Pathological damage of bones and joints in patients on hemodialysis in Saint Petersburg

2019 ◽  
Vol 23 (6) ◽  
pp. 73-82
Author(s):  
A. N. Tsed ◽  
A. V. Smirnov ◽  
A. К. Dulaev ◽  
A. Sh. Rumyantsev ◽  
A. N. Ananyev
Keyword(s):  
Pathological Fractures ◽  
X Ray ◽  
Saint Petersburg ◽  
Number Of Patients ◽  
Calcium Phosphorus ◽  
History Of ◽  
Examination Methods ◽  
Stage Renal Disease ◽  
End Stage

BACKGROUND. The number of patients with end-stage renal disease is steadily increasing. One of the main complications arising from the disorders of calcium-phosphorus metabolism in patients on hemodialysis is various types of renal osteodystrophy. The frequency of pathological fractures among patients receiving renal replacement therapy is twice as high as in the general population. The prevalence and structure of injuries, especially the diagnosis of injuries of the musculoskeletal system in hemodialysis patients, are not well understood. THE AIM: to determine the prevalence and structure of injuries and the consequences of pathological injuries of bones and joints undergoing hemodialysis in Saint-Petersburg. To achieve this goal, the authors developed a special questionnaire, consisting of 4 blocks, including 32 questions.PATIENTS AND METHODS. An analysis of questionnaires of 798 patients from 15 hemodialysis centers of Saint-Petersburg was carried out.RESULTS. A number of problems were identified, such as insufficient coverage of patients not only with specific instrumental examination methods (MSCT, MRI), but also with radiographic ones. Satisfaction with quality of life and physical activity was noted in less than half of patients. 46.4% had a history of fractures and injuries, while the proportion of operated patients was half that, which indicates the need for more active work of hemodialysis centers with city hospitals with traumatology and orthopedic departments.CONCLUSION. Patients on HD require regular x-ray examination and densitometry to detect pathological damage to bones and joints. Based on the results of these studies, it is advisable to consult a traumatologist at least 1 time per year.

Patient selection when resources are limited

2018 ◽  
Author(s):  
Bernadette A. Thomas ◽  
Christopher R. Blagg
Keyword(s):  
Population Ageing ◽  
Ethical Considerations ◽  
Number Of Patients ◽  
The World ◽  
History Of ◽  
Developing Societies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Global Growth ◽  
Triage Decisions

More than 50 years ago, outpatient care for patients with end-stage renal disease (ESRD) became possible through the invention of the Scribner shunt. Since that time, renal replacement therapy (RRT) has expanded to include haemodialysis, peritoneal dialysis, and renal transplantation. There has been tremendous global growth in the number of patients with access to RRT for ESRD, but many societies face difficult triage decisions for these costly modalities similar to those faced by the pioneers of outpatient dialysis in the early 1960s. Developed and developing societies will face the complex challenges of addressing the costly needs of an ESRD population that is projected to rise rapidly secondary to population ageing, as well as the increased burden of chronic diseases such as diabetes mellitus and hypertension. The history of outpatient RRT is outlined and trends in RRT growth throughout the world noted. The ethical considerations with which both developed and developing societies will have to contend to address the growing global burden of ESRD are discussed.

scholarly journals Evaluation of the Recipient and Donor in Living Kidney Transplantation

2020 ◽  
Vol 95 (4) ◽  
pp. 260-265
Author(s):  
Ha Yeol Park ◽  
Byung Chul Shin
Keyword(s):  
Kidney Transplantation ◽  
Supply And Demand ◽  
Deceased Donor ◽  
Good Health ◽  
Kidney Donation ◽  
Living Kidney Donation ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
End Stage

Kidney transplantation is the treatment of choice for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk of patients, as compared to maintenance dialysis. The number of patients awaiting kidney transplantation has steadily increased, and the gap between allograft supply and demand continues to widen despite initiatives to expand the use of nonstandard deceased-donor allografts. The use of organs from living donors is one strategy to address the need for transplants. A medical, surgical, and psychosocial evaluation is mandatory prior to living kidney donation to ensure that the donor candidate is in good health and has normal kidney function, is not a risk to the recipient with respect to transmission of infections and malignancy, and will not face unacceptable risks after donation.

Birth of a Benefit—Brief History of the ESRD Program

2020 ◽  
pp. 13-20
Author(s):  
Nancy C. Armistead ◽  
Jeffrey A. Perlmutter
Keyword(s):  
Focal Point ◽  
Patient Centered ◽  
Legislative History ◽  
Technological Advances ◽  
Number Of Patients ◽  
Centered Care ◽  
History Of ◽  
Returning To Work ◽  
Stage Renal Disease ◽  
End Stage

The story of the end-stage renal disease (ESRD) entitlement program is told through progressive scientific and technological advances, selection committees, and exploration of public policy values. The legislative history shows a program thought to accommodate a limited number of patients who, returning to work, would contribute to the social security program paying for their benefits. The reality has been different. Treatment is offered to virtually all patients with ESRD, often with little regard to the individual’s likelihood of benefit from dialysis and quality of life. The program’s next chapter will tell whether patient-centered care becomes a focal point in the program’s history.

scholarly journals Nuances of Arteriovenous Fistula Creation for Vascular Access in Hemodialysis

2021 ◽  
Author(s):  
Parag Sahasrabudhe ◽  
Ameya Bindu
Keyword(s):  
Life Expectancy ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Comprehensive Overview ◽  
Standardized Protocol ◽  
Number Of Patients ◽  
Rising Incidence ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background With rising incidence and increased life expectancy of patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), the number of patients requiring hemodialysis has increased substantially. Vascular access is the lifeline for a patient on hemodialysis (HD), and an arteriovenous fistula (AVF) is the undisputed gold standard for HD access. An effective and long-lasting fistula serves to increase the life expectancy of ESRD patients and improves their quality of life. Learning Objectives This paper aims to give a comprehensive overview of AVF creation, including the various techniques, patient selection, troubleshooting with decision-making, and common complications. Authors share their experience from previous publications and over 2000 AVF surgeries. They have not only described a new modification of the technique of proximal fistula but have also established a direct correlation between bruit and thrill on operation table and success of fistula surgery. Conclusion A standardized, protocol-driven multidisciplinary approach with careful patient and site selection, guided by outcome predictors, is vital in AVF surgery. Knowledge about the potential complications of AVFs contributes to their timely detection and allows measures to be taken that might prevent deleterious consequences that range from loss of vascular access to serious morbidity and mortality.

Closing the Organ Gap: A Reciprocity-Based Social Contract Approach

2006 ◽  
Vol 34 (2) ◽  
pp. 415-423 ◽  
Author(s):  
Gil Siegal ◽  
Richard J. Bonnie
Keyword(s):  
The United States ◽  
Waiting Lists ◽  
Organ Shortage ◽  
Success Rates ◽  
Number Of Patients ◽  
The Family ◽  
Stage Renal Disease ◽  
End Stage ◽  
Kidney Liver

Organ transplantation remains one of modern medicine's remarkable achievements. It saves lives, improves quality of life, diminishes healthcare expenditures in end-stage renal patients, and enjoys high success rates. Yet the promise of transplantation is substantially compromised by the scarcity of organs. The gap between the number of patients on waiting lists and the number of available organs continues to grow. As of January 2006, the combined waiting list for all organs in the United States was 90,284 (64,933, 17,269, and 3,006 for kidney, liver, and heart respectively). Unfortunately, thousands of potential organs are lost each year, primarily due to lack of consent to donation from the deceased before death, or from the family thereafter. Only fifty percent of potential donors – the “conversion” rate – become actual donors. The costs attributed to organ shortage are substantial – Medicare paid over $15.5 billion in 2002 for treating patients with end-stage renal-disease, who predominate on organ waiting lists.

scholarly journals Providers’ View on the First Kidney Transplantation Center in Ethiopia: Experience From Past to Present

2021 ◽  
Vol 8 ◽  
pp. 233339282110183
Author(s):  
Tariku Shimels ◽  
Abrham Getachew ◽  
Mekdim Tadesse ◽  
Alison Thompson
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Health Care Providers ◽  
Study Data ◽  
Care Providers ◽  
Transplant Center ◽  
Transplantation Center ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Transplantation is the optimal management for patients with end-stage renal disease. In Ethiopia, the first national kidney transplantation center was opened at St. Paul’s Hospital Millennium Medical College in September 2015. The aim of this study was to explore providers’ views and experiences of the past to present at this center. Methods: A qualitative study design was employed from 1st November to 15th December, 2019. To ensure that appropriate informants would provide rich study data, 8 health care providers and top management members were purposefully chosen for in-depth interviews. A maximum variation sampling method was considered to include a representative sample of informants. Interviews were digitally audio-recorded, and transcribed verbatim. Transcribed data was coded and analyzed using Qualitative Data Analysis (QDA) Minor Lite software and Microsoft-Excel. Result: The participants (5 males and 3 females) approached were from different departments of the renal transplant center, and the main hospital. Eight main themes and 18 sub-themes were generated initially from all interviews totaling to 109 index codes. Further evaluation and recoding retained 5 main themes, and 14 sub-themes. The main themes are; challenges experienced during and after launching the center, commitment, sympathy and satisfaction, outcomes of renal transplant, actions to improve the quality of service, and how the transplant center should operate. Providers claim that they discharge their responsibilities through proper commitment and compassion, paying no attention to incentive packages. They also explained that renal transplantation would have all the outcomes related to economic, humanistic and clinical facets. Conclusion and Recommendation: A multitude of challenges were faced during and after the establishment of the first renal transplant center in Ethiopia. Providers discharge their responsibility through a proper compassion for patients. Concerned stakeholders should actively collaborate to improve the quality of renal transplant services in the center.

QUALITY OF LIFE OF GREEK PATIENTS WITH END STAGE RENAL DISEASE UNDERGOING HAEMODIALYSIS

2010 ◽  
Vol 36 (3) ◽  
pp. 126-132 ◽  
Author(s):  
Maria Kastrouni ◽  
Eleni Sarantopoulou ◽  
Georgios Aperis ◽  
Polichronis Alivanis
Keyword(s):  
Quality Of Life ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage
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