High fidelity blood flow in a patient-specific arteriovenous fistula

An arteriovenous fistula, created by artificially connecting segments of a patient’s vasculature, is the preferred way to gain access to the bloodstream for kidney dialysis. The increasing power and availability of supercomputing infrastructure means that it is becoming more realistic to use simulations to help identify the best type and location of a fistula for a specific patient. We describe a 3D fistula model that uses the lattice Boltzmann method to simultaneously resolve blood flow in patient-specific arteries and veins. The simulations conducted here, comprising vasculatures of the whole forearm, demonstrate qualified validation against clinical data. Ongoing research to further encompass complex biophysics on realistic time scales will permit the use of human-scale physiological models for basic and clinical medicine.

KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIK YANG MENJALANI TERAPI HEMODIALISA

Chronic kidney failure is a decrease in kidney function and chronic nature which may require replacement irreversible kidney dialysis therapy accompanied on the final stages of kidney failure. Therapy hemodialysis is a replacement therapy for removing the remains of the metabolism of the human blood circulation that will affect the quality of life. Factors that affect the quality of life, among others, age, gender, occupation, education, frequency of Hemodilaisa, long Hemodialisa, chronic renal failure stage, and relationship with the nurse. This research aims to know the description of the quality of life in chronic renal failure patients at the Hemodialysis Room Wijaya Kusuma Hospital Purwokerto. The type of this research is quantitative descriptive research with methods cross-sectional. Sampling using accidental sampling. The respondents in this study as many as 94 patients. Instrument in this study using questionnaire KDQOL SF 1.3 to measure the quality of life of patients with kidney failure. Quality of life in chronic renal failure patients undergoing hemodialysis therapy at the Wijaya Kusuma Hospital Purwokerto is largely good in quality of life (73.4%). Mostly on the age group 45-60 years as many as 39 quality of life patients either (41.5%), mostly male-sex that is as much as 41 patients living quality good (43.6%), educational background of patients most life is good-quality secondary education group 35 patients (37.2%). The work of most of the patients already not working with a total of 44 patients (46.8%), quality of life is good and the length of time patients undergoing therapy at the most hemodialysis time is under 12 months with quality of life good as much as 26 patients (27.7%).

Digital Support for Renal Patients Before and During the COVID-19 Pandemic: Examining the Efforts of Singapore Social Service Agencies in Facebook

During the coronavirus disease 2019 (COVID-19) pandemic, social service agencies (SSAs) play a crucial role in supporting renal patients, who are particularly vulnerable to infections. Social media platforms such as Facebook, serves as an effective medium for these SSAs to disseminate information. Content analysis of the SSAs’ Facebook posts can provide insights on whether Facebook has been adequately utilized during the COVID-19 pandemic and enable SSAs to improve their social media use in future pandemics. This study aimed to compare renal-related SSAs’ Facebook post content before and during the COVID-19 pandemic. Facebook posts of three SSAs National Kidney Foundation (NKF), Kidney Dialysis Foundation (KDF), and Muslim Kidney Action Association (MKAC), posted during the pre-COVID-19 period (January 23, 2019 to June 2, 2019) and the peri-COVID-19 period (January 23, 2020 to June 1, 2020) were extracted. A classification scheme was developed by two coders with themes derived inductively and deductively. Each Facebook post was assigned with a theme. Quantitative analyses indicate that the number of Facebook posts increased from 115 in the pre-COVID-19 period to 293 in the peri-COVID-19 period. During peri-COVID-19, posts regarding lifestyle changes, donations and infectious disease surfaced. While the proportion of posts about encouraging kindness increased from one to 77 posts, the proportion of posts about community-based events and psychosocial support decreased from 44 to 15 posts and 17 to 10 posts respectively during the two periods. Facebook was found to be well-utilized by two of the three renal SSAs in engaging their beneficiaries during the pandemic. During future pandemics, renal SSAs should place emphasis on posts related to psychosocial support and encouraging kindness. Further studies are required to ascertain the impact of COVID-19 from the perspective of renal patients and also to validate the classification scheme which was developed in this study. The study’s methodology and classification scheme can be used to guide future studies for evaluating the social media outreach performance of renal health support groups.

ASSOCIATION BETWEEN POLYMORPHISMS IN CYTOKINE IL7 GENE AND CMV IN RENAL FAILURE PATIENTS IN DIYALA PROVINCE

Background: The human cytomegalovirus (HCMV) is an important human pathogen primarily affecting immunocompromised patients, like Renal failure patients, transplant recipients or HIV-infected individuals. Renal failure diesease is a wide dissemination among kidney patients in Ba'quba City. Aim: the study was carried out to detect the HCMV and detection of several single nucleotide polymorphisms (SNP) in IL7 among100 patient suffering from acute or chronic renal failure whom admitted to Ibn Sina Center for kidney Dialysis in Baquba Teaching Hospital. Patients and Methods: This study was conducted for the period from 1/12/2019 to 15/6/2020 in Baquba city in Iraq, with age ranged between (13-76) years. The samples were diagnosed by serological and molecular tests. Results: The obtained results showed that HCMV antibody was detected in renal failure patients by ELISA IgG (100%) while IgM were (15.0%) . Also, Distribution of genotypes for the (IL7) rs7007634 gene samples of renal failure patients 15 out of 20, Chi-Square (9.375) investigated samples (P value 0.002) . The alignment results of the 323 bp samples revealed the presence of one genetic variation variably distributed in some of the analyzed samples in comparison with the referring IL7 genetic sequences. Distribution of genotypes of the rs7007634(IL7)gene in renal failure patient samples according to CMV infection 12 sample infection in CMV and 3 sample without CMV.

Complicações e desfechos de gestações durante o tratamento hemodialítico

Trata-se de uma revisão integrativa que tem como objetivo analisar a literatura disponível acerca das complicações e desfechos de gestações de mulheres com doença renal crônica em hemodiálise, utilizando descritores em ciência da saúde (DeCS): gestação, diálise renal, insuficiência renal. A busca pelos artigos foi efetuada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Índice Bibliográfico Español en Ciencias de la Salud. Obtiveram-se 130 estudos, sendo selecionados 6 artigos para análise. As principais complicações encontradas foram pré-eclâmpsia, parto prematuro e óbito materno. Observou-se que intensificar as sessões de hemodiálise influencia positivamente no desfecho gestacional. Assim, para melhorar os resultados perinatais em gestações concomitantes à hemodiálise, é importante o acompanhamento pré-natal especializado com abordagem multidisciplinar.Descritores: Gestação, Diálise Renal, Insuficiência Renal. Complications and outcomes of pregnancies during hemodialysis treatmentAbstract: This is an integrative review that aims to analyze the available literature on complications and outcomes of pregnancies of women with chronic kidney disease on hemodialysis, using health science (DeCS) descriptors: pregnancy, kidney dialysis, kidney failure. The search for the articles was carried out in the databases of Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online and Bibliographic Index Español en Ciencias de la Salud. 130 studies were obtained, with 6 articles selected for analysis. The main complications found were pre-eclampsia, premature birth and maternal death. It was observed that intensifying the hemodialysis sessions positively influences the gestational outcome. Thus, in order to improve perinatal outcomes in pregnancies concomitant with hemodialysis, specialized prenatal care with a multidisciplinary approach is important.Descriptors: Gestation, Renal Dialysis, Renal Insufficiency. Complicaciones y resultados de los embarazos durante el tratamiento de hemodiálisisResumen: Esta es una revisión integradora que tiene como objetivo analizar la literatura disponible sobre complicaciones y resultados de embarazos de mujeres con enfermedad renal crónica en hemodiálisis, utilizando descriptores de ciencias de la salud (DeCS): embarazo, diálisis renal, insuficiencia renal. La búsqueda de los artículos se realizó en las bases de datos de Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Sistema de Análisis y Recuperación de Literatura Médica en línea e índice bibliográfico Español en Ciencias de la Salud. Se obtuvieron estudios 130, con 6 artículos seleccionados para el análisis. Las principales complicaciones encontradas fueron preeclampsia, parto prematuro y muerte materna. Se observó que intensificar las sesiones de hemodiálisis influye positivamente en el resultado gestacional. Por lo tanto, para mejorar los resultados perinatales en embarazos concomitantes con hemodiálisis, es importante la atención prenatal especializada con un enfoque multidisciplinario.Descriptores: Gestación, Hemodiálisis, Insuficiencia Renal.

Evaluation of Thyroid Hormones Levels in Libyan Patients with Chronic Renal Failure Before and AFTER Maintenance Hemodialysis

Data from recent studies revealed that kidney diseases might affect the thyroid function in various ways. A variety of alterations in thyroid hormone levels and metabolism have also been reported in patients with chronic renal failure (CRF) in some studied population. In addition, it was reported that serum levels of both T3 and T4 might altered immediately after a hemodialysis (HD) treatment than before. Therefore, this study was aimed to investigate the level of triiodothyronine (T3) and thyroxine (T4) in CRF Libyan patients before and after HD. This study was carried out on 46 CRF patients (30 male and 16 female) with a mean age of 47.46 ±15.75 years. These patients were treated at the hemodialysis unit of Educational Central Zelitin Hospital, Zelitin, Libya. None of these patients apparently have any thyroid problems and no history of drug intake that may affect thyroid function. Blood samples were taken from each patient to measure serum levels of T3 and T4, before and after HD. In addition, the effect of several variables include age, gender, body mass index (BMI), presence of both hypertension and, diabetes mellitus and duration of kidney dialysis on serum levels of T3and T4 before and after HD were also studied. After HD, there was a statistically significant increase in the serum levels of T3, T4. The age, gender, BMI, duration of kidney dialysis and the presence of hypertension and diabetes mellitus did not have any significant effect on the serum level of T3 and T4 before and after HD. However, the serum levels of T3 and T4 were still in the normal range in these examined patients either before or after HD. From these findings, it can be concluded that these CRF patients may be in a euthyroid state, because the serum levels of T3 and T4 were in the normal range. In addition, HD was seem to improve the T3 and T4 thyroid hormone concentrations, suggesting that HD might activate the secretion of thyroid glandand catabolism. The other variables did not play any role in thyroid hormone levels in these patients either before or after HD. It is highly recommended that large scale evaluation of thyroid hormone levels in Libyan CRF patients is performed more patients, especially elderly patients.

Burden and social support in informal caregivers of people undergoing kidney dialysis: a mixed study

ABSTRACT Objectives: to analyze the burden and the social support of the informal caregivers of people undergoing kidney dialysis. Methods: mixed study, based on the Theory of Stress and Overload, using instruments of sociodemographic characterization, the Social Support Survey from the Medical Outcomes Study, Zarit’s Burden Scale, and guiding questions. Analysis of data used statistical and thematic inferences. Results: 55 caregivers were evaluated, most were women, from 31 to 50 years old, married, and having worked in care for more than three years. A high level of affective and material support was observed, with a light overload on the caregiver. The central theme of the discourses was: “Experiences of the caregiver: between the burden of responsibility and the search for meaning”. Conclusions: a small overload was found in the participants, with a high median in the dimensions of affective and emotional support, in the relations between positive social interactions and the burden of the caregivers, in addition to the duality or responsibility and the meaning of care.

A multi-domain shear-stress dependent diffusive model of cell transport-aided dialysis: analysis and simulation

<abstract><p>Kidney dialysis is the most widespread treatment method for end-stage renal disease, a debilitating health condition common in industrialized societies. While ubiquitous, kidney dialysis suffers from an inability to remove larger toxins, resulting in a gradual buildup of these toxins in dialysis patients, ultimately leading to further health complications. To improve dialysis, hollow fibers incorporating a cell-monolayer with cultured kidney cells have been proposed; however, the design of such a fiber is nontrivial. In particular, the effects of fluid wall-shear stress have an important influence on the ability of the cell layer to transport toxins. In the present work, we introduce a model for cell-transport aided dialysis, incorporating the effects of the shear stress. We analyze the model mathematically and establish its well-posedness. We then present a series of numerical results, which suggest that a hollow-fiber design with a wavy profile may increase the efficiency of the dialysis treatment. We investigate numerically the shape of the wavy channel to maximize the toxin clearance. These results demonstrate the potential for the use of computational models in the study and advancement of renal therapies.</p></abstract>

Autonomic Nerve Activation Observed for Hemodialysis Patients While Squeezing a Soft Ball

In this study, a medical grade pulse rate (PR) instrument was used to monitor hemodialysis patients, and the wearable product was applied for the 4 h observation. Electrocardiogram (ECG) and photoplethysmography (PPG) data were simultaneously collected to observe physiological phenomena in patients undergoing hemodialysis. The analyzed results of 38 patients undergoing the treatment (as sympathetic/parasympathetic balance indicators before-hemodialysis (HD), and after-HD) and autonomic nerve activation for the pulse rate (PR) measurement accompanied by squeezing a soft ball were also observed. The results prove the pulse rate measurement while squeezing the soft ball and analyze data, and we show that the analyzed results have a very concentrated normal distribution. This study presents oxygen saturation (SpO2) and continuous pulse rate distribution curves during the 4 h observation of the hemodialysis patients and we show that some patients undergoing kidney dialysis have sleep apnea. They become lethargic during dialysis and experience severe hypoxia due to intermittent respiratory arrest. Studies have confirmed that such monitoring and biofeedback designs can reduce the incidence of hypotension during dialysis.