جستجوی مقالات مرتبط با کلیدواژه « Hemodialysis » در نشریات گروه « پزشکی »

Chronic kidney disease is the biggest problem in health care today, and the primary replacement therapy, hemodialysis, has a severe impact on both self‑management and quality of life. This study aimed to evaluate the effect of educational nursing guidelines on self‑management and health‑related quality of life for hemodialysis patients.

A quasi‑experimental design was used. A convenience sample of 100 hemodialysis patients in the hemodialysis unit at Ismailia General Hospital, 50 patients for the study and 50 patients for the control groups. Data were collected using a patient demographic information questionnaire, hemodialysis self‑management scale, and survey instrument on kidney disease quality of life 36‑item (KDQOL‑36). The intervention was conducted over 12 weeks in five sessions, from implementing the guidelines to the post‑test phase. The control group received the usual care. SPSS version 23, descriptive statistics, and inferential statistics like independent t</em>‑test and Pearson Chi‑square test were used.

Regarding self‑management dimensions, a statistically significant difference was found between the study and control group regarding problem‑solving and communications, fluid control, diet, self‑advocacy, and emotional control with p </em>< 0.001, and effect size 5.89,4.99, 5.06, and 4.54, respectively. Regarding the quality of life domains, a statistically significant difference was found between the study and control group regarding physical functioning, mental functioning, the burden of kidney disease, management of symptoms, and kidney disease effect with p </em>< 0.001 and the effect size 9.39, 6.07, 1.86, 7.65, and 6.96, respectively.

Pulmonary hypertension (PH) is a known complication of hemodialysis (HD) but its pathogenesis and etiology is not completely clear. The purpose of the current study is to determine the prevalence and possible causes of PH among hemodialysis patients.
Demographic, clinical and laboratory data of 40 patients referred to hemodialysis ward of Masih Daneshvari Hospital during 12 months were recorded. Detailed echocardiography was performed for each patient within 24 hours of hemodialysis. PH was defined as systolic pulmonary artery pressure (SPAP) above 35 mmHg.
12 of 40 HD patients had PH (prevalence = 30%). The hemodialysis vintage in PH group was longer than patients without PH (No PH group) . Also, left atrium size, right ventricle size, left ventricle end diastolic diameter (LVEDD) and left ventricular mass index (LV mass index) were significantly higher in PH group; but ejection fraction (EF) was lower than No PH group. Left ventricle diastolic dysfunction and pericardial effusion were significantly associated with PH. The crude mortality rate was relatively similar in PH group and No PH group.
PH is prevalent in HD patients with multifactorial etiology. Increased pulmonary capillary wedge pressure (PCWP) is a very important factor to induce PH in these patients; on the other hand, chronic volume overload and left ventricle systolic and diastolic dysfunction are some of the predominant causes of increased PCWP in this population.

 Pentoxifylline has anti-inflammatory effects in end stage renal disease (ESRD) patients and may play an important role in reducing inflammatory factors and improving quality of life (QoL) in hemodialysis (HD) patients.

 In this randomized placebo-controlled trial 88 chronic hemodialysis patients were divided into two groups with equal numbers. Intervention group received tablet pentoxifylline 400 milligrams and control group received the matching placebo, daily for 3 months. At baseline and after 3 months, inflammatory factors including serum levels of tumor necrosis factor-alpha (TNF-a) and C-reactive protein (CRP) were measured. Also, the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) quality of life (QoL) questionnaire was completed by each patient at the beginning and end of the study.

 Significant reduction in serum levels of TNF-a, CRP as well as substantial improvement of all dimensions of QoL were observed in intervention group after 3 months of pentoxifylline treatment (P = 0.04; P <0.001, P <0.05 respectively). Between groups comparison showed marked reduction in inflammatory markers including TNF-a and CRP in recipients of pentoxifylline than control group at the end of the study (P = 0.003 for both). In addition to dimensions of physical component score (PCS), mental component score (MCS) and overall score of QoL showed significant improvement in the pentoxifylline group compared to the placebo group at month 3 of the study (P = 0.003; P = 0.027, P = 0.002 respectively).

 Use of pentoxifylline in HD patients illustrated positive effects on inflammation and health-related QoL.

 The thyroid gland, a small butterfly-shaped organ in the neck, regulates the body’s metabolism. Disruptions in its function can lead to various health issues, including fatigue, weight changes, and cardiovascular problems. In hemodialysis patients, thyroid function is even more crucial. Hemodialysis, a treatment for kidney failure, filters waste and excess fluid from the blood, potentially affecting various bodily systems, including the endocrine system. This study examines the effect of thyroid function on hemodialysis.

In this descriptive-analytical study, dialysis patients were classified into three groups: hypothyroid, hyperthyroid, and euthyroid. The levels of thyroid and parathyroid hormones, serum electrolytes, clinical symptoms, laboratory results, and blood pressure of the patients in these groups were compared.

There was no significant difference between the number of dialysis sessions and thyroid function. The serum calcium level was significantly higher in hypothyroid patients than in euthyroid and hyperthyroid patients. There were no significant differences in weight changes before and after dialysis considering the participants’ sex and age (P = 0.227 and P = 0.457). Moreover, there were no significant differences in the number of dialysis sessions (P = 0.508), systolic (P = 0.419), and diastolic blood pressure (P = 0.559), or in the serum level of parathormone in patients with different thyroid functions (P = 0.103). However, the serum level of phosphorus was significantly higher in hyperthyroid patients than in normal patients and lower than in hypothyroid patients (P = 0.049). The hemoglobin concentration was higher in hyperthyroid patients than in other groups (P = 0.021).

The changes in calcium, hemoglobin, and parathormone levels in hemodialysis patients with different thyroid function statuses showed significant differences. These differences are believed to be caused by high bone metabolism in dialysis patients. Evaluating these parameters in dialysis patients is recommended, highlighting the need for regular thyroid function screening among these patients.

This study assessed the effects of Aloe verasupplementation on serum inflammatory factors, blood sugar andlipid profiles in hemodialysis patients.

Totally, 50 hemodialysis patients wereallocated randomly to either Aloe vera or placebo groups. TheAloe vera group received 2 Aloe vera capsules daily for 8 weeks(500 mg/day). Serum C-reactive protein (hs- CRP), Fasting bloodglucose (FBS), and lipid profiles levels were evaluated at thebaseline and the end of the eighth week.

Aloe vera supplementation for 8 weeks was associatedwith a significant reduction of serum hs- CRP (p=0.004), totalcholesterol (p=0.01), low density lipoprotein (LDL) (p=0.02) levesand increased high density lipoprotein (HDL) (p=0.002)concentration in the hemodialysis patients.

Aloe vera supplementation is beneficial inimprovement of cardiovascular risk factors in hemodialysispatients

Chronic kidney disease (CKD) is a growing global public health burden with significant physical and mental health challenges. This study aimed to systematically review the available evidence on the effects of yoga interventions on improving the physical and mental health of patients with CKD. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. The systematic search was conducted in January 2023 using Scopus and PubMed, resulting in 99 documents, of which 9 met the selection criteria. The studies explored the effects of different types of yoga interventions on various health aspects in hemodialysis and CKD patients. The durations ranged from 15 days to 6 months. The types of yoga used varied, including Hatha Yoga, Pranayama, and yoga therapy. Outcome measures included dialysis adequacy, fatigue, insomnia, lipid profile, oxidative stress, renal function, blood pressure, and quality of life. The findings demonstrate the feasibility of the yoga intervention and the positive effects of the intervention on health outcomes, such as improved dialysis adequacy, reduced fatigue and insomnia, better lipid profiles, decreased oxidative stress, enhanced renal function, lowered blood pressure, and improved quality of life. Yoga interventions show promise as a complementary approach for managing CKD. The positive effects observed on multiple health outcomes suggest the potential benefits of incorporating yoga into CKD care. However, further well-designed trials are needed to strengthen the evidence base. Healthcare providers should consider including yoga as part of a comprehensive approach to improve the well-being of CKD patients.

Sofosbuvir (SOF) is a revolutionary treatment for patients with hepatitis C virus (HCV). However, its efficacy and safety among patients with end-stage renal disease (ESRD) remains controversial. In this study, we examined the levels of SOF metabolite (GS-331007) (SOF-007) in human plasma of patients infected with HCV having ESRD using an optimized liquid chromatography-mass spectrometry (LC-MS) analytical method.

In this case-control study, 10 clinically confirmed cases and five controls were enrolled. SOF-007 was extracted from plasma using methanol precipitation. The limit of detection (LOD) for the drug and its metabolite were 0.85 and 2.3, respectively. Such a wide range of quantification in a period of separation time shorter than 3.0 minutes (run time) allowed monitoring of the plasma concentration of analytes up to 4 hours (pre-dialysis and post-dialysis) for 12 weeks in non-cirrhotic patients with HCV infection undergoing dialysis.

SOF-007 in the plasma of HCV patients with healthy kidneys showed no cumulative effect. An analysis comparing patients with ESRD and healthy participants showed that their behaviour was similar, followed by dialysis with a relatively small cumulative effect.

The plasma concentrations of SOF-007 decreased significantly after the 4-hour period of dialysis compared with the plasma concentrations hemodialysis of pre-dialysis in HCV patients with ESRD.

 Hypomagnesaemia secondary to the use of proton-pump inhibitor (PPI) is associated with the reduction of blood pressure.

 To determine the effect of PPI and ranitidine on the reduction of serum magnesium level and blood pressure in chronic hemodialysis patients with hypotension.

 In this double-blind randomized clinical trial, 44 hemodialysis patients who met the requirements entered the study. First, blood sample was taken from each of the patients and their serum magnesium level as well as their blood pressure was checked and recorded. Then, the patients in the intervention group received daily doses of ranitidine placebo (150 mg) and pantoprazole (40 mg) and those in the control group received daily doses of pantoprazole placebo (40 mg) and ranitidine (150 mg) for three months. After the intervention, blood samples were taken again in order to assess the patients’ serum magnesium level. The obtained data were fed into SPSS Software and analyzed.

 The mean age of the patients was 60.14±12.98 years. Moreover, 63.6% of the total patients were female. In the group of patients who had received pantoprazole, diastolic pressure reduced significantly at the end of the study as compared to the beginning of the study. Moreover, in the patients receiving pantoprazole indicated a significant reduction of magnesium at the end of the study as compared to the beginning of the study.

 In this study, a significant relationship was also observed between the use of PPI and hypomagnesemia in hemodialysis patients.
Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trials (identifier: IRCT20150808023559N19; https://en.irct.ir/trial/42478, ethical code# IR.ARUMS. REC.1398.295).

Food intake during hemodialysis (HD) is a controversial issue. The potential benefits include improvement of nutritional status and patient satisfaction. However, the risks include the possibility of intradialytic hypotension (IDH) and dialysis inadequacy. There are no guidelines regarding food intake during HD.

To assess the impact of food intake during HD on IDH and dialysis adequacy.

This was a single-center quasi-experimental study. Thirty patients undergoing regular maintenance HD were recruited for the study. The patients themselves served as their controls. In three separate sessions, they were assessed for IDH and dialysis adequacy (spKt/V, URR). The first session was without a meal, the second with a small meal, and the third with a large meal. Change in measured variables (spKt/V, URR) was assessed by repeated-measures analysis of variance (ANOVA). The McNemar test was conducted to compare the incidence of IDH between three different dialysis sessions.

Nine patients (30%) had IDH when they consumed a small meal (P=0.02, McNemar test), and eight patients had IDH (26.7%) when they consumed a large meal (P=0.03, McNemar test). The mean spKt/v and URR were not significantly different in the three sessions.

There is a significantly increased risk of IDH due to food intake. IDH is associated with significant morbidity and mortality; hence, restricting food intake during HD sessions would be prudent.

Hemodialysis is the most common treatment method for patients, and access to blood vessels is the way to save hemodialysis patients. Therefore, the purpose of this study was to compare the effect of Hugo point cold therapy with the needle insertion site on pain caused by venipuncture in hemodialysis.

This randomized clinical trial was carried out on hemodialysis patients of Hami Arak Dialysis Center in Arak, Iran. The samples were selected by purposive sampling (n=56) and assigned into two groups (28 samples each). For group A, an ice pack was used at the needle entry sites, and for group B, an ice pack was used at the Hugo point of the opposite hand for 10 minutes before cannulation by a nurse. The pain intensity of the patients was measured within 1 minute after cannulation and recorded based on the visual comparison scale of pain measurement (VAS). Data was analyzed using SPSS 23 software.

The average pain in groups A and B were 3.10±86.81 and 4.2±65.05, respectively. There was no significant difference in the average pain intensity between the two cold therapy groups at the needle insertion site and Hugo point (p>0.05).

Cryotherapy intervention at the needle insertion site and Hugo's point have the same effect on reducing arteriovenous fistula cannulation pain.

Adherence to treatment plans and prescribed drugs is considered an important challenge in chronic patients,and non-adherence to the treatment plan in these patients causes worsening of the condition of the disease and a decrease intheir quality of life. Therefore, this study was conducted with the aim of determining the effect of self-care program training ontreatment compliance in hemodialysis patients. The present study was a Quasi-experiment study in which all eligible patients of the hemodialysis department ofSanandaj were selected by census method in two intervention and control groups. In two groups, before and one month after theintervention, a demographic questionnaire and a questionnaire of adherence to the treatment of kidney patients were completed.The intervention included three training sessions as well as a training booklet for the ward. But in the control group, the patientsreceived the necessary care according to routine. Data were analyzed using spss-16 software and descriptive tests and Wilcoxonand Mann-Whitney non-parametric tests. The results of the study showed that the average age and standard deviation of the participants was 51.71 ± 15.85 yearsand the participants were homogenous in both groups. The average total score of treatment adherence in the intervention groupincreased from 93.03 ± 12.77 before the intervention to 105.23 ± 24.39 after the intervention (P < 0.05); However, in the controlgroup before and after the intervention, the results of the Wilcoxon test did not show a significant difference. The program training and training for patients has led to an increase in patients’ awareness, improved patient care,and comprehensively and accurately points out all the information related to the patient’s condition, and provides them with theopportunity to ask and answer questions with nurses.

Currently, health indicators are considered an important factor in the development of countries and can be effective in raising the level of developmental indicators.

In this regard, the present study aimed to analyze the relationship between the effect of health indicators on the developmental indices of the provinces of Iran.

The current study of an applied type was descriptive, cross-sectional, and retrospective. The data were prepared through forms designed based on experts’ opinions and classified information in statistical yearbooks for the provinces of the country during 2016 - 2020. Data analysis was carried out using Stata 17 software. Moreover, panel data was used to estimate the model, and the Xtpcse test was used to obtain the results of the hypotheses.

The results of the model estimation show the positive and meaningful impact of health indicators on educational indicators such as the ratio of students to teachers, the ratio of students to staff and management, the ratio of higher education students to the population of the provinces and the distribution of students in the province.

The country’s authorities can improve and develop health by identifying and optimizing the use of effective indicators in the field of Health and education indicators such as increasing the number of medical and health students and developing educational programs in the field of Health and health and informing the community about these programs, as well as encouraging higher education in low-income areas.

 The most common complication of central venous catheter (CVC) in hemodialysis (HD) is infection. Identifying CVC- related infection (CVC-RI) risk factors and causative micro - organisms is essential for setting prevention policies. This study aims to determine the prevalence of CVCRIs and identify any associated risk factors among these patients.

 We conducted a cross-sectional study from 2017 to 2018 to determine the prevalence of central catheter - related infections among all adult patients on both acute and chronic hemodialysis who had central catheters in place at a tertiary care hospital in Qazvin City. Data on demographics, comorbidities, dialysis duration, catheter - related complications, catheter removal, dialysis details (frequency, duration), catheter insertion site, and any history of central catheter - related infections were collected from medical records. A central catheter - related infection is defined as a positive blood culture obtained from a central venous catheter tip or any other related site (e.g., tunnel, exit site) with clinical signs of infection such as fever, chills, or localized pain and tenderness. Micro - organisms isolated from cultures of CVC, catheter tips, and blood cultures were identified. Chi-square and t-test were performed to compare demographic and clinical variables.P < 0.05 was considered statistically significant.

 171 patients (214 hospital admissions) enrolled in the study. Of these hospital admissions, 91 (42.5%) had CVC-RI. There was no significant relationship between CVC-RI and age, gender, body mass index (BMI), marital status, education, residency, comorbidities, addiction, and etiology of kidney failure. Variables such as smoking (p = 0.012), catheter type (p = 0.031), CVC location (p = 0.026), emergency catheter placement (p = 0.005), previous catheter history  (p = 0.004), and number of previous catheter (p = 0.006), previous catheter infection history (p = 0.002), and antibiotic use in the recent month (p = 0.001) were associated with an increased CVC-RI. Of the positive blood cultures, the majority were gram - positive bacteria.

 CVC-RI in HD is high and smoking, CVC location, number of previous catheters and their infection history, and antibiotic use in the recent month are risk factors related to CVC-RI. Education on proper hygiene for the prevention of CVC-RI is essential for patients that had no previous intravascular line. Staphylococcus aureus must be taken into account for empirical therapy.

World Kidney Day is an annual, global awareness campaign that aims to raise awareness of the importance of kidney health and hopes to alleviate the global burden of kidney diseases. It is observed annually on the second Thursday of March. The campaign focuses on elucidating various aspects of kidney health, including prevention, early detection, and management of kidney diseases. It highlights the risk factors contributing to kidney disease, such as diabetes, hypertension, dyslipidemia, metabolic syndrome, and obesity. By raising awareness about these risk factors, World Kidney Day encourages individuals to make lifestyle modifications and promptly seek medical intervention to reduce their risk factors.