Статті в журналах: "Program hemodialysis"

1

Yuan, Christina M., James D. Oliver, Dustin J. Little, Rajeev Narayan, Lisa K. Prince, Rajeev Raghavan, and Robert Nee. "Survey of non-tunneled temporary hemodialysis catheter clinical practice and training." Journal of Vascular Access 20, no. 5 (December 28, 2018): 507–15. http://dx.doi.org/10.1177/1129729818820231.

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Background:Nephrologists are placing fewer non-tunneled temporary hemodialysis catheters. Requiring competence for nephrology fellow graduation is controversial.Methods:Anonymous, online survey of all graduates from a single, military nephrology training program (n = 81; 1985–2017) and all US Nephrology program directors (n = 150).Results:Graduate response and completion rates were 59% and 100%, respectively; 93% agreed they had been adequately trained; 58% (26/45) place non-tunneled temporary hemodialysis catheters, independent of academic practice or time in practice, but 12/26 did ⩽5/year and 23/26 referred some or all. The most common reason for continuing non-tunneled temporary hemodialysis catheter placement was that it is an essential emergency procedure (92%). The single most significant barrier was time to do the procedure (49%). Program director response and completion rates were 50% and 79%, respectively. The single most important barrier to fellow competence was busyness of the service (36%), followed by disinterest (21%); 55% believed that non-tunneled temporary hemodialysis catheter insertion competence should be required, with 81% indicating it was an essential emergency procedure. The majority of graduates and program directors agreed that simulation training was valuable; 76% of programs employ simulation. Graduates who had simulation training and program directors with ⩽20 years of practice were significantly more likely to agree that simulation training was necessary.Conclusion:Of the graduate respondents from a single training program, 58% continue to place non-tunneled temporary hemodialysis catheters; 55% of program directors believe non-tunneled temporary hemodialysis catheter procedural competence should be required. Graduates who had non-tunneled temporary hemodialysis catheter simulation training and younger program directors consider simulation training necessary. These findings should be considered in the discussion of non-tunneled temporary hemodialysis catheter curriculum requirements.

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2

Moran, John, and Michael Kraus. "Starting a Home Hemodialysis Program." Seminars in Dialysis 20, no. 1 (January 22, 2007): 35–39. http://dx.doi.org/10.1111/j.1525-139x.2007.00239.x.

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3

Khosi’in, Khosi’in, and Dewi Purnamawati. "Analysis of Factors Related to Self-Care In Terminal Renal Failure Patients Those Who Are Taking Hemodialysis." Muhammadiyah International Public Health and Medicine Proceeding 1, no. 1 (November 1, 2021): 269–82. http://dx.doi.org/10.53947/miphmp.v1i1.55.

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This study aimed to examine factors related to self-care in end-stage renal disease (ESRD) patients undergoing hemodialysis. This study design is a comparative categorical analysis by cross-sectional. Was done to 92 hemodialyses this study was conducted at the hemodialysis unit of Dr. Muhamad Yunus hospital Bengkulul. Data was collected by a self-care measurement scale modified questionnaire. self-care level was 50% desirable. No correlation between age, sex, education level, HD duration, family income, and depression to self-care, there is a correlation between self-efficacy and social support to self-care. Self-efficacy is the most influential factor in self-care, it is important to increase self-efficacy by education program about ERSD and hemodialysis.

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Lenggogeni, Devia Putri, Hema Malini, and Boby Febri Krisdianto. "Manajemen Komplikasi dan Keluhan pada Pasien yang Menjalani Hemodialisis." Jurnal Warta Pengabdian Andalas 27, no. 4 (December 31, 2020): 245–53. http://dx.doi.org/10.25077/jwa.27.4.245-253.2020.

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Hemodialysis is one of the renal replacement therapies used by many patients with terminal renal failure. Hemodialysis is an effective renal replacement therapy and is the most commonly used in managing terminal renal failure. However, hemodialysis is a complicated and uncomfortable therapy with several complications. Hemodialysis complications need to be prevented and controlled so that the patient's life remains optimal, and the worse condition does not occur. This program provides knowledge and information to patients undergoing hemodialysis. It used to handle complications and problems caused by terminal renal failure and hemodialysis. This program is an education program to 32 patients undergoing hemodialysis at the hemodialysis unit RSUP. Dr. M. Djamil Padang. The program was carried out by using videos and giving booklet to patients. It showed an increase in patient's knowledge to manage complications and problems caused by hemodialysis. It provides information related to the management of complications and problems in patients undergoing hemodialysis, which can be done by the patient. It is aimed at patients to improve skills in managing complications and problems caused by hemodialysis.

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5

Silva-Filho, Antonio, Luana Azoubel, Rodrigo Barroso, Erika Carneiro, Carlos Dias-Filho, Rachel Ribeiro, Alessandra Garcia, Carlos Dias, Bruno Rodrigues, and Cristiano Mostarda. "A Case-control Study of Exercise and Kidney Disease: Hemodialysis and Transplantation." International Journal of Sports Medicine 40, no. 03 (January 31, 2019): 209–17. http://dx.doi.org/10.1055/a-0810-8583.

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AbstractWe aimed to analyze the effect of an exercise training program in autonomic modulation, and exercise tolerance of hemodialysis and kidney-transplanted patients. 4 groups of exercised and non-exercised patients undergoing hemodialysis and kidney-transplanted subjects had their biochemical tests, and heart rate variability evaluations analyzed. Also, sleep quality, anxiety and depression questionnaires were evaluated. Both exercised groups showed improvements in cardiovascular autonomic modulation, biochemical markers, and exercise tolerance after the exercise training program. The exercised kidney-transplanted patients group showed better improvements in cardiovascular autonomic modulation, biochemical markers, and exercise tolerance when compared to the exercised hemodialysis patients group. Both groups showed improvements in sleep quality, anxiety, and depression. The group of kidney-transplanted patients show better results in the cardiovascular autonomic modulation than subjects undergoing hemodialysis. However, the patients undergoing hemodialysis showed improvements in blood pressure, HDL, hemoglobin and phosphorus, changes not observed in the kidney-transplanted group. Exercise is beneficial for both hemodialysis and kidney-transplanted patients groups. However, exercise programs should be focused mainly in improving cardiovascular risk factors in the HD patients.

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Hernandez, Rosalba, Brett Burrows, Matthew H. E. M. Browning, Killivalavan Solai, Drew Fast, Natalia O. Litbarg, Kenneth R. Wilund, and Judith T. Moskowitz. "Mindfulness-based Virtual Reality Intervention in Hemodialysis Patients: A Pilot Study on End-user Perceptions and Safety." Kidney360 2, no. 3 (January 8, 2021): 435–44. http://dx.doi.org/10.34067/kid.0005522020.

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BackgroundVirtual reality (VR) is an evolving technology that is becoming a common treatment for pain management and psychologic phobias. Although nonimmersive devices (e.g., the Nintendo Wii) have been previously tested with patients on hemodialysis, no studies to date have used fully immersive VR as a tool for intervention delivery. This pilot trial tests the initial safety, acceptability, and utility of VR during maintenance hemodialysis treatment sessions—particularly, whether VR triggers motion sickness that mimics or negatively effects treatment-related symptoms (e.g., nausea).MethodsPatients on hemodialysis (n=20) were enrolled in a phase 1 single-arm proof-of-concept trial. While undergoing hemodialysis, participants were exposed to our new Joviality VR program. This 25-minute program delivers mindfulness training and guided meditation using the Oculus Rift head-mounted display. Participants experienced the program on two separate occasions. Before and immediately after exposure, participants recorded motion-related symptoms and related discomfort on the Simulator Sickness Questionnaire. Utility measures included the end-user’s ability to be fully immersed in the virtual space, interact with virtual objects, find hardware user friendly, and easily navigate the Joviality program with the System Usability Scale.ResultsMean age was 55.3 (±13.1) years; 80% male; 60% Black; and mean dialysis vintage was 3.56 (±3.75) years. At the first session, there were significant decreases in treatment and/or motion-related symptoms after VR exposure (22.6 versus 11.2; P=0.03); scores >20 indicate problematic immersion. Hemodialysis end-users reported high levels of immersion in the VR environment and rated the software easy to operate, with average System Usability Scale scores of 82.8 out of 100.ConclusionsPatients on hemodialysis routinely suffer from fatigue, nausea, lightheadedness, and headaches that often manifest during their dialysis sessions. Our Joviality VR program decreased symptom severity without adverse effects. VR programs may be a safe platform to improve the experience of patients on dialysis.

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7

Kalinin, R. E., I. A. Suchkov, A. A. Egorov, and E. A. Klimentova. "Endothelial dysfunction in patients on program hemodialysis." Regional blood circulation and microcirculation 19, no. 1 (April 6, 2020): 17–21. http://dx.doi.org/10.24884/1682-6655-2020-19-1-17-21.

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8

Kalinin, R. E., I. A. Suchkov, A. A. Egorov, N. N. Nikulina, and A. A. Nikiforov. "ENDOTHELIAL DYSFUNCTION IN PROGRAM HEMODIALYSIS-DEPENDENT PATIENTS." Nauka molodykh (Eruditio Juvenium) 7, no. 1 (March 30, 2019): 79–85. http://dx.doi.org/10.23888/hmj20197179-85.

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9

Bennett, Paul N., Leo Breugelmans, Robert Barnard, Megan Agius, Danwin Chan, Doug Fraser, Liz McNeill, and Lauren Potter. "Sustaining a Hemodialysis Exercise Program: A Review." Seminars in Dialysis 23, no. 1 (January 2010): 62–73. http://dx.doi.org/10.1111/j.1525-139x.2009.00652.x.

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10

Rezaei, Jahangir, Alireza Abdi, Mansour Rezaei, Jafar Heydarnezhadian, and Rostam Jalali. "Effect of Regular Exercise Program on Depression in Hemodialysis Patients." International Scholarly Research Notices 2015 (January 6, 2015): 1–6. http://dx.doi.org/10.1155/2015/182030.

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Background and Aim. Depression is the most common psychological disorder in hemodialysis patients which decreases their quality of life and increases the mortality. This study was conducted to assess the effect of regular exercise on depression in hemodialysis patients. Methods. In a randomized clinical trial, 51 hemodialysis patients were allocated in two groups. Beck Depression Inventory (BDI) scale was used to assessing depression rate in participants. Designed program was educated using poster and face-to-face methods for case group. Intervention was carried out three times a week for ten weeks. At the beginning and the end of the study, depression rate of the subjects was assessed. Data was analyzed by SPSS16 software and descriptive and inferential statistics. Findings. According to the results of this study, there were no differences between case and control groups in depression rate at the beginning of the study, but there was significant difference after intervention P=0.016. In the beginning of the study, the mean and SD of depression in case group were 23.8±9.29 and reduced to 11.07±12.64 at the end P<0.001. Conclusion. The regular exercise program could reduce the depression in hemodialysis patients; therefore it is suggested for training this program for hemodialysis patients. This trial is registered with Iranian Registry of Clinical Trial (IRCT) number IRCT201205159763N1.

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11

CONTRERAS RIOS, Rafael, and Abdías HURTADO ARESTEGUI. "Evaluación de disfunción autonómica en pacientes con insuficiencia renal crónica en programa de hemodiálisis." Revista Medica Herediana 9, no. 3 (June 10, 2013): 98. http://dx.doi.org/10.20453/rmh.v9i3.579.

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Objective: To determine the frequency of autonomic dysfunction and associated factors in patients with chronic renal failure in hemodialysis program. Material and methods: A case-control study we evaluated 30 patients in hemodialysis program and equal number of healthy volunters, using the heart rate variability test during deep breathing. Results: In hemodialysis group, twenty two patients (80%) had autonomic dysfunction, 67% were asimptomatics. In control group only two patients had autonomic dysfunction (6.7%). In both groups, we found positive correlation than age with autonomic dysfunction stage. Conclusion: Autonomic dysfunction is a frequent complication in hemodialysis patients; it’s frequently asymptomatic and it has age relationship.

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12

Lysyanska, О. U. "LEVEL ESTIMATION OF BLOOD SATURATION AT PATIENTS WITH CHRONIC KIDNEY DISEASE ON THE PROGRAM HEMODIALYSIS." Ukrainian Journal of Nephrology and Dialysis, no. 3(55) (December 12, 2017): 80–83. http://dx.doi.org/10.31450/ukrjnd.3(55).2017.10.

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Patients with chronic kidney disease, who are on outpatient program of hemodialysis treatment, have a risk of development of intradialysis chronic hypoxemia (hypoxemia, that appears during the hemodialysis), that appears during the program dialysis treatment. Aim: identifying of patients with Chronic kidney disease with decrease of the percentage oxyhemoglobin content in arterial blood during hemodialysis. Materials and Methods. Participated 91 patients with Chronic kidney disease on the program hemodialysis, who were monitored under the non-invasive method of pulsoximetry of blood saturation. Results. During the research was found that the first group of patients with initial normal medical parameters (SpO2 within the normal range 95-99%) consisted 57 patients (62,6% from the general quantity); to the second group (SpO2 within 90-94%) (including,16 patients, medical parameters of whom were changed with time) belonged 21 patients (23,1%); to the third group (SpO2 range less than 90%) belonged 14 patients (15,4%) (13 of whom came to third group from second and one person got into this group with the previously normal medical parameters). Conclusion. Part of the patients on program hemodialysis may occur the blood saturation fluctuation, with exposure of hypoxemia conditions, that may worsen the prognosis and increase the complication of the disease.

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13

Tawney, Katherine W., Paul J. W. Tawney, Gerald Hladik, Susan L. Hogan, Ronald J. Falk, Charlotte Weaver, Dominic T. Moore, and Michael Y. Lee. "The life readiness program: A physical rehabilitation program for patients on hemodialysis." American Journal of Kidney Diseases 36, no. 3 (September 2000): 581–91. http://dx.doi.org/10.1053/ajkd.2000.16197.

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14

Babaev, F. "Implementation of State Programs to Reduce Chronic Kidney Failure in Azerbaijan." Bulletin of Science and Practice 6, no. 4 (April 15, 2020): 147–52. http://dx.doi.org/10.33619/2414-2948/53/18.

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In the general structure of chronic renal failure, up to 40% is terminal chronic renal failure requiring replacement renal therapy, particularly hemodialysis, peritoneal dialysis, and kidney transplantation. Azerbaijan has an annual increase in the number of patients with chronic renal failure by 10–12 per cent. In 2006, the State Program of Measures for Chronic Renal Failure 2006–2011 was adopted to reduce the prevalence and improve the quality of treatment for chronic renal failure. The implementation of this program allowed to create a state register of patients with chronic renal failure, expand the network of hemodialysis centers, increase availability in medicines, use modern methods of early diagnosis and prevention of chronic renal failure. In order to further improve nephrological assistance, the second stage of the State Program for the Reduction of Chronic Renal Insufficiency in Azerbaijan for 2011–2016 years has been adopted. The effectiveness of Program to reduce chronic renal insufficiency in Azerbaijan has been demonstrated by the improvement of the quality of medical care, the increase in life expectancy and the reduction of mortality. It should be noted that thanks to this Program, the number of patients receiving hemodialysis per 21.0–25.0% increases annually. In 2010, the Republican Clinical Urological Hospital opened a kidney transplant center. The main objectives of the Program are to reduce mortality from chronic renal failure, Increasing hemodialysis centers according to the number of patients with chronic renal failure and kidney transplant operations. In 2016, the State Program of chronic renal failure for 2016–2020 was adopted. Some progress has been made during the implementation of the State Program. In many parts of the Azerbaijan, the population is provided with dialysis assistance free of charge from the State budget. By January 1, 2020, there are 3 kidney transplantation centers and 45 hemodialysis centers equipped with 716 dialysis devices.

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Zurnadzh’yantс, Viktor A., Eldar A. Kchibekov та Kazim G. Gasanov. "Role of β2-microglobulin and lactoferrin in differential diagnosis of uremic pseudoperitonitis and peritonitis in patients with renal replacement therapy (program hemodialysis)". Bulletin of the Russian Military Medical Academy 23, № 4 (15 грудня 2021): 79–84. http://dx.doi.org/10.17816/brmma64904.

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The significance of the serum concentrations of 2-microglobulin and lactoferrin of the patients on a renal replacement therapy (program hemodialysis) for differential diagnosis of uremic pseudoperitonitis and peritonitis is considered. The study included 56 patients with a suspected peritonitis, admitted urgently to the hospital, who received renal replacement therapy (programmed hemodialysis) in the history. The control group included 50 outpatients on a programmed hemodialysis. The study did not include patients with suspected peritonitis who did not receive programmed hemodialysis in the history. Serum concentrations of 2-microglobulin and lactoferrin were determined in the test groups. Serum 2-microglobulin concentration was found to be statistically higher than the normal in all the patients receiving a history of program hemodialysis procedures. The highest statistically significant concentration of 2-microglobulin was detected in patients with the suspected uremic pseudoperitonitis, both compared to the control group and the group of the patients with diagnosed peritonitis. The highest statistically significant concentration of lactoferrin was detected in patients with the suspected peritonitis receiving a history of program hemodialysis procedures, which is significantly higher both compared to the control group and the patients with a suspected uremic pseudoperitonitis. In the control group of outpatient patients receiving program hemodialysis procedures, no statistically significant differences in serum concentrations of 2-microglobulin and lactoferrin were detected. A statistically significant increase in the concentration of 2-microglobulin was found in uremic pseudoperitonitis, and lactoferrin in peritonitis. The obtained data do not exclude the possibility of using 2-microglobulin to diagnose the uremic pseudoperitonitis, and lactoferrin with a high probability makes it possible to establish the fact of peritonitis.

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Murea, Mariana, and Kamyar Kalantar-Zadeh. "Incremental and Twice-Weekly Hemodialysis Program in Practice." Clinical Journal of the American Society of Nephrology 16, no. 1 (September 22, 2020): 147–49. http://dx.doi.org/10.2215/cjn.04170320.

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17

Butterly, David W. "A Quality Improvement Program for Hemodialysis Vascular Access." Advances in Renal Replacement Therapy 1, no. 2 (July 1994): 163–66. http://dx.doi.org/10.1016/s1073-4449(12)80047-1.

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18

Troidle, Laura, Mark Hotchkiss, and Fredric Finkelstein. "A Thrice Weekly In-Center Nocturnal Hemodialysis Program." Advances in Chronic Kidney Disease 14, no. 3 (July 2007): 244–48. http://dx.doi.org/10.1053/j.ackd.2007.03.002.

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19

Ritz, Sally. "Pediatric hemodialysis and peritoneal dialysis: Report rewards program." Journal of Renal Nutrition 12, no. 3 (July 2002): 199–204. http://dx.doi.org/10.1053/jren.2002.33849.

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20

Radford, M. Gene, Debra S. Shultman, Anna G. Pasour, Anne M. Cobb, and Joseph T. Chandler. "An Incenter Nocturnal Hemodialysis Program-Three Years Experience." Hemodialysis International 7, no. 1 (February 2003): 73–104. http://dx.doi.org/10.1046/j.1492-7535.2003.01231.x.

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21

Koga, Satomi, Nobue Ochiai, Akemi Asao, Masumi Nomura, Youko Hongo, Reiko Shimada, and Hidehisa Soejima. "Evaluation of a teaching program for hemodialysis patients." Journal of Japanese Society for Dialysis Therapy 25, no. 12 (1992): 1369–72. http://dx.doi.org/10.4009/jsdt1985.25.1369.

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22

Honkanen, E., R. Muroma-Karttunen, R. M. Taponen, and C. Grönhagen-Riska. "Starting a Home Hemodialysis Program: Single Center Experiences." Scandinavian Journal of Urology and Nephrology 36, no. 2 (January 2002): 137–44. http://dx.doi.org/10.1080/003655902753679445.

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23

Buur, Tom. "DiaKin: an integrated program package for hemodialysis kinetics." Computer Methods and Programs in Biomedicine 31, no. 3-4 (March 1990): 243–54. http://dx.doi.org/10.1016/0169-2607(90)90009-x.

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24

Shilo, V. Yu Shilo, and I. Yu Drachev Drachev. "New instrumental options for optimizing the hemodialysis program." Nephrology 3_2019 (October 28, 2019): 10–18. http://dx.doi.org/10.18565/nephrology.2019.3.10-18.

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25

Scorza, Carla Alessandra, Ricardo Mario Arida, Roberta Monterazzo Cysneiros, Esper Abrão Cavalheiro, and Fulvio Alexandre Scorza. "Omega-3 intake in people with epilepsy under regular hemodialysis program: here to stay." Arquivos de Neuro-Psiquiatria 71, no. 7 (July 2013): 474–77. http://dx.doi.org/10.1590/0004-282x20130065.

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Among the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Furthermore, it has been established that hemodialysis-associated seizure is a complication of the dialysis procedure. Thus, since a possible relation between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program should not be neglected, we propose in this paper that omega-3 fatty acids offer opportunities for prevention of sudden cardiac death or improved treatment in people with epilepsy under the regular hemodialysis program.

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26

Geary, Denis F., Elizabeth Piva, Mukesh Gajaria, Jennifer Tyrrel, Gail Picone, and Elizabeth Harvey. "DAILY HEMODIALYSIS-SELECTED TOPICS: Development of a Nocturnal Home Hemodialysis (NHHD) Program for Children." Seminars in Dialysis 17, no. 2 (March 29, 2004): 115–17. http://dx.doi.org/10.1111/j.0894-0959.2004.17207.x.

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Papini, Adam, Braden J. Manns, and Meghan J. Elliott. "Evaluation of the Cost of a High-Dose Intravenous Iron Protocol in a Regional Hemodialysis Program: Research Letter." Canadian Journal of Kidney Health and Disease 8 (January 2021): 205435812110639. http://dx.doi.org/10.1177/20543581211063984.

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Background: Intravenous (IV) iron and erythropoietin stimulating agents (ESAs) are standard treatments for anemia in patients receiving maintenance hemodialysis. These medications are associated with significant costs to hemodialysis programs and patients. Recent trial evidence demonstrated that a high-dose IV iron protocol reduces ESA usage and improves cardiovascular outcomes. The cost of implementing a high-dose iron protocol within the Canadian public healthcare context remains unknown. Objective: Our primary aim was to estimate the costs of a high-dose IV iron protocol in a large Canadian hemodialysis program that currently uses a low-dose and reactive IV iron strategy. Our secondary aim was to estimate the reduction in ESA use required to maintain cost neutrality with a high-dose IV iron protocol. Design: In this modeling study of IV iron and ESA utilization from a regional hemodialysis program, changes in medication utilization were calculated based on observed effects from published trial data. Using data from a quality improvement audit of regional anemia management and medication utilization, we estimated potential cost differences under various modeling conditions. Setting: Four adult hospital-based and 9 community in-center hemodialysis units in the Alberta Kidney Care—South renal program during the observation period of September 1, 2018, to November 30, 2018. Patients: In total, data from 826 patients were included. Measurements: Mean monthly IV iron and ESA doses were obtained from routine audit data captured within an electronic medical record. Costs were determined from provincially negotiated medication prices. Methods: Current IV iron and erythropoietin dosages were aggregated at the hemodialysis unit level. We used the results from the PIVOTAL trial to estimate the expected increase in IV iron dose and reduction in ESA dose with a high-dose IV iron protocol. We assumed the split between various manufactures of IV iron and ESA were maintained in our cost model. Total medication costs were aggregated by hemodialysis unit, and the mean costs in each unit were used to estimate per-patient costs. Sensitivity analyses included models that assumed 100% IV iron sucrose usage, as well as models where community hemodialysis units and hospital-based hemodialysis units were examined separately. Finally, we calculated a break-even point for ESA dose reduction required to maintain cost neutrality. Results: Actual baseline IV iron and ESA dose utilization across 13 adult HD units were 118 mg/patient/month (95% confidence interval [CI]: 102-134 mg) and 20,764 IU/pt./mo. (95% CI: 18,104-23,424 IU), respectively. The mean combined cost of ESA and IV iron was $315/pt./mo. (95% CI: $274-$355). In comparison, using the results of the PIVOTAL trial and assuming a high-dose IV iron scenario, we estimated mean IV iron use of 215 mg/pt./mo. (95% CI: 187-243 mg/pt./mo.) and a reduction in mean ESA use to 15,923 IU/pt./mo. (95% CI: 13,883-17,962 IU/pt./mo.). This resulted in an estimated cost savings of $38/pt./mo. (95% CI: $33–$42/pt./mo.) and a total program savings of $370,000 per year (95% CI: $325,000-$420,000). Sensitivity analyses under various alternate conditions also showed potential cost savings. We estimated that a dose reduction of ESA of 10% would be required for cost neutrality with a high-dose IV iron protocol. Limitations: Our study is limited in its use of data from a single randomized controlled trial (RCT) to estimate cost savings rather than actualized utilization. Our models do not take into consideration anticipated reductions in transfusions and hospitalizations that could be realized from a high-dose IV iron protocol. Conclusions: Based on cost modeling, a high-dose IV iron protocol could be integrated in large Canadian regional hemodialysis program in a cost saving manner. Programs implementing such a protocol should monitor IV iron and EPO use prospectively to determine if the trial protocol as applied in a real-world setting translates into cost savings.

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Husain, Fida', Henni Kusuma, and Andrew Johan. "Effects of Peer Support Program on Self-Management in Patients with End-Stage Renal Disease Undergoing Hemodialysis." Nurse Media Journal of Nursing 10, no. 2 (August 21, 2020): 171–81. http://dx.doi.org/10.14710/nmjn.v10i2.26502.

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Background: End-stage renal disease (ESRD) patients undergoing hemodialysis require essential self-management to lifestyle changes to minimize the risk of complications, morbidity, and mortality. Efforts made to improve self-management of hemodialysis patients in previous studies were carried out by health workers that may not provide 'real' knowledge, while peer support programs carried out by patients as peers to share their experiences may provide more benefits.Purpose: The purpose of this study was to determine the effects of peer support programs on improving self-management in patients with ESRD undergoing hemodialysis.Methods: This study employed a quasi-experimental design and involved a total of 33 patients in the control group and 32 patients in the intervention group, who met the inclusion and exclusion criteria. The samples were recruited consecutively. The intervention of peer support programs was implemented through information support, emotional support, and mutual reciprocity in groups of 10-12 people to share experiences related to their self-management. The intervention was given for six sessions; each lasted for 30-45 minutes. The data were collected using the Indonesian version of the hemodialysis self-management instrument (HDSMI) and analyzed using a paired-sample t-test and independent-sample t-test.Results: The results showed that after the intervention, the mean score of self-management in the intervention group increased from 79.47±7.919 to 90.75±7.089, and in the control group, the mean increased from 81.88±8.291 to 82.12±7.692. After the implementation of peer support programs, there was a significant difference in the score of self-management between the intervention and control groups (p<0.001).Conclusion: Peer support programs gave an effect on increasing self-management in patients with ESRD undergoing hemodialysis. Peer support programs should be introduced early to ESRD patients undergoing hemodialysis so that they can learn about self-management from other patients.

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D’Agata, Erika M. C., Curt C. Lindberg, Claire M. Lindberg, Gemma Downham, Brandi Esposito, Douglas Shemin, and Sophia Rosen. "The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities." Infection Control & Hospital Epidemiology 39, no. 12 (September 26, 2018): 1400–1405. http://dx.doi.org/10.1017/ice.2018.237.

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AbstractBackgroundAntimicrobial stewardship programs are effective in optimizing antimicrobial prescribing patterns and decreasing the negative outcomes of antimicrobial exposure, including the emergence of multidrug-resistant organisms. In dialysis facilities, 30%–35% of antimicrobials are either not indicated or the type of antimicrobial is not optimal. Although antimicrobial stewardship programs are now implemented nationwide in hospital settings, programs specific to the maintenance dialysis facilities have not been developed.ObjectiveTo quantify the effect of an antimicrobial stewardship program in reducing antimicrobial prescribing.Study design and settingAn interrupted time-series study in 6 outpatient hemodialysis facilities was conducted in which mean monthly antimicrobial doses per 100 patient months during the 12 months prior to the program were compared to those in the 12-month intervention period.ResultsImplementation of the antimicrobial stewardship program was associated with a 6% monthly reduction in antimicrobial doses per 100 patient months during the intervention period (P=.02). The initial mean of 22.6 antimicrobial doses per 100 patient months decreased to a mean of 10.5 antimicrobial doses per 100 patient months at the end of the intervention. There were no significant changes in antimicrobial use by type, including vancomycin. Antimicrobial adjustments were recommended for 30 of 145 antimicrobial courses (20.6%) for which there were sufficient clinical data. The most frequent reasons for adjustment included de-escalation from vancomycin to cefazolin for methicillin-susceptible Staphylococcus aureus infections and discontinuation of antimicrobials when criteria for presumed infection were not met.ConclusionsWithin 6 hemodialysis facilities, implementation of an antimicrobial stewardship was associated with a decline in antimicrobial prescribing with no negative effects.

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Lewis, Rachel A., Karen M. Benzies, Jennifer MacRae, Chandra Thomas, and Marcello Tonelli. "An Exploratory Study of Person-Centered Care in a Large Urban Hemodialysis Program in Canada Using a Qualitative Case-Study Methodology." Canadian Journal of Kidney Health and Disease 6 (January 2019): 205435811987153. http://dx.doi.org/10.1177/2054358119871539.

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Background: Person-centered care (PCC) can benefit patients, clinical staff, and health care organizations, but has not yet been widely adopted into practice. Hemodialysis is a unique care environment in which clinical staff can be involved with patients for protracted periods of time each week and often over a number of years. While kidney care is arguably more holistic than other chronic condition management programs, most patients requiring hemodialysis do not receive care that is optimally person-centered. Objective: The purpose of this research was to explore how care is experienced and provided in a large urban hemodialysis program in western Canada in relation to key principles of PCC. In addition, we wanted to understand what factors at an individual, unit, and organizational level facilitate or inhibit PCC in this environment. Methods: We used a qualitative case-study approach to explore multiple perspectives of care provision using a number of data sources including semi-structured interviews with patients, family members, clinical staff, and administrative staff, as well as observing patterns of clinical practice in local hemodialysis units. Findings: In our study of a single hemodialysis program, we found limited evidence of PCC. Overall, patients reported that their care was good and they had positive relationships with their care team. However, they did not feel involved in decisions regarding their care or consider it to be individualized. In general, providers acknowledged the potential benefits of PCC but were constrained in their practice by a number of factors, including individual perceptions of their role, a prescriptive care environment, and an organizational focus on managing demand. Conclusions: Evidence of PCC within hemodialysis services was limited, with a number of individual, unit level, and organizational barriers mitigating against its adoption and spread.

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Tarigan, Amira Permata Sari, Endang Susilawati, and Chandra F. Zendrato. "FAKTOR-FAKTOR YANG MEMENGARUHI KEPATUHAN DIET PASIEN GAGAL GINJAL KRONIK YANG MENDAPAT TERAPI HEMODIALISA DI RUANG HEMODIALISA RSUD Dr. PIRNGADI KOTA MEDAN TAHUN 2015." Jurnal Ilmiah PANNMED (Pharmacist, Analyst, Nurse, Nutrition, Midwivery, Environment, Dentist) 10, no. 3 (November 5, 2018): 272–81. http://dx.doi.org/10.36911/pannmed.v10i3.114.

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Chronic kidney failure patients treated by hemodialysis therapy should be consistent in participating in dieting program in order to forestall the incidence of nutrition deficiency, liquid and electrolyte imbalance, and the incidence of the excessive accumulation of metabolism residual. Compliance in dieting program is one of the factors which contribute to the success or failure in hemodialysis therapy. The objective of the research was to find out some factors which influenced compliance in dieting of chronic kidney failure patients who got hemodialysis therapy in Hemodialysis Room of RSUD dr. Pirngadi, Medan. The research used descriptive method with cross sectional design. The samples were 35 respondents, taken by using purposive sampling technique. The instruments of the research were questionnaires and food recall. The result of the research showed that 19 respondents (54.3%) did not quite understand the instruction, 26 respondents (74.3%) had good interaction, 21 respondents (60%) lack of support, 31 respondents (88.6%) did not comply with dieting program, and 4 respondents (11.4%) complied with dieting program. The factor which influenced the compliance of the majority of patients was interaction quality. Patients had good understanding in instruction, good interaction quality, and family support. Only a small number of patients complied with dieting. Patients’ awareness of diet is very important. The majority of patients did not comply with dieting program.

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Hassan Abd Elhameed, Soad, and Doaa El Sayed Fadila. "Effect of Exercise Program on Fatigue and Depression among Geriatric Patients Undergoing Hemodialysis." International Journal of Advanced Nursing Studies 8, no. 2 (July 22, 2019): 23. http://dx.doi.org/10.14419/ijans.v8i2.29316.

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Background: Fatigue is one of the foremost common complications faced the hemodialysis elderly patients. Fatigue not only impact the daily lives and activities of patients but it conjointly influences their quality of life, which can afterwards result in magnified depression, tiny social interactions and increase dependency on others.Aim: Determine the effect of exercise program on fatigue and depression among geriatric patients undergoing hemodialysis.Design: Randomized controlled trial (pretest post-test) design was used.Setting: The study was carried out in the dialysis units of Mansoura University Hospital and New Mansoura General Hospital.Subjects: A purposive sample of 62 geriatric patients undergoing hemodialysis was selected and randomly allocated into two equal groups, study group (n = 31) and control group (n =31).Tools: Three tools were used; Structured interview questionnaire sheet, Multidimensional Fatigue Inventory Scale and Geriatric Depression Scale Short Form.Results: The mean age of the study and control groups was 63.45±4.49 and 64.7±5.25 respectively. A high statistically significant change in fatigue and depression score (pre and post 2 months) between the study and the control groups was observed (P=0.000). Moreover, a statistically significant relation was observed between fatigue and age of the hemodialysis geriatric patients after implementation of the exercise program (P= 0.002).Conclusion: Implementation of the exercise program proved to be effective in improving the level of fatigue and depression among geriatric patients undergoing hemodialysis in the study group.Recommendation: Encourage geriatric patients undergoing hemodialysis to perform regularly range of motion and relaxation exercises in order to alleviate fatigue and overcome depression.

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Giuliano, KK, and EE Pysznik. "Renal replacement therapy in critical care: implementation of a unit-based continuous venovenous hemodialysis program." Critical Care Nurse 18, no. 1 (February 1, 1998): 40–51. http://dx.doi.org/10.4037/ccn1998.18.1.40.

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Implementing a program as complex as continuous venovenous hemodialysis without the involvement of nephrology nurses is a challenge. However, with proper planning, appropriate staff support, and the ability to make changes as implementation proceeds, a successful program can be developed. Our reward is that we are now able to offer a therapy that is important and potentially lifesaving to those critically ill patients with renal failure who are unable to tolerate intermittent hemodialysis.

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Soliman, Amin R., Mohamed Momtaz Abd Elaziz, and Mona I. El lawindi. "Evaluation of an Isolation Program of Hepatitis C Virus Infected Hemodialysis Patients in Some Hemodialysis Centers in Egypt." ISRN Nephrology 2013 (October 31, 2013): 1–5. http://dx.doi.org/10.5402/2013/395467.

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Introduction. Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in hemodialysis (HD) patients. Several studies demonstrated nosocomial transmission of HCV among HD patients. Aim. We aimed to evaluate the isolation program of HCV seropositive patients among a group of Egyptian haemodialysis patients to decrease the incidence of HCV seroconversion. Methods. One hundred and fourteen HCV seronegative patients who were receiving regular haemodialysis in different four haemodialysis units in Egypt. The first group included forty six patients on regular hemodialysis in two centers following strict isolation of the HCV seropositive patients, and the second group included sixty eight patients on regular hemodialysis in the other two centers not following this strict isolation. All these patients were followed up over a period of 36 months. Results. There was a significantly higher incidence of HCV seroconversion of patients on hemodialysis in units not following strict isolation of HCV seropositive patients (42.9%) than those on regular hemodialysis in units following strict isolation (14.8%). Conclusions. In HD units with a high prevalence of HCV+ patients, strict isolation of HCV+ patients in combination with implementation of universal prevention measures can limit the spread of HCV infection in HD patients.

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D’Agata, Erika M. C., Diana Tran, Josef Bautista, Douglas Shemin, and Daniel Grima. "Clinical and Economic Benefits of Antimicrobial Stewardship Programs in Hemodialysis Facilities." Clinical Journal of the American Society of Nephrology 13, no. 9 (August 23, 2018): 1389–97. http://dx.doi.org/10.2215/cjn.12521117.

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Background and objectivesInfections caused by multidrug-resistant organisms and Clostridium difficile are associated with substantial morbidity and mortality as well as excess costs. Antimicrobial exposure is the leading cause for these infections. Approximately 30% of antimicrobial doses administered in outpatient hemodialysis facilities are considered unnecessary. Implementing an antimicrobial stewardship program in outpatient hemodialysis facilities aimed at improving prescribing practices would have important clinical and economic benefits.Design, setting, participants, & measurementsWe developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The main outcomes were total antimicrobial use, infections caused by multidrug-resistant organisms and C. difficile, infection-related mortality, and total costs. The analysis considered all patients on outpatient hemodialysis in the United States. The value of implementing antimicrobial stewardship programs, assuming a 20% decrease in unnecessary antimicrobial doses, was calculated as the incremental differences in clinical end points and cost outcomes. Event probabilities, antimicrobial regimens, and health care costs were informed by publicly available sources.ResultsOn a national level, implementation of antimicrobial stewardship programs was predicted to result in 2182 fewer infections caused by multidrug-resistant organisms and C. difficile (4.8% reduction), 629 fewer infection-related deaths (4.6% reduction), and a cost savings of $106,893,517 (5.0% reduction) per year. The model was most sensitive to clinical parameters as opposed to antimicrobial costs.ConclusionsThe model suggests that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.

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Walton, Ted, Katherine P. Holloway, and Michael D. Knauss. "Pharmacist-Managed Anemia Program in an Outpatient Hemodialysis Population." Hospital Pharmacy 40, no. 12 (December 2005): 1051–56. http://dx.doi.org/10.1177/001857870504001206.

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André, Mauro B., Simone M. Rembold, Claudia M. Pereira, and Jocemir R. Lugon. "Prospective Evaluation of an In-Center Daily Hemodialysis Program." American Journal of Nephrology 22, no. 5-6 (2002): 473–79. http://dx.doi.org/10.1159/000065280.

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Hryciw, E., M. Courtney, N. Herian, L. Wales, C. Bainey, C. Adams, and J. Foster. "Establishing a Home Nocturnal Hemodialysis Program: “Starting From Scratch”." Hemodialysis International 8, no. 1 (January 23, 2004): 98. http://dx.doi.org/10.1111/j.1492-7535.2004.0085ba.x.

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Dashtidehkordi, Alireza, Nahid Shahgholian, and Jaleh Sadeghian. "The effect of exercise during hemodialysis on serum levels of albumin, calcium, phosphorus and parathyroid hormone: a randomized clinical trial." Journal of Preventive Epidemiology 7, no. 1 (November 4, 2021): e09-e09. http://dx.doi.org/10.34172/jpe.2022.09.

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Introduction: Disorders in the levels of blood electrolytes are often considered as complications of kidney illnesses which are responsible for various systemic problems experienced by patients. Objectives: The aim of this study was to investigate the efficiency of an exercise program during hemodialysis on serum levels of biochemical factors such as albumin, calcium, phosphorus and intact parathyroid hormone (iPTH). Patients and Methods: Sixty patients undergoing hemodialysis were evaluated in the clinical trial. The patients in the intervention group pedaled on a stationary bicycle for one hour in every hemodialysis session for eight weeks. At the beginning of the study and at the end of it, the patients’ blood samples were sent to hospital’s laboratory to measure the levels of biochemical factors in blood. Data were analyzed by SPSS software. Results: The serum levels of electrolytes showed no significant improvement between the study groups before and after the exercise program (P>0.05). A significant improvement was observed after the program in serum phosphorus and iPTH (P=0.04). In contrast, serum albumin (P=0.3) and calcium (P=0.5) did not alter significantly after the exercise program. Conclusion: Exercise improved some biochemical factors of blood in the patients undergoing hemodialysis. Exercise is therefore a complementary procedure for these patients. Trial Registration: The trial protocol was approved in the Iranian Registry of Clinical Trial (#IRCT20150116020675N4; https://en.irct.ir/trial/50492, ethical code# IR.MUI.MED.REC.1399.212).

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Sadowski, R. H., E. N. Allred, and K. Jabs. "Sodium modeling ameliorates intradialytic and interdialytic symptoms in young hemodialysis patients." Journal of the American Society of Nephrology 4, no. 5 (November 1993): 1192–98. http://dx.doi.org/10.1681/asn.v451192.

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Despite advances in the delivery of hemodialysis, significant dialytic morbidity persists. Sodium modeling in older adults has been shown to decrease some dialytic symptoms, but clear benefits in young patients without coexisting diabetes or advanced cardiovascular disease have not been shown. The effects of sodium modeling were evaluated in 16 adolescent and young adult hemodialysis patients (16 to 32 yr of age) treated with conventional hemodialysis for a median of 11.5 months. The 8-wk study was divided into four 2-wk blocks. During each block, one of three sodium programs or a constant (control) dialysate sodium of 138 mEq/L was used. During each sodium program, the initial dialysate sodium of 148 mEq/L was decreased by an exponential, linear, or step program to 138 mEq/L. Treatments with sodium modeling were significantly better than those with constant sodium dialysate. When all sodium programs were grouped and compared with constant dialysate sodium, the odds of improvement in dialytic cramps, headaches, and nausea were 1.8, 2.1, and 3.9, respectively (P < 0.05). Sodium modeling also significantly decreased the frequency of postdialysis hypotension and interdialytic fatigue, dizziness, and muscle cramping (P < 0.05). No differences were seen among the sodium protocols in the incidence of symptomatic hypotension, the amount of normal saline administered, the degree of hemo-concentration during treatments, or the decrease in serum osmolality. There was no increase in pretreatment or posttreatment serum sodium concentrations, interdialytic thirst, weight gain, or hypertension. Sodium modeling dramatically decreases both intradialytic and interdialytic morbidity in young hemodialysis patients. There was no increase in adverse events associated with sodium modeling.

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Purnawinadi, I. Gede. "PERAN HEMODIALISIS TERHADAP KADAR KREATININ DARAH PASIEN GAGAL GINJAL KRONIK." Klabat Journal of Nursing 3, no. 1 (April 30, 2021): 28. http://dx.doi.org/10.37771/kjn.v3i1.534.

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Hemodialisis merupakan terapi pengganti fungsi ginjal berteknologi tinggi dalam upaya mengeluarkan sisa-sisa metabolisme atau racun tertentu dari peredaran darah dengan tujuan utama menghilangkan gejala dengan mengendalikan kadar ureum dan kreatinin dalam darah, kelebihan cairan dan ketidakseimbangan elektrolit yang terjadi pada pasien dengan kondisi gagal ginjal kronik. Penelitian ini bertujuan menambah pemahaman tentang peran dan manfaat hemodialisis melalui analisis perbandingan kadar kreatinin serum pre dan post hemodialisis pada pasien gagal ginjal kronik di unit hemodialisa RSUP. Prof. DR. R. D. Kandou Manado. Metode penelitian yang dilakukan adalah kuantitatif komparatif dengan pendekatan cross sectional. Pengambilan sampel menggunakan teknik purposive sampling. Data yang terkumpul akan diolah dan dianalisis menggunakan komputer program microsoft excel dan program Statistical Product and Service Solutions (SPSS). Data dianalisis secara univariat mencari nilai rata-rata dan analisis bivariat dengan paired sample t-test. Hasil penelitian membuktikan hemodialisis mempunyai pengaruh yang signifikan dalam upaya menurunkan kadar kreatinin darah yang berlebihan pada pasien dengan gagal ginjal kronik (p=0,000<0,005). Untuk penelitian selanjutnya terkait peran hemodialisis diharapkan dapat menganalisis variabel lainnya seperti kadar ureum dan lain-lain sebagai indikator fungsi ginjal. Kata kunci: hemodialisis, kreatinin, gagal ginjal kronik Hemodialysis is a substitute therapy for high-tech kidney function in an effort to remove metabolic remnants or certain poisons from the bloodstream with the main goal of relieving symptoms by controlling ureum and creatinine levels in the blood, fluid overload, and electrolyte imbalance that occurs in patients with chronic kidney failure. This study aims to increase understanding of the role and benefits of hemodialysis through a comparative analysis of serum creatinine levels pre and post hemodialysis in patients with chronic renal failure in the hemodialysis unit of the General Hospital. Prof. DR. R. D. Kandou Manado. The research method used is comparative quantitative with cross-sectional approach. Sampling using a purposive sampling technique. The collected data is processed and analyzed using Microsoft Excel computer programs and Statistical Product and Service Solutions (SPSS) programs. Data were analyzed univariately by looking for mean and bivariate analysis with paired sample t-tests. The results showed that hemodialysis had a significant effect in reducing excessive blood creatinine levels in patients with chronic renal failure (p = 0.000 <0.005). For further research related to the role of hemodialysis, it is hoped that other variables can be analyzed such as urea levels and others as indicators of kidney function. Keywords: hemodialysis, creatinine, chronic renal failure

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Chang, AeKyung, YoonChung Chung, and MoonJa Kang. "Effects of the Combination of Auricular Acupressure and a Fluid-Restriction Adherence Program on Salivary Flow Rate, Xerostomia, Fluid Control, Interdialytic Weight Gain, and Diet-Related Quality of Life in Patients Undergoing Hemodialysis." International Journal of Environmental Research and Public Health 18, no. 19 (October 7, 2021): 10520. http://dx.doi.org/10.3390/ijerph181910520.

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Adherence to fluid-restriction is a clinical priority in nephrology care. This study examines the effects of a combination of auricular acupressure (AA) and a fluid-restriction adherence program on the salivary flow rate, xerostomia, fluid control, interdialytic weight gain (IDWG), and diet-related quality of life (DQOL) among hemodialysis patients in South Korea. Using a quasi-experimental design, 84 hemodialysis patients were assigned to the experimental group (AA + fluid-restriction adherence program; n = 29), the comparison group (fluid-restriction adherence program; n = 27), and the control group (usual care; n = 28). The program lasted 6 weeks, and data were collected at baseline, immediately after the intervention, and 4 months post-intervention. There was a significant interaction between group and time for salivary flow rate, fluid control, IDWG, and DQOL (all p < 0.005). Compared with the control group, the experimental group had a significantly improved salivary flow rate, fluid control, IDWG, and DQOL at weeks 6 and 22, whereas the comparison group had improved fluid control and DQOL at week 6. The combination of AA and a fluid-restriction adherence program could be provided to hemodialysis patients as cost-effective, safe, and complementary interventions to promote sustainable patient adherence to fluid-restriction.

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Parker, Kristen, Xin Zhang, Adriane Lewin, and Jennifer M. MacRae. "The association between intradialytic exercise and hospital usage among hemodialysis patients." Applied Physiology, Nutrition, and Metabolism 40, no. 4 (April 2015): 371–78. http://dx.doi.org/10.1139/apnm-2014-0326.

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Hemodialysis (HD) patients have high hospitalization rates. Benefits of intradialytic exercise have been proven in numerous studies yet exercise programs are still rarely used in the treatment of end-stage kidney disease (ESKD). Our objective was to determine if there was an association between a 6-month intradialytic bicycling program and hospitalization rates and length of stay (LOS) in ESKD patients. This was a retrospective cohort study that took place 6 months prior to and 6 months during an intradialtyic exercise program at an outpatient HD unit in Calgary, Alberta, Canada. Participants comprised 102 patients who had commenced HD <6 months (incident) or >6 months (prevalent) prior to starting exercise. The intervention comprised a 6-month intradialytic bicycling program. Main outcome measures were hospitalization rate, cause of hospitalization, and LOS. Patients were predominantly male (67.6%) aged 65.6 ± 13.5 years and median HD vintage 1 year (range: 0–12). Comorbidities included diabetes mellitus (50%) and cardiac disease (38.2%). The hospitalization incidence rate ratio (IRR) was 0.48 (0.23–0.98; P = 0.04) in incident and 0.89 (0.56–1.42; P = 0.64) in prevalent patients. The LOS decreased from 7.8 (95% confidence interval (CI): 7.3–8.4) to 3.1 (95% CI: 2.8–3.4) days and LOS IRR was 0.39 (0.35–0.45; P < 0.001). The main predictors of hospitalization were lower albumin levels (P = 0.007) and lack of intradialytic exercise program participation (P < 0.001). In conclusion, 6 months of intradialytic exercise was associated with decreased LOS in both incident and prevalent HD patients.

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Kaplan, Barbara, Leslie A. Shimp, Nancy A. Mason, and Frank J. Ascione. "Chronic Hemodialysis Patients. Part II: Reducing Drug-Related Problems through Application of the Focused Drug Therapy Review Program." Annals of Pharmacotherapy 28, no. 3 (March 1994): 320–24. http://dx.doi.org/10.1177/106002809402800304.

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OBJECTIVE: To test the value and measure the impact of a model of pharmacy practice called the Focused Drug Therapy Review Program (FDTRP)in patients with endstage renal disease on hemodialysis. DESIGN: A modified version of FDTRP, adapted for a hemodialysis population, was assessed for its impact on prescriber behavior. The impact was measured by examining the percentage of pharmacist therapeutic recommendations accepted and implemented by the prescriber. SETTING: Thirty patients at a university hospital-based outpatient hemodialysis unit participated in the study. Twenty-four patients completed the study through the implementation evaluation. RESULTS: The pharmacist generated 114 therapeutic recommendations and 85 informative comments regarding drug therapy. The prescriber accepted 76 percent and implemented 70 percent of the therapeutic recommendations. The prescriber considered the informative comments to be helpful, even if the information was known previously. CONCLUSIONS: The FDTRP has been shown to be useful in the care of chronic hemodialysis patients. In addition, the pharmacist was able to provide clinically important recommendations in a closely monitored patient population.

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Yang, Li-Yu, Bih-O. Lee, Kai-Ni Lee, and Chien-An Chen. "Effects of Electrical Stimulation of Acupoints on Xerostomia for Patients Who Undergo Hemodialysis." Healthcare 10, no. 3 (March 9, 2022): 498. http://dx.doi.org/10.3390/healthcare10030498.

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Xerostomia plays a major role in higher interdialytic weight gain (IDWG), which causes cardiovascular complications in patients who undergo hemodialysis. However, few studies have determined a method to manage xerostomia. This study determines the effect of transcutaneous electrical acupoint stimulation (TEAS) on hemodialysis patients with xerostomia and the percentage of IDWG. The study was a single-blind and quasi-experimental study. There are 75 participants: 37 in the TEAS group and 38 in the contrast group. The TEAS group used 250 µs and 50 Hz and the contrast group used 50 µs and 2 Hz three times a week for 3 weeks to stimulate ST 6 and TE17 acupoints. The salivary flow rates, dry mouth, and %IDWG were determined before, during and one week after the program. Compared with the contrast group, the TEAS group showed a significantly improved salivary flow rate (mL/min) (F (2, 123) = 15.28, p < 0.0001), and patients recovered their normal salivary flow rate. However, the results show that both groups showed significant improvement in dry mouth after treatment. The TEAS group demonstrated no effect in terms of %IDWG, as expected. The results show that a TEAS program is an effective means of symptom management for xerostomia patients who undergo hemodialysis. A TEAS program can be used to manage symptoms for xerostomia patients who undergo hemodialysis.

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Szymczak, Anna, Maciej Kanafa, Marcin Chuć, and Mariusz Kusztal. "Heparin-free hemodialysis." Postępy Higieny i Medycyny Doświadczalnej 72 (July 22, 2018): 671–77. http://dx.doi.org/10.5604/01.3001.0012.2055.

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Hemodialysis is the most widely applied renal replacement therapy. Due to the fact that the hemocyte - dialyzer contact leads to the activation of the coagulation pathway, adequate anticoagulation to provide fluent blood flow is crucial. Since the standard parenteral use of heparin is not free from complications and may increase already raised bleeding risk in renal patients, the alternative methods of performing hemodialysis, including heparin-free procedures, are being investigated. These include the usage of anticoagulants regionally in the extracorporeal circuit or repeated saline flushes or other substituting compounds. Citrate module has already become the standard anticoagulant in intensive care for patients on continuous hemofiltration. Its usage in intermittent dialysis program requires some protocol modifications, but it is a valuable input in the development of heparin-free strategies. The other approach that allows reduced heparin usage is the use of an airless dialysis tubing system. Amongst coated dialyzer membranes, the one with heparinized hydrogel polyacrylonitrile was perceived as a significant step forward. Despite the fact that innovative strategies may turn out to be time and resource consuming and not always free of side-effects, they are worth investigating.

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Prasad, Narayan, and Vivekanand Jha. "Hemodialysis in Asia." Kidney Diseases 1, no. 3 (2015): 165–77. http://dx.doi.org/10.1159/000441816.

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Background: Asia is the largest, most populous and most heterogeneous continent in the world. The number of patients with end-stage renal disease is growing rapidly in Asia. Summary: A fully informed report on the status of dialysis therapies including hemodialysis (HD) is limited by the lack of systematic registries. Available data suggest remarkable heterogeneities, with some countries like Taiwan, Japan and Korea exhibiting well-established HD systems, high prevalence and universal access to all patients, while low- and low-middle income countries are unable to provide HD to eligible patients because of high cost and poor healthcare systems. Many Asian countries have unregulated dialysis units, with poor standards of delivery, quality control and outcome reporting. This leads to high mortality due to preventable complications like infections. Modeling data suggest that at least 2.9 million people need dialysis in Asia, which represents a gap in availability of dialysis to the tune of -66%. The population is projected to grow rapidly in the coming years. Several countries are expanding access to HD. Innovative modifications in dialysis practice are being made to optimize outcomes. It is important to develop robust systems of documentation and outcome reporting to evaluate the effects of such changes. HD needs to develop in conjunction with effective preventive programs and improvement of health systems. Key Messages: The practice of HD in Asia is growing and evolving. Rapid expansion will improve the currently dismal access to care for large sections of the population. Quality issues need to be addressed if the full benefit of this therapy is to reach the population. Developed countries of Asia can provide substantial messages to developing economies. HD programs must develop in conjunction with prevention efforts. Facts from East and West: (1) While developed Western and Asian countries provide end-stage renal disease patients full access to HD, healthcare systems from South and South-East Asia can offer access to HD only to a limited fraction of the patients in need. Even though the annual costs of HD are much lower in less developed countries (for instance 30 times lower in India compared to the US), patients often cannot afford costs not covered by health insurance. (2) The recommended dialysis pattern in the West is at least three sessions weekly with high-flux dialyzers. Studies from Shanghai and Taiwan might however indicate a benefit of twice versus thrice weekly sessions. In less developed Asian countries, a twice weekly pattern is common, sometimes with dialyzer reuse and inadequate water treatment. A majority of patients decrease session frequency or discontinue the program due to financial constraint. (3) As convective therapies are gaining popularity in Europe, penetration in Asia is low and limited by costs. (4) In Asian countries, in particular in the South and South-East, hepatitis and tuberculosis infections in HD patients are higher than in the West and substantially increase mortality. (5) Progress has recently been made in countries like Thailand and Brunei to provide universal HD access to all patients in need. Nevertheless, well-trained personnel, reliable registries and better patient follow-up would improve outcomes in low-income Asian countries.

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Ivandić, Ema, Vanja Ivković, Vedran Premužić, Ivan Barišić, Ružica Šmalcelj, Ljubica Bubić Filipi, Nikolina Bašić Jukić, Lea Katalinić, Ana Jelaković, and Bojan Jelaković. "Blood pressure characteristic in patients in a chronic hemodialysis program." Cardiologia Croatica 12, no. 3 (March 2017): 69. http://dx.doi.org/10.15836/ccar2017.69.

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49

Kim, Youngmee, In Sug Chun, and Young Mi Park. "Development of a Hemodialysis Nurse Educational Program and its Effects." Journal of the Korea Academia-Industrial cooperation Society 13, no. 12 (December 31, 2012): 5839–48. http://dx.doi.org/10.5762/kais.2012.13.12.5839.

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Rumyantcev, A. Sh, H. Rafrafi, and O. V. Galkina. "CALCIFICATION OF THE AORTIC VALVE IN PATIENTS ON PROGRAM HEMODIALYSIS." Nephrology (Saint-Petersburg) 22, no. 4 (July 21, 2018): 90–95. http://dx.doi.org/10.24884/1561-6274-2018-22-4-90-95.

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Анотація:

THE AIM: to determine the relationship between non-traditional risk factors and calcification of the aortic valve in patients with CKD C5D.PATIENTS AND METHODS. We examined 103 patients receiving treatment with program hemodialysis (53 men and 50 women, mean age 54.8 ± 15.2 years). A traditional nephrological examination was carried out, including the determination of synchronous 24-hour ECG and AD monitoring, an echocardiographic study evaluating the thickness of the carotid arteries intima-media complex. In 79 patients, the status of vitamin D was determined by the enzyme immunoassay.RESULTS.Traditional (age over 50, male and dyslipidemic) and non- traditional (duration of hemodialysis more than 5 years, calcitriol level less than 10 pmol/L) risk factors for the calcification of the aortic valve were revealed. The average concentration of calcifediol in serum was 33.3 ± 13.8 nmol /L, calcitriol – 11.5 ± 6.9 pmol /L. Calcification of the aortic valve was detected in 48 patients, 2 times more often in men. Stenosis of the aortic valve was found in 28% of men and 22% of women. During the first five years of HD, the prevalence of aortic valve calcification increased 1,5 times and continued to increase later, however, not to the degree of stenosis. The risk of stenosis increased by age over 50 years (3,6 times), whereas the use of alfacalcidol was accompanied by a 70% decrease of stenosis risk. Deficiency of calcitriol (but not calcifediol) increased the risk of calcification (but not stenosis) of the aortic valve in 2 times.CONCLUSION.Vitamin D deficiency is associated with an increased risk of developing extraosteal calcification, including aortic valve. A decrease in the concentration of calcitriol in the blood serum is a predictor for a specific lesion of the aortic valve. Adequate correction of phosphoric calcium exchange can serve as one of the methods for its prevention.

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