scholarly journals Factors responsible for increased percent recirculation in arterio-venous fistula among the haemodialysis patients

2013 ◽  
Vol 39 (1) ◽  
pp. 28-33 ◽  
Author(s):  
T Mahbub ◽  
MNU Chowdhury ◽  
F Jahan ◽  
MN Islam ◽  
FM Khan ◽  
...  
Keyword(s):  
Common Factors ◽  
Cross Sectional ◽  
Medical College ◽  
Needle Technique ◽  
Close Proximity ◽  
The Mean ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Training

Recirculation is an important issue in haemodialysis (HD) patients as increased percent recirculation causes decreased dialysis delivery of the patients. The purpose of the study was to determine the amount and factors of recirculation in those patients. The study was a cross sectional one carried in the department of Nephrology, Dhaka Medical College and Hospital during October 2010 to September 2011. A total of 118 end stage renal disease patients with arterio-venous fistula who were on HD for more than 3 months were purposively selected. The degree of recirculation was measured with urea based two needle technique method. For each patient distances between arterial and venous and distances of needles from fistula and its directions were recorded. Echocardiography and A-V fistula Colour Doppler Ultrasound were also performed. The mean A-V fistula recirculation was 8.1±5.5% with a range 0-66%. The most common factors were close proximity and improper arterial and venous needles placement. No difference was observed between diabetic and non diabetic also between hypertensive and normotensive. A-V fistula recirculation is common occurrence in HD patients and the most common factors of recirculation are misplacement and close proximity of needles therefore emphasis should be given on education and training of HD staffs. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15807 Bangladesh Med Res Counc Bull 2013; 39: 28-33

scholarly journals Accuracy of Peak Systolic Velocity of Radial Artery as Predictor of Maturation of Radiocephalic Arteriovenous Fistula in Cipto Mangunkusumo Hospital

2019 ◽  
Vol 1 (1) ◽  
pp. 30-33
Author(s):  
Dedy Pratama ◽  
Richard Yehuda Limen ◽  
Akhmadu Muradi
Keyword(s):  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Peak Systolic Velocity ◽  
Cross Sectional ◽  
Arteriovenous Fistulas ◽  
The Mean ◽  
Cross Sectional Design ◽  
Stage Renal Disease ◽  
End Stage ◽  
Relationship Of

Introduction: Hemodialysis is an essential treatment in patients with stage 5 chronic kidney disease (CKD) or End-Stage Renal Disease (ESRD). The maturity of arteriovenous fistulas determines the success of hemodialysis. FAV maturity depends on preoperative preparation. The study aims to examine the preoperative and intraoperative peak systolic velocity (PSV) of the radial artery as a predictor of the successful maturation of the radiocephalic FAV. Method: This study used an analytic cross-sectional design to obtain the relationship of FAV maturation with preoperative and intraoperative PSV. Subjects were those who will undergo radiocephalic FAV surgery with preoperative ultrasound mapping. Shortly after anastomosis, PSV was measured. After 6 weeks, FAV was assessed for its maturity. Results: As many as 71 patients were undergone radiocephalic FAV surgery and followed for six weeks. The mean preoperative PSV of mature fistula was significantly higher than immature (54.6 ± 11.7 cm/s and 26.7 ± 7.7 cm/s; p <0.001). The mean intraoperative PSV of mature fistula was significantly higher than immature (57.9 + 12.6 cm/s and 27.1 + 8.1 cm/s; p <0.001). The mean PSV difference in mature fistulas was significantly higher than immature (3 cm/s and 0 cm/s; p <0.001). Preoperative PSV with a cut-off of 40 cm/s, intraoperative with a cut-off of 42 cm/s, and a difference of PSV with a cut-off of 42 cm/s all had 92.9% accuracy as a predictor of FAV maturation compared to “rule of 6” as a reference standard. Conclusion: Preoperative PSV >40 cm/s and intraoperative PSV >42 cm/s had a good predictor value for radiocephalic FAV maturation. Keywords: peak systolic velocity, maturation, arteriovenous fistula, radial artery

Priorities of palliative care: comparison of perspectives of patients and nurses in a haemodialysis ward in Iran

2020 ◽  
Vol 26 (1) ◽  
pp. 22-31
Author(s):  
Shima Sarafi ◽  
Mansooreh Azizzadeh Forouzi ◽  
Batool Tirgari
Keyword(s):  
Palliative Care ◽  
Standard Deviation ◽  
Nursing Staff ◽  
Or Education ◽  
Cross Sectional ◽  
Significance Level ◽  
Physical Disorders ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: Palliative care is an important branch of nursing care. Patients with end-stage renal disease, owing to the chronic nature of the disease, will require palliative care, with nursing staff being responsible for delivering these services. Understanding the priorities of this type of care from the perspective of patients and nursing staff can be helpful in delivering it effectively and efficiently. This study was conducted to determine and compare palliative care priorities from the perspectives of patients and nursing staff in a haemodialysis ward in Iran. Method: This research is a cross-sectional and descriptive-analytic study with a sample size equal to the research population (322 patients and 45 nursing staff) in a haemodialysis ward in Kerman, Iran. Data were collected using two self-administered questionnaires that included demographic information and palliative care priorities. Data were analysed using SPSS19 with central tendency and dispersion indicators (frequency, percentage, mean and standard deviation, Mann–Whitney U-test, Kruskal–Wallis, independent t, ANOVA and one-way ANOVA). The significance level was P<0.05. Results: The mean total score (± standard deviation) of palliative care priorities from the patients' and nurses' perspective was 268.83±3.90 and 271.11±29.76, respectively, which was categorised for both groups as ‘high priority’. From the patients' perspective, the highest mean score was obtained from ‘supporting patient with insurance concerns’, while the lowest mean score was derived from ‘managing diarrhoea’. The nurses also believed that ‘managing and relief of pain’ had the highest priority and ‘bloating’ had the lowest priority in palliative care. From the perspective of both groups, holistic support and relief of physical disorders had the highest and lowest mean scores, respectively. Further, the mean scores of palliative care priorities did not differ significantly from the perspective of patients and nursing staff in the haemodialysis ward (P=0.68). Conclusion: Palliative care is a high priority for both haemodialysis patients and nursing staff and both groups prioritised it similarly. As palliative care has not yet been initiated formally across all treatment centres in Iran, it is necessary to prioritise its inclusion within the renal and haemodialysis wards in Iran and provide further training or education for nurses to ensure they are equipped to deliver effective and informed palliative care.

scholarly journals Factors Affecting the Burden on Family Caregivers of ESRD Patients

2019 ◽  
Vol 31 (Number 2) ◽  
pp. 22-27
Author(s):  
E H Rabin ◽  
E Hogue ◽  
SN Ahmad ◽  
S Shikder
Keyword(s):  
Family Caregivers ◽  
Additional Stress ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Medical College ◽  
Care Givers ◽  
Care Giving ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Patients of chronic kidney disease on hemodialysis face varieties of challenges and comorbid conditions need regular assistance from family caregiver. Caregivers of end stage renal disease (ESRD) have to bear loads of patient's daily activities, cares, medication, carrying to hospital, managing their psycho-social and financial demands which impose additional stress and burden among them. The study was conducted to evaluate the effect of care giving of patients with ESRD and to analyze the factors associated with it This cross sectional, observational and descriptive type of study was conducted in the Department of Nephrology and Psychiatry of Holy Family Red Crescent Medical College during the period of July 2018 to June 2019. Fifty family caregivers of age more than 18 years providing care or assistance to a relative with ESRD on dialysis were included. The burden of the care giver was assessed by a verified and culturally adopted Bangla-version of 22 factor Zarit Burden Interview (ZBI-B) scale. Difference of burden was not statistically significant considering its sex, marital status, place of residence, education level, religion, relation with patient, living in same house with patient or duration of the care giving of the patients (p>0.05). In JO% cases care givers had little or no burden, 26% mild to moderate, 22% moderate and 2% severe burden. So, in Bangladesh caregiving to ESRD patients imposes no or little burden on majority offamdy caregivers.

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

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.

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

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Sri Suparti ◽  
Sodikin Sodikin ◽  
Endiyono Endiyono
Keyword(s):  
Life Quality ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Severe Fatigue ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

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.

scholarly journals Assessment of Proximal Radio-median Cubital/Radio-Cephalic Arterio-venous Fistula

2021 ◽  
pp. 612-619
Author(s):  
Jawed Akther ◽  
Y. R. Lamture ◽  
Varsha P. Gajbhiye ◽  
Ranjit Ambad ◽  
Aditya V. Ghunage
Keyword(s):  
Postoperative Complications ◽  
Chronic Glomerulonephritis ◽  
Mean Flow ◽  
Cross Sectional ◽  
Av Fistula ◽  
Proximal Forearm ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage

The present study aims to conducted the Assessment of Proximal radio-median cubital/radio-cephalic Arterio-venous Fistula. Arterio-venous Fistula is life line for long-term hemodialysis for end stage renal disease patients. The order of preference as per National Kidney Foundation/ Kidney Disease Out Come Quality Initiative (KDOQI) is distal Radio Cephalic fistula is considered as gold standard followed by elbow Brachio Cephalic Fistula, transposed Brachio-Basilic Fistula, forearm arterio-venous graft. This is a cross sectional-prospective interventional study, 05/2017 to 04/2019, JNMC, Wardha, MH, with sample size of 66 cases. Out of 66 cases 25 % patients had diabetes mellitus, 48% cases were suffering from chronic glomerulonephritis, 15 % cases were suffering hypertension, 6 % cases had COPD and another 6 % cases had some cardiovascular disease. About 54 % cases had previous access failure. In our study the mean flow volume for AV fistula in proximal forearm was 485± 291 ml/minon postoperative day1, 695 ± 298 on postoperative day 7 and 755± 347 ml/min. Overall postoperative complications in 12% cases was reported in our case study though Yilmiz et al reported postoperative complications in 15% cases.

scholarly journals SECONDARY HYPERPARATHYROIDISM AMONG END-STAGE RENAL DISEASE PATIENTS

2020 ◽  
pp. 29-32
Author(s):  
ROZAN ATTILI ◽  
HATEM A HEJAZ ◽  
ASMAA ALKOMI ◽  
RAZAN JUBEH ◽  
SAFAA ERJOUB ◽  
...  
Keyword(s):  
Renal Disease ◽  
Secondary Hyperparathyroidism ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Social ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Objectives: The study aims to determine the incidence of secondary hyperparathyroidism (SHPT) in chronic kidney disease patients, the correlation between creatinine, parathyroid hormone (PTH) and phosphate, and calcium in renal disease. Methods: A retrospective cross-sectional study was performed, a total of 100 hemodialysis patients’ reports were analyzed from January 2019 to December 2019, at Hebron Governmental Hospital, in Hebron, Palestine. The patients’ data were collected, including creatinine level, calcium, and phosphorus in addition to PTH concentrations. Twenty-five healthy persons with normal kidney function were also included in the study as a control for comparison. Statistical Package for the Social Sciences version 22 was used to analyze the data. T-test and Pearson’s tests were used to study the results. R (Pearson’s test) was used to determine the correlation between creatinine, PTH, phosphate, and calcium. Results: The mean values of serum of creatinine, phosphate, calcium, and PTH were determined for both patients and the control. Levels of PTH were significantly higher in kidney failure patients and positively correlated with creatinine and phosphate. However, levels of PTH were significantly negatively correlated with calcium. All patients included in the study have very high levels of PTH PTH. This increase might be due to many factors that contributed to the hypersecretion of PTH. The correlations between these predisposing factors of SHPT are explained. Conclusion: The study showed that SHPT is common among patients with end-stage renal disease. The most complications of SHPT are mineral and bone metabolism disorders and cardiovascular diseases. Thus, early detection and treatment of SHPT may control these complications.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals A therapeutic vascular conduit to support in vivo cell-secreted therapy

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Edward X. Han ◽  
Hong Qian ◽  
Bo Jiang ◽  
Maria Figetakis ◽  
Natalia Kosyakova ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Large Scale ◽  
Biological Effects ◽  
Therapeutic Protein ◽  
Close Proximity ◽  
Delivery Platform ◽  
Stage Renal Disease ◽  
End Stage

AbstractA significant barrier to implementation of cell-based therapies is providing adequate vascularization to provide oxygen and nutrients. Here we describe an approach for cell transplantation termed the Therapeutic Vascular Conduit (TVC), which uses an acellular vessel as a scaffold for a hydrogel sheath containing cells designed to secrete a therapeutic protein. The TVC can be directly anastomosed as a vascular graft. Modeling supports the concept that the TVC allows oxygenated blood to flow in close proximity to the transplanted cells to prevent hypoxia. As a proof-of-principle study, we used erythropoietin (EPO) as a model therapeutic protein. If implanted as an arteriovenous vascular graft, such a construct could serve a dual role as an EPO delivery platform and hemodialysis access for patients with end-stage renal disease. When implanted into nude rats, TVCs containing EPO-secreting fibroblasts were able to increase serum EPO and hemoglobin levels for up to 4 weeks. However, constitutive EPO expression resulted in macrophage infiltration and luminal obstruction of the TVC, thus limiting longer-term efficacy. Follow-up in vitro studies support the hypothesis that EPO also functions to recruit macrophages. The TVC is a promising approach to cell-based therapeutic delivery that has the potential to overcome the oxygenation barrier to large-scale cellular implantation and could thus be used for a myriad of clinical disorders. However, a complete understanding of the biological effects of the selected therapeutic is absolutely essential.

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