scholarly journals Nursing Care for Kidney Transplant Patients: A Scoping Review

Aquichan ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 1-15
Author(s):  
Cintia Capistrano Teixeira Rocha ◽  
Alcides Viana da Lima Neto ◽  
Ana Beatriz Pereira da Silva ◽  
Victor Alexandre Silva Farias ◽  
Aurean D’Eça Junior ◽  
...  

Objectives: Mapping nursing care in kidney transplant patients. Materials and method: A scoping review was conducted according to the recommendations of the Joanna Briggs Institute Reviewers’ Manual. Data were collected through 13 national and international databases from December 2020 to January 2021, following scientific rigor in the selection of the material. The pre-selection was made by reading the title, abstract and introductory text in advance; the materials included in this stage were read in full to define the content for the study. Results: Fifteen studies were included. Of these, 60% are articles; dissertations, manuals, protocols, guidelines and bulletins totaled 40% of the material studied. 86.6% of the material has a quantitative approach. Regarding the methodological design, 73.3% were descriptive/transversal character studies. Regarding the mapping of nursing care, it was possible to divide them into two categories: nursing care after kidney transplantation (immediate, mediated and late) and nursing care after kidney transplantation in primary health/extra-hospital care. Conclusions: It is concluded that the study allowed mapping nursing care to kidney transplant patients in the immediate, late and primary health care periods.

2021 ◽  
Vol 15 (11) ◽  
pp. 3087-3089
Author(s):  
Rashida Jabeen ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Sadia Khan

Kidney transplantation is the famous and most important choice of treatment of renal replacement therapies (RRTs) because of its positive impact on morbidity, survival and cost. The health related quality of life is becoming important outcome. Quality of life is usually impaired in patients who have renal transplant because of renal transplant patients have anxiety, lack of social, physical and emotional support and diminished ability to take care of themselves. The basic purpose of renal transplantation is to achieve maximum quality of life with minimum side effects. Methods: A cross sectional study was conducted at Rukhsana Akhtar Bahria International Orchard Hospital Lahore after approval from institution board of university of Lahore. 36 patients were enrolled in study by using purposive sampling technique. After taking informed consent all Kidney transplant patients aged between 18 years to 60 years, visited the post-transplantation OPD and continuously in follow-up sessions were included in study. A validated and standard WHO questionnaire of “Kidney Disease and Quality of Life (KDQOL-36™)” was used for data collection. Data was entered and analyzed in SPSS version.21.Chi-square test was applied to find out significant association between qualitative variables. P -Value < 0.05will be considered as statistically significant. Results: Majority of patients were from 40-49 years 10(27.0%). Females were more as compared to men (20(55.6) vs 16(44.4%)). 10(27.8) patients can read and write and 8(22.2%) have done matriculation. More patients live in Urban area as compared to rural area(19(52.8%) vs 17(47.2%)).8(22.2%) patients have less than 1 year of post kidney transplantation time and 19(52.8%) have 1 to 3 years. All the seven domains of KDQOL show poor QOL. General Health, Physical function and physical and emotional function shows average QOL and Emotional, social, daily activities and overall KDQOL shows poor QOL. There was insignificant association with age, gender, education; residential area and Post kidney transplantation length of time (years)(p-value > 0.05). Conclusions: After renal transplantation HRQOL becomes very important factor. After kidney transplantation HRQOL depends on many factors. It was concluded from current study that the HRQOL was not as good as it should be. Over the period of transplantation time patient’s quality of life remain same. The society, government, family, and medical staff need to support patients so they can also improve their QOL. Key word: Renal Diseases, Kidney transplant, Quality of life, KDQOL-36


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kentaro Nakai ◽  
Shutaro Yamamoto ◽  
Megumi Inoue ◽  
Chiaki Kohara ◽  
Tomoya Shukuri ◽  
...  

Abstract Introduction Patients with chronic kidney disease often suffer from cardiovascular disease, and vascular calcification has been identified as one of the risk factors for cardiovascular disease. We aimed to examine the effect of dialysis treatment before kidney transplantation on graft survival, vascular calcification, and its progression after kidney transplantation. Methods Among the 102 patients who underwent kidney transplant between 2008 and 2017, two patients were excluded for moved and lost to follow-up and primary nonfunction. The clinical characteristics and laboratory data were assessed according to pretransplant treatment modality. Rapid progression of vascular calcification was defined when patients showed an increase in the highest tertile of progression of each iliac artery calcification thickness (IACT) and aortic calcification index (ACI). Results Cox proportional hazard models did not show any significant association between pretransplant treatment modality and graft survival to the doubling of creatinine from nadir creatinine during the first 3 months after kidney transplantation. At baseline, the IACT was significantly higher in hemodialysis patients than in preemptive kidney transplant patients, whereas the ACI was comparable among the pretransplant treatment modality groups. IACT was independently associated with dialysis vintage. There was no significant association between rapid progression of vascular calcification (IACT and ACI) and dialysis modality. Conclusions Dialysis modality was an independent factor related to IACT, whereas there was no legacy effect for the progression of vascular calcification after kidney transplantation.


2011 ◽  
Vol 21 (4) ◽  
pp. 306-311
Author(s):  
Jessica Brennan ◽  
Marilyn McEnhill

It is well documented that kidney transplantation is the treatment of choice for children with end-stage renal disease. Pediatric kidney transplant patients are a complex population because of their need for lifelong immunosuppression, potential for delayed growth and development, and increased risk of heart disease and cancer. Although many large pediatric kidney transplant programs use nurse practitioners, the role of the nurse practitioner is still emerging in relation to the transplant coordinator role. This article describes the practice of pediatric nurse practitioners caring for children who require a kidney transplant and why nurse practitioners are ideal for providing comprehensive care to this population. Transplant programs are regulated by the United Network for Organ Sharing and the Centers for Medicare and Medicaid Services. Both organizations require transplant programs to designate a transplant coordinator with the primary responsibility of coordinating clinical aspects of transplant care. Incorporating transplant coordinator activities into the role of the pediatric nurse practitioner is discussed as a model for providing care throughout the process of kidney transplantation. Transplant pediatric nurse practitioners are in a unique position to expand the care for pediatric kidney transplant patients by assuming the role of clinician, educator, administrator, and coordinator.


2020 ◽  
Vol 9 (11) ◽  
pp. 3465
Author(s):  
Bruno Watschinger ◽  
Clara Watschinger ◽  
Roman Reindl-Schwaighofer ◽  
Elias L. Meyer ◽  
Andras T. Deak ◽  
...  

SARS-CoV-2 led to considerable morbidity/mortality worldwide and tremendously impacted on daily life. Strict lockdown measures were implemented early to contain the viral outbreak in Austria. Massive changes in organizational structures of healthcare facilities followed with unclear implications on the care of non-COVID-19-affected patients. We studied the nationwide impact of COVID-19 on kidney transplantation in Austria during the first six months of 2020. Concurrent with general lockdown measures, all kidney transplant activity was suspended from 13 March to 9 April. Nevertheless, between January and June, total transplant (p = 0.48) and procured donor organ numbers (p = 0.6) did not differ significantly from earlier years. Ten (0.18%) of 5512 prevalent Austrian kidney transplant recipients were diagnosed with SARS-CoV-2. The case fatality rate (one death; 10%) in renal transplant patients was less than in other countries but higher than in Austria’s general population (2.4%). We conclude that early and strict general lockdown measures imposed by the government allowed an early, however cautious, re-opening of Austrian transplant programs and played a crucial role for the favorable outcomes of SARS-CoV-2 in Austrian kidney transplant patients. Even though it may be uncertain whether similar results may be obtainable in other countries, the findings may support early intervention strategies during similar episodes in the future.


2021 ◽  
Vol 11 (34) ◽  
pp. 296-306
Author(s):  
Beatriz Pinheiro da Mota Costa ◽  
Alessandra Rosa Vicari ◽  
Carla Elisabete da Silva Oliveira ◽  
Fernanda Guarilha Boni ◽  
Isabel Cristina Echer

Conhecer a percepção de pacientes e familiares acerca do grupo de orientação multiprofissional para transplantados renais. Método: trata-se de um estudo qualitativo realizado em hospital universitário do sul do Brasil nos meses de fevereiro a maio do ano de 2019. As informações foram coletadas pelos pesquisadores por meio de entrevista estruturada com os participantes do grupo de orientação multiprofissional. Foi realizada a técnica de análise de conteúdo. Resultados: participaram 15 pacientes transplantados renais e quatro familiares. A análise dos depoimentos resultou em três categorias: “Motivação para participar do grupo”, “Sou transplantado renal, e agora?” e “Compreendendo as orientações: o impacto no autocuidado”. As orientações em grupo foram consideradas objetivas, claras e relevantes para a recuperação. Considerações finais: participar do grupo possibilitou estreitamento de laços familiares/profissionais, crescimento pessoal, maior conhecimento sobre o transplante renal, mudança de comportamento e comprometimento com o autocuidado.Descritores: Enfermagem, Transplante de Rim, Equipe de Assistência ao Paciente, Educação em Saúde. Multiprofessional guidance group for kidney and family transplant patientsAbstract: To know the perception of patients and family members about the multiprofessional guidance group for kidney transplant patients. Method: this is a qualitative study carried out at a university hospital in southern Brazil from February to May of 2019. The information was collected by the researchers through a structured interview with the participants of the multiprofessional guidance group. The content analysis technique was performed. Results: 15 kidney transplant patients and four family members participated. The analysis of the testimonies resulted in three categories: “Motivation to participate in the group”, “I am a kidney transplanted, what now?” and “Understanding the guidelines: the impact on self-care”. The group guidelines were considered objective, clear and relevant to recovery. Final considerations: to participate in the group allowed for closer family/professional ties, personal growth, greater knowledge about kidney transplantation, behavior change and commitment to self-care.Descriptors: Nursing, Kidney Transplantation, Patient Care Team, Health Education. Grupo de orientación multiprofesional para pacientes con trasplante renal y familiarResumen: Conocer la percepción de los pacientes y familiares sobre el grupo de orientación multiprofesional para pacientes con trasplante renal. Método: es un estudio cualitativo realizado en un hospital universitario del sur de Brasil de febrero a mayo de 2019. La información fue recolectada por los investigadores mediante una entrevista estructurada con los participantes del grupo de orientación multiprofesional. Se realizó la técnica de análisis de contenido. Resultados: participaron 15 pacientes con trasplante renal y cuatro familiares. El análisis de los testimonios resultó en tres categorías: “Motivación para participar en el grupo”, “Soy un trasplante de riñón, ¿ahora qué?” y “Comprender las pautas: el impacto en el autocuidado”. Las pautas del grupo se consideraron objetivas, claras y relevantes para la recuperación. Consideraciones finales: participar en el grupo permitió estrechar lazos familiares/profesionales, crecimiento personal, mayor conocimiento sobre trasplante de riñón, cambio de comportamiento y compromiso con el autocuidado.Descriptores: Enfermería, Trasplante de Riñón, Grupo de Atención al Paciente, Educación en Salud.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258319
Author(s):  
Hong Si Nga ◽  
Lilian Monteiro Pereira Palma ◽  
Miguel Ernandes Neto ◽  
Ida Maria Maximina Fernandes-Charpiot ◽  
Valter Duro Garcia ◽  
...  

Background Atypical Hemolytic Uremic Syndrome (aHUS) is an ultra-rare disease that potentially leads to kidney graft failure due to ongoing Thrombotic Microangiopathy (TMA). The aim was evaluating the frequency of TMA after kidney transplantation in patients with aHUS in a Brazilian cohort stratified by the use of the specific complement-inhibitor eculizumab. Methods This was a multicenter retrospective cohort study including kidney transplant patients diagnosed with aHUS. We collected data from 118 transplant centers in Brazil concerning aHUS transplanted patients between 01/01/2007 and 12/31/2019. Patients were stratified into three groups: no use of eculizumab (No Eculizumab Group), use of eculizumab for treatment of after transplantation TMA (Therapeutic Group), and use of eculizumab for prophylaxis of aHUS recurrence (Prophylactic Group). Results Thirty-eight patients with aHUS who received kidney transplantation were enrolled in the study. Patients’ mean age was 30 years (24–40), and the majority of participants was women (63% of cases). In the No Eculizumab Group (n = 11), there was a 91% graft loss due to the TMA. The hazard ratio of TMA graft loss was 0.07 [0.01–0.55], p = 0.012 in the eculizumab Prophylactic Group and 0.04 [0.00–0.28], p = 0.002 in the eculizumab Therapeutic Group. Conclusion The TMA graft loss in the absence of a specific complement-inhibitor was higher among the Brazilian cohort of kidney transplant patients. This finding reinforces the need of eculizumab use for treatment of aHUS kidney transplant patients. Cost optimization analysis and the early access to C5 inhibitors are suggested, especially in low-medium income countries.


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Afshin Goodarzi ◽  
Seyed Reza Borzou ◽  
Fatemeh Cheraghi ◽  
Mahnaz Khatiban ◽  
Mehdi Molavi Vardanjani

Background: Proper use of nursing models and theories is an important step in improving patient care standards and quality of life. The growing trend of kidney failure and subsequent kidney transplantation in the country shows the importance of creating a proper structure in nursing patient care for transplant patients and recognizing the stressors that affect these patients. Objectives: This study aimed to investigate the ability of the Betty Neuman model to provide a comprehensive model for nursing care of clients undergoing kidney transplantation. Methods: This clinical and clinical study was performed on the client of the kidney transplant candidate based on the application of Betty Neuman system theory. During the data collection, the interactions between the client’s five variables were examined and the stressors and resources in the internal, inter, and extra-individual domains were identified. Nursing diagnoses were created in accordance with the North American International Nursing Diagnostics Association (2018 - 2018) classification, and then nursing interventions were designed and implemented at three levels of prevention. Results: The results of the study of physiological, psychological, social, evolutionary, and spiritual variables, as well as interpersonal and extra-individual stressors, were 15 potential and actual nursing diagnoses. Conclusions: Designing and applying a nursing process based on this model is a holistic and systematic attitude toward the client that requires proper, efficient, and evidence-based nursing care but increases the need for nursing human resources.


2020 ◽  
Vol 45 (2) ◽  
pp. 331-338
Author(s):  
Ning Guo ◽  
Zehua Wang ◽  
Laurine M. Bow ◽  
Xianquan Cui ◽  
Luwei Zhang ◽  
...  

Introduction: Impaired cardiac function is one of the most concomitant symptoms in patients with kidney failure after long-term dialysis. In addition, the preservation of adequate perfusion pressure to the graft plays a significant role in the intraoperative management during kidney transplantation, but the use of positive inotropic drugs in kidney transplant patients has been studied less. We investigated the protective effects of renal function by means of cardiac inotropes in kidney transplant patients. Methods: Eighty-nine patients that received kidney transplantation between April 2014 and December 2016 at Qilu Hospital were included and randomly divided into the treatment group receiving levosimendan and a control group. All kidney recipients received ABO-compatible donors. A poor outcome was defined as one of the following: delayed graft function, graft hemorrhage, or nephrectomy. Results: The treatment group had a better composite outcome and the level of neutrophil gelatinase-associated lipocalin was also lower than in the control group. Conclusion: Inotropic drugs may play a protective role in renal function in kidney transplantation.


2020 ◽  
Vol 24 (3) ◽  
pp. 256-264 ◽  
Author(s):  
Guy E. Efune ◽  
Jeron Zerillo ◽  
George Zhou ◽  
Michael A. Mazzeffi ◽  
Samuel Demaria ◽  
...  

Background Limited evidence exists with regard to best practices in fluid management during kidney transplantation, which may directly affect the incidence of DGF. The authors of this study embarked on a collaborative observational multicenter pilot study to evaluate fluid administration practices in different transplant centers, with a focus on the relationship between total administered crystalloid volume and its association with DGF. Methods Twenty consecutive kidney transplant patients were included from 9 academic medical centers in the United States. One hundred eighty patients were included in the final cohort and variables were compared between patients with and without DGF. Administered crystalloid volume was the primary variable of interest; however, additional patient and surgical variables were compared between patients with and without DGF. Variation in crystalloid administration was explored between centers by comparing median administered crystalloid volumes per kilogram of body weight. Also, unadjusted and adjusted logistic regression analyses were performed to determine which variables were independently associated with DGF. Results Multivariable regression modeling demonstrated that cold ischemic time and ephedrine use during surgery were independently associated with DGF. There was no independent association between administered crystalloid volume and DGF. Conclusion In this study of patients having kidney transplantation, we did not find an independent association between administered crystalloid volume and DGF, although there was significant variability in crystalloid administration between centers. Our data suggest that DGF was driven mainly by surgical factors such as cold ischemic time. Ephedrine was also independently associated with DGF, which should be explored in future studies.


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