Search results

1

Cardiac valve calcifications and predictive parameters in hemodialysis patients

100%

Selcoki Y., Turgut F., Kanbay M., Ozkara A., Tekin O., Uz B., Akcay A.

Open Medicine

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2007

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vol. 2

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issue 3

304-312

EN

Cardiac valvular calcification is frequent among hemodialysis (HD) patients. The presence of valvular calcification can help identify HD patients with a higher risk for cardiovascular diseases. Our aim was to determine the prevalence of valvular calcification (VC) in our maintenance hemodialysis (HD) population and to examine some possible etiologic factors for its occurrence. We studied forty-four patients on hemodialysis (23 women and 21 men; mean age 57 ± 18 year; mean HD duration 34 ± 28 months). Valvular calcification (VC) was observed in 21 patients (48%). Of these patients, 6 patients (13%) had mitral valvular calcification, 9 patients (20%) had aortic valvular calcification, and 6 patients (13%) had calcification of both valves. The patients with VC were older than patients without VC (66±14 vs. 50±18). The patients with aortic calcification had longer HD duration than others (48±29 vs. 27±24 months). Patients with VC had higher systolic and diastolic blood pressures than patients without VC. The patients with mitral calcification had higher C-reactive protein (CRP) levels (14 ± 13 vs. 7 ± 7). No significant differences were found with respect to calcium, phosphorus, parathyroid hormone, alkaline phosphatase and mean Ca × P product. Our study confirmed that there is an increased prevalence of VC in HD patients. Age is a risk factor for cardiac VC in HD patients. Longer HD duration was associated with aortic valve calcification. In addition, elevated level of CRP is associated with mitral valve calcification in HD patients.

2

Bilateral brachiocephalic vein stenosis in a chronic hemodialysis patient with well-functioning arteriovenous fistula – A rare entity

100%

SINGH M. G., KUMAR V.

Polish Journal of Surgery

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2021

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vol. 93

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issue 4

74-75

EN

Introduction: Central vein stenosis has been reported in patients of end stage renal disease with subclavian vein being more commonly affected than brachiocephalic vein. Case report: We present a case of young female with bilateral brachiocephalic vein obstruction following arteriovenous fistula creation for hemodialysis.

3

Comparison of results of placement of cuffed –tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis

100%

Zafarghandi M.-R., Nazari I., Taghavi M., Salimi J., Moini M., Askarpour S.

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vol. 85

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issue 3

133-136

EN

Aim of the study was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis. Material and methods. Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter’s placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA). Results. There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04). Conclusion. Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement.

4

SARS-CoV-2 infection in vaccinated maintenance hemodialysis patients despite anti-spike seroconversion: a report of 3 breakthrough cases

100%

Biedunkiewicz B., Tylicki L., Puchalska-Reglińska E., Dąbrowska M., Ślizień W., Kubanek A., Rąbalski Ł., Kosiński M., Grzybek M., Renke M., Dębska-Ślizień A.

European Journal of Translational and Clinical Medicine

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2022

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vol. 5

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issue 1

12-16

EN

Chronically hemodialyzed (HD) patients are at a high risk of developing very severe forms of COVID-19 disease. In this article we describe three HD patients (all males, aged 70, 70 and 74 years) vaccinated intramuscularly with a two-dose mRNA BNT162b2 vaccine; BionTech/Pfizer Comirnaty, in whom subsequent breakthrough SARS-CoV-2 infections developed. All patients achieved post-vaccine seroconversion for anti-spike antibodies with IgG titers of 445, 227 and 92.5 AU/mL (cut-off, 13 AU/mL) case 1, 2 and 3 respectively. SARS-CoV-2 infection was diagnosed 44, 28 and 48 days after the second dose of BNT162b2 and confirmed with the polymerase-chain-reaction (PCR) test. Two asymptomatic patients underwent this test because of their direct contact with a person with confirmed COVID-19. The third patient reported only a non-significant drop in oxygen saturation, and was hospitalized (case 3). All these patients were characterized by a low post-vaccination neutralizing antibody titer and a high production of these antibodies after falling ill (795, 845 and 5770). Perhaps this production of antibodies is responsible for the mild course of the disease, and the likely reduction of mortality. These breakthrough cases in no way undermine the importance of the vaccinations, and on the contrary argue for their urgency.

5

Survival of tunneled hemodialysis catheters after percutaneous placement

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Weber E., Liberek T., Wołyniec W., Gruszecki M., Rutkowski B.

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2016

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vol. 63

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issue 1

139-143

EN

Background. Tunneled catheters are becoming increasingly used as a permanent dialysis access. Easy way of insertion and good long-term patency make them competitive to fistulas in some groups of patients. Methods. Late complications and survival of 180 tunneled catheters inserted from June 2010 to December 2013 in 171 unselected hemodialysis patients were analyzed. Results. The cumulative time of observation was 2103.5 patient-months and median observation was 9 months (range of 0.5-45 months). Only 19 out of 180 catheters were removed due to complications (12 for infections, 4 due to malfunction and 3 because of mechanical damage). Majority of catheters were removed electively: 27 after maturation of arterio-venous fistula (AVF), 4 after kidney transplant, 5 after transfer to peritoneal dialysis and 3 due to the recovery of renal function. At the end of the observation, 58 catheters were still in use and 64 patients had died with functioning catheter. When censored for elective catheter removal and patient death, 88.2% of catheters survived for 1 year. Catheter survival was significantly better in older patients (over 65 years, in comparison to patients < 65 years, p = 0.046). Conclusions. Nearly 90% of all inserted catheters gave reliable dialysis access as long as it was needed. Among them, over 30% of the inserted catheters were in use at the end of the observation period, and over 30% of patients had died with a functioning catheter. The results of tunneled catheters survival are encouraging and they should be taken into consideration during decision-making on vascular access, especially in the older patients.

6

Quality of Life and Sleep Disorders Among Patients Treated with Hemodialysis in Relation to Dialysis Adequacy

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Dryl-Rydzyńska T., Sak J., Książek A.

Polish Journal of Public Health

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2015

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vol. 124

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issue 3

111-114

EN

Introduction. Recent studies in this field are insufficient to determine the relationship between life quality and hemodialy-sis adequacy. The problem, which requires further analysis is the issue of verification of these relationships and the problem of the relationship between sleep disorders and hemodialysis indicators. Aim. The aim of this study is to determine the relationship between quality of life and sleep disorders occurring among patients with end stage renal disease (ESRD) treated with hemodialysis and the dialysis adequacy parameters. Material and methods. The survey was based on two standardized international scales: the Quality of Life Scale (SF-36) and the Pittsburg Sleep Quality Index (PSQI). The study was conducted among 150 patients (67 women and 83 men) treated with hemodialysis at the Fresenius center. All patients participating in the study were undergoing dialysis three times a week. The average value of Kt/V was 1.45 (SD=0.22) and URR ration 71.78 (SD=5.95). Results. The urea level prior to hemodialysis moderately strongly correlates with life energy deficit (r=-0.34, p=-0.049) and that the values of urea reduction ratio URR weakly correlates with the patient's conviction on restricting life's activity (SF-36) (r=0.18, p=0.046). The level of urea prior to dialysis correlates positively with the time of falling asleep in PSQI scale (r=-0.39, p=0.023). Conclusions. Patients with lower urea level before hemodialysis have a significantly higher vitality level. Higher fluctuations of urea concentrations before and after hemodialysis (higher urea reduction ratio URR) are associated with restrictions of physical activity in hemodialysis patients.

7

Relationships Between Perception of Illness, Social Support and Hemodialysis Adequacy

100%

Sak J., Dryl-Rydzyńska T., Książek A.

Polish Journal of Public Health

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2015

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vol. 124

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issue 4

174-177

EN

Introduction. The patients in situations of “being ill” have to face not only pain and disabilities, but also problems in their social relationships. Perceptions of illness are results of reactions to the changes in the existential situations, and that these correspond to determined illness coping strategies. Aim. The aim of the research was to determine the relationships between perception of illness and social support, with the indicators of the adequacy of the renal replacement treatment and the level of urea as a biomarker of disease offset. Material and methods. The study was conducted on a group of 150 patients who were on chronic hemodialysis, and who were suffering from end stage renal disease. The patients were treated at on of the several Fresenius Medical centres. As a group, average Kt/V value was 1.45 (SD=0.22) and the URR ratio 71.78 (SD=5.95). Moreover, average urea concentration before HD equaled to 133.78mg% (SD=39.68) and after hemodialysis - 38.22mg% (SD=14.60). The research procedure was based on a questionnaire study. This applied three standardized scales: the Imagination and Perception of Illness Scale (IPIS), the brief Illness Perception Questionnaire (IPQ-Brief) and the Berlin Social Support Scale (BSSS). Results. Patients who exhibited higher values of urea concentration in the blood serum measured before HD, perceived their disease (IPIS scale) as causing more motivation loss to carrying out specific activities, as well as mental and physical sphere destruction, pessimism and lost control over the disease. What is more, higher values of urea reduction ratio (URR) positively correlate with the loss of control over the disease (r=-0.20, p=0.024). Moreover, patients characterized by higher values of urea concentration in the blood serum before hemodialysis, evinced greater need for social support (BSSS). Conclusions. The need for social support among ESRD patients treated by hemodialysis does not correlate with dialysis adequacy indicators. Furthermore, the level of urea marked before hemodialysis exhibits an interdependence with psychological determinants of illness perception and social support.

8

Plasma levels of catecholamines and asymmetric dimethylarginine levels as predictive values of mortality among hemodialysis patients

100%

Dziedzic M., Orlowska E., Gawel K., Zawadzka M., Bednarek-Skublewska A., Solski J.

Current Issues in Pharmacy and Medical Sciences

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2014

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vol. 27

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issue 1

37-40

EN

The aim of the study was to assess plasma concentration of catecholamines and asymmetric dimethyl arginine levels and a possible relationship to predict the mortality rates among hemodialysis patients. The study population comprised 27 subjects, aged 65-70 years. Each patient underwent dialysis thrice a week. Furthermore, the median duration of hemodialysis was 3.5 years. Based on the conducted research, it can be concluded that the concentrations of adrenaline and the level of asymmetric dimethylarginine have predictive value of mortality among hemodialysis patients. Of note, lowering plasma asymmetric dimethylarginine concentration may represent therapeutic target for prevention of progressive renal damage.

9

Quality of life and functional status in patients with end-stage renal disease

100%

Strugała M., Talarska D., Niewiadomski T., Dziechciaż M., Wojewoda K.

Long-Term Care Nursing

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2020

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vol. 5

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issue 2

105-118

EN

Aim The specifics of progressive course of the disease leads to the development of functional dependence which contributes to later disability, significantly influences quality of life. The goal of the research described here was to determine the relationship between the functioning of patients treated with hemodialysis and selected socio-demographic factors and quality of life. Material and methods The research included 100 patients in the range 20-90 years of age who were being treated with hemodialysis in a renal replacement facility in the area of western Poland. The average age for the entire group was 59.5±14.4 years of age. The average time spent on dialysis for the group was 44.7 ± 48.6 months. In order to evaluate patients’ functional status the Barthel Index, Lawton’s IADL and the Karnofsky Performance Status Scale were used. In order to evaluate QOL, the multidimensional instrument – the Health Questionnaire Specific for ESRD was used. Results Using the Spearman coefficient correlation moderate and strong correlations were found between particular sub-scales Health Questionnaire Specific for ESRD and functional capacity. There was no statistically significant dependence between the length of renal-replacement therapy and particular scales on the Parfrey et al Health Questionnaire as well as the functional capacity of patients. Conclusions Demographic variables, especially sex and age, and to a lesser degree educational level and marital status have an influence on the results of the Health Questionnaire Specific for ESRD. Activity levels had a signficant influence on the results in the area of QOL

10

Selenium supplementation to chronic kidney disease patients on hemodialysis does not induce the synthesis of plasma glutathione peroxidase

88%

Zachara B. A., Gromadzinska J., Zbrog Z., Swiech R., Wasowicz W., Twardowska E., Jablonska E., Sobala W.

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issue 1

183-187

EN

Background: Numerous authors have shown that selenium (Se) concentration and glutathione peroxidase (GSH-Px) activity in plasma of chronic kidney disease (CKD) patients are lower than in healthy subjects, but there are only few publications on the level of GSH-Px protein in those patients and no reports on the effect of Se supplementation to HD patients on the level of this enzyme. Subjects and Methods: Se concentration and GSH-Px protein level in plasma were measured in a group of 30 CKD patients on hemodialysis (HD) supplemented with 200 µg Se/day for 3 months, and 28 patients on HD administered with placebo. Se concentration was measured by graphite furnace atomic absorption spectrometry and plasma GSH-Px protein level by the sandwich ELISA method using polyclonal antibody specific for human plasma GSH-Px. Results: Se concentration in patients on placebo did not change throughout the 3-month study period, but increased significantly in Se supplemented group. Se supplementation to CKD patients on HD had no effect on the level of GSH-Px protein. Conclusions: The lack of GSH-Px protein in CKD patients on HD is not linked to Se deficiency since the level of this element increased after Se supplementation while enzyme protein level did not change. The damaged kidney of HD patients is unable to synthesize GSH-Px, even after induction with selenium.

11

Estimation of Predictive Factors Affecting Patency of Dialysis Arteriovenous Fistulae

88%

Mularczyk T., Kostewicz W.

Polish Journal of Surgery

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2010

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vol. 82

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issue 3

147-158

EN

Native arteriovenous fistula is considered the best type of access for dialysis. Its function is affected by multiple factors.The aim of the study was to identify risk factors of the loss of fistula patency.Material and methods. Between 1990-2004, 218 patients underwent 276 surgical procedures involving vascular access creation. In 245 (89%) of cases, a fistula was created using only patient's own blood vessels; in 31 (11%) of cases a vascular graft was implanted. 158 (64%) radio-cephalic fistulae were created, 15 (6%) radiobasilic fistulae, 33 (14%) brachiocephalic and 39 (16%) brachiobasilic fistulae. Duration of primary patency was identified for 217 native fistulae. Age, gender, diabetes mellitus, type, mode of creation and fistula location, vein translocation, type of anastomosis and time of initial cannulation were analyzed as potential factors affecting the fistula patency. Cox proportional hazards model was used in the analysis.Results. Probability of fistula patency loss in patients above 46 years of age was 2.12-fold higher than in younger patients and 1.62-fold higher for end-to-side anastomosis versus end-to-end anastomosis. Risk of loss of patency in fistulae cannulated for the first time within the first 14 days, 15-21 days and 22-35 days from their creation was 31-, 19- and 7-fold higher than when they were cannulated after the first 35 days.Conclusions. Type of vascular anastomosis, age above 46 years and time of the first cannulation are independent risk factors of the loss of patency of vascular access. First cannulation should not take place earlier than 7 weeks after its creation.

12

QUALITY OF LIFE AND ITS GENERATING FACTORS IN HEMODIALYSIS PATIENTS HOSPITALIZED AT THE REGIONAL HOSPITAL IDRISSI KÉNITRA MOROCCO

88%

Touil D., Boualam A., El Harchaoui I., Louragli I., Aouane M., Touhami Ahami A. O.

Acta Neuropsychologica

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2022

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vol. 20(1)

67-79

EN

To assess the quality of life of patients with chronic end-stage renal failure under hemodialysis, and to determine its main generators in hemodialysis patients. This is a descriptive and analytical cross-sectional study carried out at the regional hospital of Kénitra (Morocco) in the level of the hemodialysis unit during a period of 3 months with 70 hemodialysis patients diagnosed and treated for chronic renal failure. Data were collected using a questionnaire comprising the socio-demographic, clinical, and nutritional characteristics of Hemodialysis patients and a KDQOL scale (Kidney Disease Quality Of Life) that assesses the quality of life. The scores of the KDQOL-36 were used to assess family, social support, and social support from caregivers. The average age was 51.66± 15.96 years with 57.1% of patients who are female. The components of the quality of life studied show an alteration in the quality of life with a decrease in the scores of the “component of physical health” dimensions with a score of 27.64 ± 29.13,“Component of mental health” with a score of 37.81 ± 22.99, “effects of kidney disease on daily life” with a score of 48.41 ± 21.22 and “burdens of kidney disease” with a score of 28.47 ± 21.50. While the dimension “Symptoms / problems of kidney disease” remains close to normal with a score of 64.61 ± 17.98. Our results showed that certain dimensions of the quality of life correlate with age, sex, family situation, level of education, the presence of a transplant plan, the presence of comorbidities and the duration of hemodialysis. Our study also found a correlation between family social support and quality of life in its “Burdens of Kidney Disease”, “Effects of Kidney Disease on Daily Living”, and the overall quality of life score. On the other hand, there is no significant relationship with support from caregivers. The quality of life of hemodialysis patients is deteriorating. It is influenced by several parameters including family and caregiver social support. The involvement of the family and the health care team in the psychological support process is paramount.

13

Evaluation of anxiety and depression disorders and the associated factors among hemodialysis subjects

75%

Touil D., Aouane M., Touhami Ahami A. O.

Acta Neuropsychologica

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2019

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vol. 17(4)

405-416

EN

Identifying anxio-depressive disorders, evaluating their prevalence and determining the different factors that can intervene in their hap- pening to the patients suffering from hemodialysis. Transversal descriptive and analytical study over 70 patients, real- ized at the dialysis unit of the Idrissi regional hospital’s department of medicine at Kenitra, Morocco, over a period of three months starting from 27 March to 26 June 2015. The data were acquired from a survey and psychiatric evaluation scales: The scale HADS (Hospital Anxiety and Depression Scale ) to evaluate anxiety and depression and the scale of « Big Five French Inventory to evaluate the treats of personality» (BF-Fr). Average age was from 54,66±15,96 years. The seniority of the hemodialysis was on average 5,20±3,23 years. The studied traits of personality show a decrease regard to the average score of dimen- sion O (overture of sense) and of the dimension E score (extraversion) versus an evaluation of the dimension N score (Neu ro ticism). The prevalence of anxio-depressive troubles were as the following; 74,29% presented an anxious state (suspected or proven) and 70% had a depressive state (suspected or proven). The anxious troubles were correlated to age and to N and O characters of personality traits BFI-Fr. the depressive troubles were correlated to N charac- ters traits of personality BFI-Fr, and the anxious troubles were pos- itively correlated to depressive troubles. The prevalence of anxio-depressive troubles among hemodialysis subjects was elevated with repercussions on the personality. The involvement of a psychologist in the processes of taking charge is obligatory.

14

Red blood cell and plasma glutathione peroxidase activities and selenium concentration in patients with chronic kidney disease: A review

75%

Zachara B. A., Gromadzińska J., Wąsowicz W., Zbróg Z.

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2006

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vol. 53

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issue 4

663-677

EN

The metabolism of oxygen in aerobic organisms leads to generation of reactive oxygen species (ROS). These entities are able to oxidize almost all classes of macromolecules, including proteins, lipids and nucleic acids. The physiological level of ROS is usually regulated by antioxidant defense mechanisms. There are at least three groups of antioxidant enzymes: superoxide dismutases, catalases and glutathione peroxidases (GSH-Pxs) which neutralize ROS. The trace elements (copper, zinc and selenium) bound to the active sites of the above listed enzymes play an important role in the antioxidant defense system. In mammals, a major function of selenium (Se) and Se-dependent GSH-Pxs is to protect cells from oxidative stress. Selenium concentrations and GSH-Px activities are altered in blood components of chronic kidney disease (CKD) patients. The Se level is frequently lower than in healthy subjects and the concentration very often decreases gradually with advancing stage of the disease. Studies on red cell GSH-Px activity in CKD patients reported its values significantly lower, significantly higher and lower or higher, but not significantly as compared with healthy subjects. On the other hand, all authors who studied plasma GSH-Px activity have shown significantly lower values than in healthy subjects. The degree of the reduction decreases gradually with the progression of the disease. High inverse correlations were seen between plasma GSH-Px activity and creatinine level. A gradual decrease in plasma GSH-Px activity in CKD patients is due to the fact that this enzyme is synthesized predominantly in the kidney and thus the impairment of this organ is the cause of the enzyme's lower activity. Se supplementation to CKD patients has a slightly positive effect in the incipient stage of the disease, but usually no effect was observed in end-stage CKD. Presently, kidney transplantation is the only treatment that may restore plasma Se level and GSH-Px activity in patients suffering from end-stage CKD. A few studies have shown that in kidney recipients, plasma Se concentration and GSH-Px activity are restored to normal values within a period of 2 weeks to 3 months following surgery and thus it can be acknowledged that Se supplementation to those patients has a positive effect on plasma GSH-Px activity.

15

Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

75%

Serra R., Butrico L., Grande R., Placida G. D., Rubino P., Settimio U. F., Quarto G., Amato M., Furino E., Compagna R., Amato B., Gallelli L., Franciscis S. d.

Open Medicine

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2014

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vol. 10

|

issue 1

EN

Introduction: An arteriovenous fistula (AVF) for placed for hemodialysis may be burdened by one particular complication-the formation of a venous aneurysm. It has been shown that matrix metalloproteinases (MMPs) and neutrophil gelatinase-associated lipocalin (NGAL) could represent markers of disease in both venous and arterial vessels. Materials and methods: This case study reports a rare case of enormous venous aneurysm-correlated MMP and NGAL levels in a woman with an AVF. Results: Significantly higher levels of plasma MMP-1, MMP-8, MMP-9, and NGAL were detected in this patient during aneurysmal evaluation before the surgery; these levels significantly decreased 1, 3 and 6 months after surgery. Conclusion: MMP and NGAL levels could represent a marker of aneurysmal disease, and their plasma evaluation could help physicians to stratify the risk of complications in patients with an AVF.

16

Wpływ hemodializoterapii na zmienność glikemii

63%

Pruś G., Firlej-Pruś M., Śnit M.

|

issue 73

53-59

EN

The steady increase in the incidence of type 2 diabetes, which is the leading cause of end-stage renal failure among hemodialysis patients, has been the subject of multidisciplinary research. Much attention has been devoted to the effects of hemodialysis on blood glucose fluctuations during hemodialysis and intervals between treatments, as well as differences in glycemic variability in patients with and without diabetes mellitus. A large group of studies is those related to methods of monitoring glucose levels and the usefulness of individual biomarkers. The results clearly show the significant and different effects of hemodialysis on glycemic dysfunction in people with and without diabetes. It has also been shown that due to the numerous interfering factors, the usefulness of HbA1c to monitor glucose levels in hemodialysis patients is lower compared to non-demyelised individuals, but still remains the primary biomarker for glucose monitoring. Research has also become a method of treating diabetes in hemodialysis patients, dietary recommendations and an attempt to develop standards for the care of hemodialysis patients. The results of individual studies on obesity and dietary recommendation remain unchanged, suggesting a positive effect on the quality of life, renal failure, and hemodialysis itself. These results have not yet been confirmed by subsequent studies.

PL

Stały wzrost zapadalności na cukrzycę typu 2, będącą główną przyczyną schyłkowej niewydolności nerek u chorych hemodializowanych, stał się przedmiotem wielokierunkowych badań. Wiele uwagi poświęcono wpływowi hemodializy na wahania glikemii w trakcie zabiegu hemodializy oraz w okresach między zabiegami, jak również na różnice między zmiennością glikemii u chorych z rozpoznaną cukrzycą oraz bez tego schorzenia. Dużą grupę stanowią badania dotyczące metod monitorowania poziomu glikemii oraz przydatności poszczególnych biomarkerów. Wyniki badań jednoznacznie wykazują istotny oraz odmienny wpływ hemodializy na zmienność glikemii u osób z cukrzycą oraz bez tego schorzenia. Wykazano również, że z uwagi na liczne czynniki interferujące przydatność HbA1c do monitorowania poziomu glikemii u chorych hemodializowanych jest mniejsza niż u osób niehemodializowanych, nadal jednak pozostaje ona głównym biomarkerem służącym do monitorowania poziomu glikemii. Przedmiotem badań stały się również metody leczenia cukrzycy u chorych hemodializowanych, zalecenia dietetyczne oraz próba opracowania standardów opieki nad tymi chorymi. Wyniki pojedynczych badań nad otyłością i zaleceniami dietetycznymi różnią się od pozostałych, sugerując korzystny wpływ na jakość życia chorych, przebieg niewydolności nerek oraz sam zabieg hemodializy. Wyniki te nie zostały dotychczas potwierdzone.

17

Ocena stanu odżywienia pacjentów hemodializowanych

63%

Stadnik N., Antczak-Komoterska A.

Innowacje w Pielęgniarstwie i Naukach o Zdrowiu

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2023

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vol. 8

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issue 2

60-81

EN

Introduction: The incidence of kidneydisease (CKD) increases with the aging of the world'spopulation. In Poland, itisabout 16%. The most commoncauses of CKD arediabetes and hypertension. Earlydiagnosis of thisdisease and implementation of actionsare of greatimportance. Aim of the study: Evaluation of the nutritional status of hemodialysispatients. Material and methods: The researchmethodused in thisworkis the method of diagnosticexamination and researchmethods. In thiswork, the surveytechnique and the use of a scalewereused as researchtechniques. Tools used in thiswork for Self-assessmentquestionnaire, subjectiveglobalassessment of nutritional status (SGA), NRS scale - Riskassessmentrelated to nutritional status. Results: Results of a study of associationsbetweenmultiplenutritionalstatuses in hemodialysispatients. Conclusions: Nutritional status does not significantlydepend on sociodemographicvariables. The nutritional status dependssignificantly on the appetite, quantity and size of eatenmeals. People whoseappetiteisverypoor and the number of mealsis small aresuspected of malnutritionormoderatemalnutrition. peoplewhoeat the rightamount of meals show a goodnutritional status Nutritional status dependssignificantly on the fluidsyou drink. In the group of patientstaking less than 3 glasses a day, theyaresuspected of malnutritionormoderatemalnutrition. Ifpatientstakemorefluids, theirnutritional status isnormal. The nutritional status dependssignificantly on the symptoms and severity of the disease. The occurrence of ailmentssuch as loss of appetite, nausea, diarrhoea, vomiting, anorexiamayresult in poornutritional status. Such a conclusioncan be drawnthanks to ourownresearch. Nutritional status does not significantlydepend on the level of knowledgeaboutpropernutrition. It depends, however, on the observance of itsrules. People who do not follow the rules of propernutrition show abnormalorsuspectednutritional status. Dialysispatientswho report thattheysometimesfollow the rules show normalnutritional status

PL

Wstęp. Częstość występowania przewlekłej choroby nerek (PChN) wzrasta wraz ze starzeniem się społeczeństwa na świecie. W Polsce jest około 16%. Najczęstszymi przyczynami PChN jest cukrzyca i nadciśnienie tętnicze. Bardzo duże znaczenie ma wczesne rozpoznanie tej choroby i wdrożenie działań. Cel pracy. Ocena stanu odżywienia pacjentów hemodializowanych. Materiał i metody. Metodą badawczą, którą zastosowano w tej pracy jest metoda sondażu diagnostycznego i metoda szacowania. W tej pracy jako techniki badawcze wykorzystano technikę ankietowania i korzystanie ze skali. Narzędzia jakie wykorzystano w tej pracy to Kwestionariusz ankiety własnego autorstwa, subiektywna globalna ocena stanu odżywienia (SGA), skala NRS – Ocena ryzyka związanego ze stanem odżywienia. Wyniki.Wyniki badań wskazują zależność pomiędzy wieloma czynnikami na stan odżywienia pacjentów hemodializowanych. Wnioski. Stan odżywienia nie zależy istotnie od zmiennych socjodemograficznych. Stan odżywienia zależy istotnie od apetytu, ilości i wielkości zjadanych posiłków. Osoby, u których apetyt jest bardzo słaby i ilość posiłków jest mała wykazują podejrzenie niedożywienia lub niedożywienie średniego stopnia. Osoby, które przyjmują prawidłową ilość posiłków wykazują prawidłowy stan odżywienia Stan odżywienia zależy istotnie od wypijanych płynów. W grupie pacjentów przyjmujących mniej niż 3 szklanki dziennie wykazują podejrzenie niedożywienia lub niedożywienie w średnim stopniu. W przypadku przyjmowania przez pacjentów większej ilości płynów, stan odżywienia jest prawidłowy. Stan odżywienia zależy istotnie od występujących dolegliwości i nasilenia choroby. Występowanie dolegliwości takich jak utarta apetytu, nudności, biegunka, wymioty, jadłowstręt może skutkować złym stanem odżywienia. Taki wniosek można wysunąć dzięki przeprowadzonym badaniom własnym. Stan odżywienia nie zależy istotnie od poziomu wiedzy na temat prawidłowego żywienia. Zależy natomiast istotnie od przestrzegania jego zasad. Osoby nieprzestrzegające zasad prawidłowego odżywiania wykazują nieprawidłowy stan odżywienia lub jego podejrzenie. Chorzy dializowani, którzy podali, że czasami przestrzegają zasad wykazują prawidłowy stan odżywienia.

18

Wybrane aspekty jakości życia pacjentów hemodializowanych

63%

Piernikowska A.

Innowacje w Pielęgniarstwie i Naukach o Zdrowiu

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2023

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vol. 8

|

issue 1

59-87

EN

Introduction. Renal replacement therapy performed as part of dialysis among patients allows replacing the work of their renal failure. However, due to the aggravating nature of this method of treatment, it significantly affects the modification of patients' quality of life. Aim. The purpose of research in this study was to verify selected aspects of the life of hemodialysis patients using a hemodialysis catheter and – venous arteriovenous fistula. Material and methods. The studies were conducted among 100 patients undergoing hemodialysis. They used the diagnostic survey method, estimation method, techniques: survey and estimation scale, and the WHOQOL - BREF questionnaire with the proprietary record. Results. Research results indicate a varied level of quality of life for hemodialysis patients in different domains of their functioning. Conclusions. Most hemodialysis patients present an average level of satisfaction with the quality of their lives. They perceive the individual, general perception of quality of life better than the individual general perception of their own health. The quality of life of patients undergoing hemodialysis does not depend significantly on their age, education and place of residence. Significantly higher assessment of the quality of life within the environmental domain was presented by persons in relationships, the lowest assessment within the social domain was made by widows / widowers. The quality of life of patients undergoing hemodialysis does not depend significantly on the cause, method and time of renal replacement therapy.

PL

Wstęp. Terapia nerkozastępcza realizowana w ramach dializoterapii wśród pacjentów umożliwia zastąpienie pracy ich niewydolnych nerek. Jednak z uwagi na obciążający charakter tej metody leczenia wpływa ona istotnie na modyfikację jakości życia pacjentów. Cel pracy. Celem badań pracy była weryfikacja wybranych aspektów życia pacjentów hemodializowanych przy użyciu cewnika do hemodializ oraz przetoki tętniczo – żylnej. Materiał i metody. Badania przeprowadzono wśród 100 pacjentów poddawanych hemodializie. Wykorzystano w nich metodę sondażu diagnostycznego, metodę szacowania, techniki: ankietowania i skali szacunkowej oraz kwestionariusz WHOQOL - BREF z autorską metryczką. Wyniki. Wyniki badań wskazują one na zróżnicowany poziom jakości życia pacjentów hemodializowanych w różnych domenach ich funkcjonowania. Wnioski. Pacjenci hemodializowani w większości prezentują przeciętny poziom zadowolenia z jakości swojego życia. Postrzegają oni indywidualną, ogólną percepcję jakości życia lepiej, aniżeli indywidualną ogólną percepcję własnego zdrowia. Jakość życia pacjentów poddawanych hemodializie nie zależy istotnie od ich wieku, wykształcenia i miejsca zamieszkania. Istotnie wyższą ocenę jakości życia w ramach domeny środowiskowej prezentowały osoby pozostające w związkach, najniższej oceny w ramach domeny socjalnej dokonywali wdowy/wdowcy. Jakość życia pacjentów poddawanych hemodializie nie zależy istotnie od przyczyny, metody i czasu prowadzenia leczenia nerkozastępczego.

19

Akceptacja choroby i style radzenia sobie ze stresem u osób dializowanych

63%

Kurowska K., Kasprzyk A.

Psychiatria i Psychologia Kliniczna

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2013

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vol. 13

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issue 2

99-107

EN

Introduction: A chronic disease changes the patients functioning in many different areas of their lives. Most of them cannot accept the disease and rarely make an effort to change their current health situation. Aim of the study: To define the level of acceptance of the disease as well as the preferred ways of coping with stress in patients on dialysis, suffering from chronic renal disease. Material and methods: Ninety-four patients on dialysis, with chronic renal failure, were examined. The study was conducted in two dialysis units: Dialyses Centre Fresenius Nephrocare III in Bydgoszcz and NZOZ Avitum, Dialysis Unit in Nakło. Adjustment to the disease was assessed using the Acceptance of Illness Scale (AIS) adapted by Juczyński, the way of dealing with stressful situations was tested using CISS questionnaire by Endler and Parker, in Polish adaptation by Szczepanik, Strelau and Wrześniewski. Results: The examined group reached the average level of the disease acceptance. Men, people aged up to 59 years and those living in towns exhibit a higher level of disease acceptance. The higher the education level, the higher the patient’s ability to adjust to the disease. The most common style of coping with stress was the task-oriented style which was followed by the emotion-oriented style and the avoidance-oriented style. The level of the disease acceptance decreased with increasing emotion-oriented style. Conclusions: The obtained results will help to understand people with chronic renal failure, assist them in finding new ways of coping with stress, and thereby increase the acceptance of the disease. They will also allow to plan a better care for dialysis patients.

PL

Wstęp: Schorzenia przewlekłe zmieniają funkcjonowanie pacjentów w poszczególnych obszarach życia. Większość osób nie potrafi zaakceptować choroby, rzadko podejmuje wysiłki mogące zmienić aktualną sytuację zdrowotną. Cel pracy: Określenie stopnia przystosowania się do choroby i preferowanych stylów radzenia sobie ze stresem u chorych z przewlekłą niewydolnością nerek poddawanych dializoterapii. Materiał i metody: Przebadano 94 dializowanych pacjentów z przewlekłą niewydolnością nerek. Badania przeprowadzono w dwóch stacjach dializ – NZOZ Centrum Dializ Fresenius Nephrocare III w Bydgoszczy oraz NZOZ Avitum, Stacja Dializ w Nakle nad Notecią. Przystosowanie się do choroby oceniono za pomocą Skali Akceptacji Choroby – AIS w adaptacji Juczyńskiego, a sposób radzenia sobie w sytuacjach stresowych kwestionariuszem CISS Endlera i Parkera w polskiej adaptacji Szczepanika, Strelaua i Wrześniewskiego. Wyniki: Badana grupa uzyskała przeciętny poziom akceptacji choroby. Wyższy poziom przejawiali mężczyźni, osoby w wieku do 59 lat oraz zamieszkujące w mieście. Im wyższy był poziom wykształcenia, tym większe zdolności w przystosowaniu się do życia z daną jednostką chorobową przejawiał chory. Najczęściej stosowany był styl zadaniowy radzenia sobie ze stresem, w następnej kolejności styl skoncentrowany na emocjach i unikowy. Poziom akceptacji choroby malał wraz ze wzrostem stylu skoncentrowanego na emocjach. Wnioski: Uzyskane wyniki pozwolą zrozumieć osoby chore na przewlekłą niewydolność nerek i pomóc im w wypracowaniu nowych metod radzenia sobie ze stresem, a co za tym idzie – zwiększyć stopień akceptacji choroby. Umożliwią również lepsze zaplanowanie opieki nad pacjentami dializowanymi i wdrożenie działań pomagających w pogodzeniu się z chorobą.

20

Postępowanie diagnostyczno-lecznicze u dzieci z przewlekłą chorobą nerek w okresie przeddializacyjnym

51%

Szczepańska M., Olesik-Śmietana J.

Annales Academiae Medicae Silesiensis

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2010

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vol. 64

|

issue 1-2

66-74

EN

Chronic Kidney Disease (CKD) in children could be initially maintained on conservative treatment but at the end it leads unavoidably to renal replacement therapy application. Disease progression in children not exclusively aff ects renal function but also causes systemic complications (proteinuria consequences, cardiovascular complications, anemia, calcium-phosphate metabolism disorders, metabolic acidosis, hypostature, hypertension, chronic systemic infl ammation and malnutrition). Psychological aspect of CKD should not be forgotten because as other chronic illnesses, it aff ects both the quality of life of a child and the whole family. Early diagnosis of CKD gives a chance for the eff ective control of disease symptoms and for the prolongation of the period on conservative treatment. During the predialytic period the child and the family could be better prepared for renal replacement therapy or pre-emptive transplantation. In conclusion, diagnostic and treatment procedures require an achievement of good cooperation and close contact with the child and its family by the specialized team (pediatrician, nephrologist, dialysis nurse, psychologist, dietetician and social worker) at each treatment stage. Predialytic period is the time when child and his family inevitably experience the harmful consequences of CKD. The important task for the medical staff is the optimalization of the methods of treatment.

PL

Przewlekła choroba nerek (PChN) u dzieci, początkowo leczona zachowawczo w konsekwencji prowadzi do rozpoczęcia leczenia nerkozastępczego. Zaawansowanie procesu chorobowego wpływa nie tylko na czynność nerek, ale ma także u dzieci skutki ogólnoustrojowe, m.in. następstwa białkomoczu, powikłania w układzie sercowo - naczyniowym, niedokrwistość, zaburzenia gospodarki wapniowo - fosforanowej, kwasicę metaboliczną, niedobór wzrostu, nadciśnienie tętnicze, stan zapalny oraz zaburzenia odżywiania. Nie można także pominąć aspektu psychologicznego, gdyż jak każda choroba przewlekła wpływa zarówno na życie dziecka, jak i pozostałych członków rodziny. Wczesne wykrycie choroby to szansa na jej skuteczniejszą kontrolę, wydłużenie czasu leczenia zachowawczego a w okresie predializy lepsze przygotowanie młodego pacjenta i jego rodziny do podjęcia terapii nerkozastępczej lub przeprowadzenia przeszczepu wyprzedzającego nerki. Cały proces diagnostyczno - leczniczy wymaga dobrej współpracy z dzieckiem i jego rodziną na poszczególnych etapach leczenia poczynając od lekarza pierwszego kontaktu – pediatry poprzez specjalistę nefrologa, pielęgniarkę nefrologiczną, psychologa, dietetyka oraz pracownika socjalnego. Okres predializy to czas, w którym dziecko wraz z rodziną doświadcza nieuchronności następstw PChN, a zadaniem personelu medycznego jest konsolidacja działań w celu optymalizacji sposobu leczenia.

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Akceptacja choroby i style radzenia sobie ze stresem u osób dializowanych

Postępowanie diagnostyczno-lecznicze u dzieci z przewlekłą chorobą nerek w okresie przeddializacyjnym