique by the patients, as well as the prejudices or myths about the technique.

Renal transplantation and quality of life in Tanzania

2020 ◽  
Vol 31 (1) ◽  
pp. 1-15
Author(s):  
Onesmo A. Kisanga ◽  
Francis F. Furia ◽  
Paschal J. Ruggajo ◽  
Eden E. Maro
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Renal Transplant Recipients ◽  
End Stage Renal Failure ◽  
Laboratory Test Results ◽  
The Government ◽  
End Stage

Background: Renal replacement therapy (RRT), which includes dialysis and kidney transplantation, is the treatment of choice for patients with end stage renal failure (ESRF). Most sub-Saharan African countries have not developed renal transplantation services and are relying on referring patients to overseas countries. This study was carried out to describe renal transplantation experience in Tanzania.Methods: Forty-four renal transplant recipients were recruited in this study. Standardized questionnaire and Swahili version of standard form – 36 (SF-36) were used to collect socio-demographic information, clinical data, laboratory test results and health related quality of life information.Results: Ages of transplant recipient ranged from 21 to 66 years with mean age of 45.9 ± 10.5 years. The leading causes of end stage renal failure among participants was hypertension 58.8% (25/44) followed by glomerulonephritis 15.9% (7/44). Twentyeight (63.6%) of transplantations were paid by the government. Most of the donors (97.7%) were living out of which 26 (59.1%) were siblings and 11 (25%) were second-degree relatives (cousins and nephews). Most common complication noted following transplantation was diabetes mellitus 9 (20.5%) and 3 (6.8%) had chronic rejection. Mental health was the domain with highest mean score (75.6 ± 14.3) and role physical had the least mean score (44 ± 45.6).Conclusions:  Hypertension was the leading cause of ESRF in this study. Most of the donors were siblings and the costs of transplantation were largely covered by the government. There is a need for concerted effort to establish local kidney transplantation services in Tanzania. Keywords: Renal transplantation, quality of life in transplantation, Tanzania.

Benefits and Costs of Recombinant Human Erythropoietin for End-Stage Renal Failure: A Review: Benefits and Costs of Erythropoietin

1993 ◽  
Vol 9 (4) ◽  
pp. 490-504 ◽  
Author(s):  
Paul McNamee ◽  
Eddy van Doorslaer ◽  
Rob Segaar
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Cost Effectiveness ◽  
Medical Care ◽  
Recombinant Human Erythropoietin ◽  
End Stage Renal Failure ◽  
Human Erythropoietin ◽  
End Stage ◽  
Benefits And Costs

AbstractRecombinant human erythropoietin is an efficacious therapy in treatment of the anemia of end-stage renal failure. However, the scale of impact on quality of life and medical care resources remains uncertain. By reviewing the literature we evaluate cost-effectiveness of recombinant human erythropoietin and show how previous studies may have implicitly overestimated cost-effectiveness.

Systematic review of the effectiveness of home versus hospital or satellite unit hemodialysis for people with end-stage renal failure

2004 ◽  
Vol 20 (3) ◽  
pp. 258-268 ◽  
Author(s):  
Graham Mowatt ◽  
Luke Vale ◽  
Alison MacLeod
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Mortality Risk ◽  
Lower Mortality ◽  
Home Hemodialysis ◽  
End Stage Renal Failure ◽  
End Stage ◽  
Lower Mortality Risk ◽  
Satellite Unit

Background:Home hemodialysis offers potential advantages over hospital hemodialysis, including the opportunity for more frequent and/or longer dialysis sessions. Expanding home hemodialysis services may help cope with the increasing numbers of people requiring hemodialysis.Methods:We sought comparative studies or systematic reviews of home versus hospital/satellite unit hemodialysis for people with end-stage renal failure (ESRF). Outcomes included quality of life and survival. We searched MEDLINE, EMBASE, HealthSTAR, CINAHL, PREMEDLINE, and BIOSIS. Two reviewers independently extracted data and assessed the quality of the studies included.Results:Twenty-seven studies of variable quality were included. People on home hemodialysis generally experienced a better quality of life and lived longer than those on hospital hemodialysis. Their partners, however, found home hemodialysis more stressful. Four studies using a Cox proportional hazards model to compare home with hospital hemodialysis reported a lower mortality risk for home hemodialysis. Of two studies using a Cox model to compare home with satellite unit hemodialysis, one reported a similar mortality risk, whereas the other reported a lower mortality risk for home hemodialysis.Conclusions:Home hemodialysis was generally associated with better outcomes than hospital hemodialysis and (more modestly so) satellite unit hemodialysis, in terms of quality of life, survival, and other measures of effectiveness. People on home hemodialysis, however, are a highly selected group. Home hemodialysis also provides the opportunity for more frequent and/or longer dialysis sessions than would otherwise be possible. It is difficult to disentangle the true effects of home hemodialysis from such influencing factors.

scholarly journals 022 Hospice-based multi-disciplinary clinic for end-stage renal failure improves quality of care and reduces hospital admission

2013 ◽  
Vol 3 (Suppl 1) ◽  
pp. A8.3-A9
Author(s):  
Nicola Wilderspin ◽  
Marian Turner ◽  
Martin Ferring ◽  
Jenny Garside ◽  
Felix Blaine ◽  
...  
Keyword(s):  
Renal Failure ◽  
Quality Of Care ◽  
Hospital Admission ◽  
End Stage Renal Failure ◽  
End Stage

scholarly journals Effects of haemoglobin normalization on quality of life and cardiovascular parameters in end‐stage renal failure

2000 ◽  
Vol 15 (9) ◽  
pp. 1425-1430 ◽  
Author(s):  
Lawrence P. McMahon ◽  
Kim Mason ◽  
Sandford L. Skinner ◽  
Caroline M. Burge ◽  
Leanne E. Grigg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Cardiovascular Parameters ◽  
End Stage Renal Failure ◽  
End Stage
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