scholarly journals MUSCULOSKELETAL ULTRASOUND ABNORMALITIES IN PATIENTS ON DIALYSIS, COMPARED TO PATIENTS WITH PRE-DIALYSIS STAGE CHRONIC KIDNEY DISEASE

2017 ◽  
Vol 26 (4) ◽  
pp. 169-172
Author(s):  
Raluca-Daniela Decianu ◽  
◽  
Mihai Bojinca ◽  
Cristina Capusa ◽  
Violeta-Claudia Bojinca ◽  
...  

Background. The musculoskeletal system is deeply involved in patients with CKD on dialysis. The studies that were done by now with regarding this subject mostly aimed the bone metabolism.So far, there is few data on the subject concerning the articular and abarticular abnormalities in dialysed patients(1). Objectives. To indentify the musculoskeletal soft tissue abnormities associated to dialysis and to evaluate whether or not they are more frequent. Also, we set ourselves to point out the importance of detecting these anomalies early in the evolution, in order to preserve the joint function and the quality of life, in a category of patients already severely affected. Materials and methods. This is a prospective study, ran on a period of 4 months. We included 55 patients ( 32 in the study group – on dialysis, 23 in the control group – late stage pre-dialysis chronic kidney disease). For each patient, we evaluated 68 joints using ultrasonography. Also, a visual analogue scale for pain was applied for each patient. Results. The findings vary from median nerve entrapment and tendon calcifications, to usual degenerative abnormalities, synovitis and tenosynovitis. The type of abnormalities does not vary between the two groups, but the percent of the affected patients was much higher in the study group. Conclusions. A great number of patients from the study group presented important articular and mostly abarticular abnormalities, sometimes with no correlation with the algofunctional symptoms.

2019 ◽  
Vol 12 (1) ◽  
pp. 77-82
Author(s):  
Ewa Kwiatkowska ◽  
Martyna Opara ◽  
Sebastian Kwiatkowski ◽  
Leszek Domański ◽  
Małgorzata Marchelek-Myśliwiec ◽  
...  

Background: According to the currently applicable KDIGO-2012 and ERBP 2013 guidelines, iron metabolism assessments for patients with Chronic Kidney Disease (CKD) are performed using such parameters as ferritin concentration and Transferrin Saturation (TSAT). Their values are to be treated as a basis on which to decide on providing iron substitution. Patients with Stage 5 CKD on maintenance hemodialysis commonly suffer from malnutrition syndrome and inflammation. One of the markers for malnutrition and inflammation is low transferrin concentration. Our study focused on establishing what percentage of patients this applied to and whether or not the transferrin saturation figure was artificially inflated in such cases. Materials and Methods: The study group included 66 patients with Stage 5 CKD on maintenance hemodialysis. Such data were analyzed as complete blood count, iron and ferritin concentrations, and Transferrin Saturation (TSAT). Other parameters - age, sex, time from their first hemodialysis, and the quality of their dialysis in the last six months – the Kt/V average. Results: It was found that only 12% of the study group patients had their transferrin concentrations above the lower limit of normal. The TSAT value correlated negatively with transferrin concentration. Transferrin concentration correlated negatively with time from first hemodialysis or ferritin concentration, and positively with body weight. Normal transferrin concentration was only seen in patients with ferritin concentrations of up to 400 μg/L. The group was divided according to transferrin concentration of <1.5 g/L or >1.5 g/L. These groups differed significantly in ferritin concentration and transferrin saturation. (p = 0.0005 and p = 0.004, respectively). The 1.5 g/L transferrin concentration point divides patients with mild and medium malnutrition. It is also the minimum transferrin content necessary to achieve hemoglobin values ≥10 g/dL determined using the ROC curve. Conclusion: Low transferrin concentrations cause abnormally high TSAT values. In most patients on maintenance hemodialysis, this marker is not useful for assessing the availability of iron for erythropoiesis.


2016 ◽  
Vol 44 (6) ◽  
pp. 473-480 ◽  
Author(s):  
Rukhsana Foster ◽  
Simon Walker ◽  
Ranveer Brar ◽  
Brett Hiebert ◽  
Paul Komenda ◽  
...  

Background: Chronic kidney disease (CKD) affects more than one third of older adults, and is a strong risk factor for vascular disease and cognitive impairment. Cognitive impairment can have detrimental effects on the quality of life through decreased treatment adherence and poor nutrition and results in increased costs of care and early mortality. Though widely studied in hemodialysis populations, little is known about cognitive impairment in patients with pre-dialysis CKD. Methods: Multicenter, cross-sectional, prospective cohort study including 385 patients with CKD stages G4-G5. Cognitive function was measured with a validated tool called the Montreal Cognitive Assessment (MoCA) as part of a comprehensive frailty assessment in the Canadian Frailty Observation and Interventions Trial. Cognitive impairment was defined as a MoCA score of ≤24. We determined the prevalence and risk factors for cognitive impairment in patients with CKD stages G4-G5, not on dialysis. Results: Two hundred and thirty seven participants (61%) with CKD stages G4-G5 had cognitive impairment at baseline assessment. When compared to a control group, this population scored lower in all domains of cognition, with the most pronounced deficits observed in recall, attention, and visual/executive function (p < 0.01 for all comparisons). Older age, recent history of falls and history of stroke were independently associated with cognitive impairment. Conclusions: Our study uncovered a high rate of unrecognized cognitive impairment in an advanced CKD population. This impairment is global, affecting all aspects of cognition and is likely vascular in nature. The longitudinal trajectory of cognitive function and its effect on dialysis decision-making and outcomes deserves further study.


2021 ◽  
Author(s):  
Mohammad Habibur Rahman Sarker ◽  
Michiko Moriyama ◽  
Harun Ur Rashid ◽  
Md Moshiur Rahman ◽  
Mohammod Jobayer Chisti ◽  
...  

BACKGROUND Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. OBJECTIVE The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. METHODS A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. RESULTS Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. CONCLUSIONS It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30191


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Miriam Serrano ◽  
Alicia Garcia-Testal ◽  
Inmaculada Rico-Salvador ◽  
Conrado Carrrascosa López ◽  
Rafael Ortiz Ramón ◽  
...  

Abstract Background and Aims Patients with chronic kidney disease on hemodialysis (HD) treatment have a health-related quality of life (HRQoL) lower than the reference values of the Spanish population. Previous studies have shown through music therapy reduce levels of pain, anxiety and depression in chronic kidney disease patients on hemodialysis. This study presents an intervention with classical music performed live during HD sessions. It is the first time to study the effect of classical music heard live on HRQL. Method Randomized clinical trial by groups. 90 patients agreed to participate. They were randomized into an intervention group (IG) and a control group (CG). The IG listened to 30/45 minutes of live classical music in two of the three weekly HD sessions for 1 month. The CG followed his usual treatment. Different individual scales of the quality of life test in kidney diseases (KDQOL-SF) were analyzed, in two times, baseline (Start) and after (End) the musical intervention in both groups. The analysis was performed using a mixed linear regression model for repeated measures with independent variables (age, sex, months in HD, Kt/v, Hemoglobin (Hb)) and dependent variables (individual KDQOL-SF scale scores). Results The CG sample included 43 patients with a mean age of 75.8 years; 22 women (51%); mean Kt/v 1.53; mean Hb 11.5 and mean time on HD 60.46 months. The GI sample included 47 patients with a mean age of 73.53 years; 18 women (38%); mean Kt/v 1.47; mean Hb 11.3 and mean time on HD 63.34 months. The results show that after the intervention, IG vs CG increased the mean score (pm) in all the scales significantly. The End time and GI interaction showed a mean score increase of 15.78 (p &lt;0.001) for the Symptoms/problems scale; 14.96 (p &lt;0.001) scale Effects of kidney disease; 16.36 (p &lt;0.001) on the Kidney disease burden scale; 14.78 (p &lt;0.001) on the Sleep scale; 25.46 (p &lt;0.001) on the Vitality scale; 29.57 (p &lt;0.001) on the Emotional well-being scale; 41.92 (p &lt;0.001) on the Pain scale and 23.39 (p &lt;0.001) on the General Health scale. Conclusion Live classical music intervention during hemodialysis sessions improves self-perceived HRQL in patients with chronic kidney disease on HD


Author(s):  
O. Karaarslan Cengiz ◽  
G. Nergizoglu

The risk of cardiovascular disease begins to increase from the early stages of chronic kidney disease (CKD). Abdominal aortic aneurysms are the most common arterial aneurysms of peripheral arterial diseases. The frequency of abdominal aortic aneurysm varies according to the population studied. This study aimed to determine the prevalence of abdominal aortic aneurysm in patients with stage 3-4  CKD and investigate  CKD is a risk factor for abdominal aortic aneurysm formation. Methods. Patients aged 55 years and older who were followed up in the internal medicine outpatient clinics were enrolled. Two hundred CKD patients with glomerular filtration rates between 15-59 mL/min per 1.73 m2 were included in the study group, and 110 patients with glomerular filtration rates of 60 mL/min per 1.73 m2 or above were assigned to the control group. An ultrasonography device with a 3.5 MHz probe was used for screening. Abdominal aortic diameters of 3 cm and above were accepted as abdominal aortic aneurysms. Results. Eighteen patients in the study group (9%) and four in the control group (3.6%) had an abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysms was higher in the  CKD  group. However, the difference was not statistically significant (p=0.078). Moreover, the median aortic diameter was 21.8 mm (14-44 mm) in the study group, compared to 21.0 mm (14-46 mm) in the control group. The prevalence of the abdominal aortic aneurysm was 14.9% in stage 4  CKD patients and 6% in stage 3  CKD patients (p=0.038). Conclusion. An abdominal aortic aneurysm is more common in patients with  CKD although it does not reach statistical significance. The median aortic diameter was significantly wider in CKD patients compared to the control group . The prevalence of abdominal aortic aneurysm increased with an increase in the CKD stage .


2020 ◽  
Vol 48 (14) ◽  
pp. 3566-3572
Author(s):  
Felix Zimmermann ◽  
Juliane Börtlein ◽  
Danko Dan Milinkovic ◽  
Peter Balcarek

Background: Complications and the need for revision surgery after medial patellofemoral ligament reconstruction (MPFLR) are evident in the current literature. However, there is a shortage of clinical data evaluating the results of revision surgery in individual patients after failed MPFLR. Purpose: To investigate the results of tailored revision surgery for failed MPFLR, including the correction of predisposing factors. Study Design: Cohort study; Level of evidence, 3. Methods: Between August 2015 and March 2019, 25 patients (male:female, n = 9:16; mean ± SD age, 25.9 ± 6.5 years) underwent revision surgery for failed MPFLR (study group). The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (0-10) for patellofemoral pain and subjective knee joint function were used to assess patient-reported quality of life before and after revision surgery. The control group of 50 patients (male:female, n = 18:32; age, 22.8 ± 4.3 years) who underwent identical patellar-stabilizing procedures was matched 1:2 by the surgical procedure, predisposing factors, sex, age, and follow-up time. Results: Evaluation was performed postoperatively at a mean 27.8 ± 14.0 months (range, 12-54 months) in the study group and 26.1 ± 11.2 months (range, 12-56 months) in the control group ( P = .55). The BPII 2.0 score increased from 28.6 ± 17.9 points to 68.7 ± 22.3 points ( P < .0001) in the study group and from 43.8 ± 22.5 points to 75.5 ± 21.4 points ( P < .0001) in the control group from preoperatively to postoperatively, respectively. Before revision surgery, the BPII 2.0 scores in the study group were significantly inferior to those in the control group ( P = .0026). At the final follow-up, the BPII 2.0 score in the study group was not significantly lower ( P = .174), and a similar number of patients in the study group and the control group achieved the minimally clinically important difference ( P = .49). Patellofemoral pain and subjective knee joint function improved significantly in both groups ( P < .0001, P < .0001), without any significant difference between them at the final follow-up ( P = .85, P = .86). Conclusion: Revision surgery for MPFLR failure, including the correction of major anatomic risk factors, yielded a significant improvement in patient-reported quality-of-life outcome measures. Patients with failed MPFLR, however, were significantly more restricted before revision surgery than patients without previous interventions when evaluated with the BPII 2.0.


2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S154-S154
Author(s):  
A S Boraik ◽  
M Abdelmonem ◽  
M Shedid ◽  
H M Abd Elaal ◽  
A Elhusseny ◽  
...  

Abstract Introduction/Objective Chronic kidney disease (CKD) is affecting about 14% of the general population. CKD is associated with a decrease in calcium level in the body. In the early stages of (CKD), dialysis may not be needed. The late stages of CKD will require dialysis or a kidney transplant to save a life. Secondary hyperparathyroidism is a crucial disorder in CKD patients. It explains why the illness causes a significant change in bone and mineral metabolism. This study aims to study renal hyperparathyroidism (rHPT) in dialysis patients with late-stage of chronic kidney disease (CKD). Methods/Case Report A total of 55 subjects were enrolled in this study for late-stage dialysis patients from Egypt. Serum creatinine and PTH levels were measured. Among the 55 subjects; 41 subjects (74.5%) were males, 14 subjects (25.5%) were females with a mean age of 52.7 and 34.3 years for males and females, respectively. Subjects were divided into two groups; Study group I consists of 33 dialysis patients; three patients were females (9%) while 30 patients were males (91%), and control group II consists of 22 healthy individuals, 11 subjects were females (50%), and 11 subjects were males (50%). Results (if a Case Study enter NA) In our study, in comparison between two groups as regards blood investigations. The means of creatinine and PTH in the study group I were 8.93 mg/dl and 316.8, while in the control group II were 0.9, and 38.4 respectively. Comparing the two groups shows that mean of Creatinine and PTH in the study group was statistically significantly higher than the control group (p-value less than 0.001). Conclusion In patients with CKD, accurate measurement of (PTH) is critical for treatment decision-making to reduce the risk of bone and cardiovascular diseases. We recommend that patients with diabetes and high blood pressure be aware that they must take their medications consistently to avoid kidney problems.


2019 ◽  
Author(s):  
Santi Herlina

Fatigue is a major complaint of patients undergoing long-term hemodialysis, which has a high value, so it will affect the quality of life of patients. The purpose of this study was to determine the influence of PMR on the level of fatigue in patients with chronic kidney disease undergoing hemodialysis. This study used a quasi experiment design approach pretest-posttest control group. The number of respondents in the study were 32 patients divided into 2 groups: the 16 intervention group and 16 control group. The research concludes that there are significant differences on the level of fatigue in the intervention group between before and after PMR with p = 0.000. Suggested training PMR can be used as an independent nursing intervention in reducing fatigue in patients with chronic kidney disease undergoing hemodialysis.


Jurnal NERS ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 81
Author(s):  
Sariati Sariati ◽  
Dwi Uswatun Sholikhah ◽  
Cahya Mustika Narendri ◽  
Gevi Melliya Sari ◽  
Qolbi Nur Qoidah Yahya

Introduction: The number of patients with chronic kidney disease (CKD) who undergo hemodialysis is increasing every year. Various attempts have been made to maximize the process of hemodialysis, one of which is by providing complementary therapy with music as therapy and through the administration of aromatherapy. The aim of this study was to identify the effectiveness of the use of music therapy and aromatherapy in a patient diagnosed with chronic kidney disease undergoing hemodialysis.Methods: The literature review followed on from the identification of the interventions then the studies were identified by keyword according to the topic and title. There were 15 articles that discussed the effect of music therapy and aromatherapy on patients undergoing hemodialysis. The design RCT was 7 articles, 3 quasi-experimental articles, and 5 clinical trial articles.Results: Music can raise the endorphin and serotonin levels and reduce the catecholamine levels, so it can change the respiratory rate and oxygen saturation, improve their quality of sleep and reduce fatigue.Conclusion: Our findings indicate that music therapy and aromatherapy have a positive effect on patients with chronic kidney disease undergoing hemodialysis.


2021 ◽  
Vol 10 (1) ◽  
pp. 289-295
Author(s):  
Sihombing JP ◽  
Nasution AT ◽  
Sitanggang H

Objective: To elicit quality of life of chronic kidney disease (CKD) patients with routine hemodialysis receiving erythropoietin from clinical and humanistic outcome, to analysis characteristic factors to Hb, fatique and the quality of life (QOL) of CKD patients with routine hemodialysis, and to explore the change in QOL over one month for patients managed in the hospitals. Methods: A prospective study was conducted among adult CKD patients in Haji Adam Malik Hospital Medan. QOL was measured using kidney disease quality of life – short form (KDQOL–SFTM) questionnaire and FACIT fatigue scale questionnaire. CKD patients. Patients were asked to complete the KDQOL–SFTM questionnaire and FACIT fatigue scale questionnaire two times in one month range. Results: Average rate of haemoglobin was increased after one month anemia treatment using erythropoietin 8.68: 8.82. Average rate of FACIT was increased after one month anemia treatment using erythropoietin 43.98: 44.81. Average rate of KDQOL was increased after one month anemia treatment using erythropoietin 76.83: 77.94. Conclusion: Erythropoietin can improve QOL of CKD patients with routine hemodialysis.


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