Chronic Renal Failure Patients Research Articles

Kronik Böbrek Yetmezliği, Obezite ve Kanser Hastalarında Vitamin D Düzeyleri Üzerine Bir İnceleme

OBJECTIVE: In our study, it was purposed to research the distribution of vitamin D according to age, sex, and seasons of thepatients diagnosed with obesity, cancer, and chronic renal failure who applied to Inonu University Turgut Ozal Medical Centerbetween 2018-2021.MATERIALS AND METHODS: In our descriptive study, vitamin D measurements from 01.01.2018-01.01.2021 users who visitedInonu University Turgut Ozal Medical Center and were diagnosed with obesity, cancer, and chronic renal failure were scanned intheir files and assessed retrospectively. The patients were grouped according to their sex, age, and seasons in which the sampleswere taken. 25(OH)D levels were analyzed by LC-MS/MS method. The patients were classified as deficient, inadequate, andnormal in terms of vitamin D levelRESULTS: Vitamin D deficiency was monitored in 54.9% (n = 981) of 1787 cancer patients admitted to our hospital, 63.3% (n =558) of 882 chronic renal failure patients, and 65.8% (n = 1903) of 2894 obese patients.CONCLUSION: Of the 5563 obesity, cancer, and chronic renal failure patients who applied to our hospital; vitamin D deficiencywas found in 61.9% (n = 3442), vitamin D deficiency was found in 23.1% (n = 1284), while vitamin D level was found to be normalin only 15% (n = 837). In terms of vitamin D deficiency, the highest deficiency was seen in obese patients with a rate

Ochratoxin A levels in serum of Polish dialysis patients with chronic renal failure

Ochratoxin A (OTA) is a mycotoxin produced by the fungi Aspergillus and Penicillium. It occurs naturally in many products of plant origin and in animals because of the carry-over from feed to meat or milk. Ochratoxin A has nephrotoxic, carcinogenic, hepatotoxic, neurotoxic, and genotoxic properties. Data on ochratoxin concentrations in blood or serum from patients with different kidney disorders are available for several European countries, as well as for Africa and Asia. In this study, we determined OTA concentrations in serum samples from chronic renal failure patients receiving dialysis and from healthy controls, collected in central Poland. Ochratoxin A was analyzed after extraction and purification using immunoaffinity columns by liquid chromatography with fluorescence detection (limit of quantification: 0.1ng/mL) in 88 patients and 16 healthy volunteers. The dialysis group consisted of 40 women and 48 men aged between 23 and 85 years. The mean OTA concentrations were 0.75ng/mL (maximum 2.78ng/mL) in dialysis patients and 0.70ng/mL (maximum 1.44ng/mL) in healthy controls. The mean concentrations in patients treated by dialysis were 0.76 and 0.74ng/ml for women and men, respectively (maximum 2.53ng/ml for women and 2.78ng/ml for men). Statistical analysis using Student's t-test showed no statistically significant differences between the control group (non-dialysis patients) and all dialysis patients.

Haematological Indicators of Response to Erythropoietin Therapy in Chronic Renal Failure Patients on Haemodialysis: Impact of Angiotensin-Converting Enzyme rs4343 Gene Polymorphism.

PurposeThis is the first cross-sectional study studying the changes in haematological indicators of the response to recombinant human erythropoietin (rHuEPO) therapy in chronic renal failure (CRF) patients on haemodialysis (HD) stratified according to ACE G2350A (rs4343) gene polymorphism.DesignAn observational cross-sectional study.SettingNephrology department and Biochemistry and molecular biology department, faculty of medicine, Cairo University.PatientsA total of 256 CRF patients on HD for at least six months (162 male and 103 female) and 160 healthy subjects (122 male and 38 female) were recruited in the current study after signing a consent form. ACE G2350A (rs4343) Insertion/Deletion (I/D) was tested, the association between ACE G2350A (RS4343) gene polymorphisms and patients response to rHuEpo was evaluated.ResultsACE G2350A (rs4343) I/D was the most prevalent genotype, while I/I genotype was the lowest prevalent among patient or control subjects included in the study. D allele is the most prevalent allele, either among patients or the control group. Hemoglobin (Hb) level in patients with I/I and Deletion/Deletion (D/D) genotype was significantly higher compared to those with I/D genotype (P = 0.012 and P = 0.005, respectively). Serum iron in the I/D genotype was significantly higher than those with either I/I or D/D genotype (P = 0.045 and P = 0.018, respectively). Angiotensin-converting enzyme (ACE) content, total leukocytic count (TLC), and soluble erythropoietin receptor (sEpoR) were independent predictors of Hb level. The ACE gene, TLC, and serum iron were the independent factors that may affect the Haematocrit (Hct) level. ACE G2350A (rs4343) gene polymorphisms may affect the HD patient’s responses to rHuEPOs.ConclusionIn HD patients, screening for ACE G2350A (rs4343) gene polymorphisms before rHuEpo administration may help predict patient response.

Self-Support Group for Chronic Renal Failure Patients and Caregivers on their Quality of Life: A Study Protocol

Background: Chronic renal failure (CRF) or Chronic kidney disease (CKD) is an irreversible progressive loss of kidney functions in which, kidney fails to sustain the metabolic waste, fluid and electrolyte balance in the body. The prevalence of chronic renal failure is 15% to 17 % in adult population in many developing countries.
 Objective: To find out the effectiveness of Self Support Group (SSG) for Chronic Renal Failure patients (CRF) and caregivers on their quality of life (QOL)
 Methodology: It is a single arm trial, interventional hospital based study. The patients of chronic renal failure of age group 18 to 50 years and caregivers age group above 18 years. Selection of patients and caregivers as per inclusion criteria, detail explanation about nature and purpose of the study, from the subject will be taken before data collection by the investigator after that the formation of groups for chronic renal failure patients and caregivers. Empowerments of the group with knowledge of chronic renal failure and its management, than evaluation quality of life (QOL) for patient and their caregivers with use of QOL scale. The assessments of quality of life for four times, it include day one to three months, six months and nine months respectively. The setting of the study is selected hospitals of Vidarbha Region.
 Expected Results:
 
 Formation of Self Support Group for CRF patients and their caregivers in Hospital Setting
 Improvement in knowledge regarding CRF of patients and their caregivers
 Improvement in QOL for both CRF patients and caregivers
 
 Conclusion: Conclusion will be drawn from the statistical analysis after completion of data collection.

Omega 3 fatty acids effect on the vascular calcification biomarkers fetuin A and osteoprotegerin in hemodialysis patients.

Chronic renal failure patients on dialysis are at a high risk of death due to vascular calcification. This study aimed at investigating the effect of omega-3 fatty acids on the vascular calcification biomarkers fetuin-A and osteoprotegerin (OPG) in patients with chronic renal failure who are undergoing hemodialysis. This prospective, open-label, controlled, parallel study included 60 hemodialysis patients who were randomized to receive either omega-3 fatty acids capsule along with their standard care of treatment (omega-3 group) or their standard care of treatment only (control group). Serum levels of fetuin-A, OPG, calcium, phosphorus, hemoglobin, parathyroid hormone, blood urea nitrogen (BUN), albumin, serum creatinine (SCr), and serum triglycerides (TG) were measured at baseline and after six months of intervention and follow-up of both groups. Significantly increased levels of fetuin-A and OPG (p < 0.001) were observed in the omega-3 group six months after the intervention compared with the control group. Levels of TG, albumin, SCr, BUN, phosphorous, calcium, hemoglobin, and parathyroid hormone were not significantly different in the omega-3 group compared with the control group after six months of intervention. Our study concluded that omega-3 may have a clinically beneficial effect in decreasing cardiovascular events by increasing the levels of the protective vascular calcification inhibitors fetuin-A and osteoprotegerin in chronic renal failure patients who are undergoing hemodialysis.

Self Support Group for Chronic Renal Failure Patients

Self-support groups bring the patients together who is suffering from the same kind of disease conditions or problems or illnesses to share their experiences. Chronic renal failure patients and other illness support groups are a growing need in many communities.&#x0D; When planning for the management for CKD (Chronic Kidney Disease) patient, if involve the patient or patient is participating actively, it will help in effective management of chronic kidney disease. &#x0D; It may aid in the patient's prognosis and can be postponed in part by self-management. Self-management of Chronic Kidney Disease is complicated due to the progressive nature of the condition and its progression. The management of Chronic Kidney Disease by a self-help group is difficult to assess, particularly over time. SMS (Self-Management Support) is important for this progressive disease because of the special nature of Chronic Kidney Disease self-management. SMS stands for the programmes that health-care providers provide to their patients in order to help them better control of their health. Dissemination of health information, patient education, telephone support, and participation in a support group are all part of you.

Dynamics of changes in renal function in patients undergoing radical cystoprostatectomy with various variants of heterotopic reservoir

Relevance. Chronic renal failure in patients undergoing radical cystoprostatectomy (RCPE) with various variants of urine derivation is one of the significant problems that requires an interdisciplinary approach. To date, there is an insufficient number of studies comparing a significant decrease in glomerular filtration rate (GFR) between different types of urine diversion after radical cystectomy. Purpose of research. To study glomerular filtration rate (GFR) indicators in patients who underwent radical cystectomy with a heterotopic Bricker reservoir and compare them with similar indicators in patients who underwent radical cystectomy with a « V « shaped heterotopic reservoir. To compare early postoperative complications in patients who underwent radical cystoprostatectomy with the formation of a heterotopic Bricker reservoir and with a modified V-shaped heterotopic reservoir. Materials and methods. To study and compare the dynamics of glomerular filtration rate (GFR), we retrospectively selected patients after radical cystoprostatectomy with heterotypic ileocystoplasty. Patients were divided into two groups: the control group — patients with radical cystoprostatectomy and Bricker ileocystoplasty (n=46), the study group — patients with radical cystoprostatectomy and modified V-shaped heterotopic ileocystoplasty (n=49). Results. At the stage of discharge of patients from the hospital after radical cystoprostatectomy, the level of glomerular filtration rate (GFR) was not statistically significant differences between the study and control group (P=0.3791), including patients with the presence of hydronephrosis (P=0.4664). The difference in glomerular filtration rate (GFR) between the study group and the control group was statistically significant after 6 years of dynamic follow-up. As a result, it can be argued that the dynamics of glomerular filtration rate (GFR) reduction in the study group is lower than in the control group. A particularly significant difference in glomerular filtration rate (GFR) was observed in patients with existing hydronephrosis at the preoperative stage. Conclusion. Modified «V» — shaped heterotopic urine derivation can be recommended for patients who have undergone radical cystoprostatectomy, especially with existing hydronephrosis at the preoperative stage. This method should be used in patients with chronic pyelonephritis against the background of previously diagnosed ureterohydronephrosis, which is a fairly frequent consequence of the invasive nature of the growth of bladder cancer with ureteral obstruction.

Alloimmunization to Erythrocyte Antigens in Patients Receiving Multiple Blood Transfusions

Background and Objectives: The risk of red blood cell (RBC) alloimmunization is always a concern for multi-transfused patients. Various factors have been found to be associated with alloimmunization. Alloimmunization rates were reported from 4% to 50%, 1.9% to 13% and 1.27% to 13.1% in thalassemic, onco-hematology and renal patients respectively. Transfusion of extended phenotype-matched blood was found to reduce rate of alloimmunization. This study investigated the various risk factors associated with RBC alloimmunization and the impact of transfusing phenotype-matched PRBC to multi-transfused patients. Methods: The retrospective observational study included 4350 multi-transfused patients of hemoglobinopathies, onco-hematological diseases and chronic renal failure (CRF). Pre-transfusion testing that included ABO and Rh(D) typing, antibody screening and crossmatching were performed following departmental standard operating procedure (SOP). Rh (C, c, E, e) and Kell (K) antigen phenotyping of blood donors as well as patients were performed by recommended techniques. Statistical analysis was done using the SPSS statistical package. Results: The mean age of multi-transfused patients was 41.4 years with a female preponderance. A total of 122 alloantibodies with various specificities were found in the 4350 patients (2.8%). Anti-E was the most frequent alloantibody (27.87%) followed by anti-c (11.48%). Frequency of alloimmunization in patients with hemoglobinopathies receiving phenotype-matched blood was 1.89% which was significantly lower than those receiving phenotype-unmatched blood (p=0.0019). Gender, age, splenomegaly status, number of PRBC unit transfused, phenotype-matched status, and transfusion duration in years were independent risk factors of alloimmunization. Conclusion: Alloimmunization to red blood antigens challenge the proper management of multi-transfused patients. Based on the present results we suggest considering antibody screening as an important tool of pre-transfusion testing to ensure safe blood transfusion. It will be prudent to adopt a transfusion policy that provides at least the Rh-Kell phenotype-matched blood to minimize red cell alloimmunization among multi-transfused patients.

Effectiveness of selected nursing interventions on Fatigue and Quality of life among Chronic Renal Failure patients undergoing Hemodialysis in a selected hospital at Madurai

Title: Effectiveness of selected nursing interventions on fatigue and quality of life among Chronic Renal Failure Patients undergoing Hemodialysis in a selected hospital at Madurai. Background: Non communicable diseases are increasing day by day. Health is wealth is an old saying, which is realised by people who has CKD today. As their wealth is reduced by treating the disease throughout their life time, the restrictions in food and fluid impose lot of stress, affects their Quality of life. Nearly 10% of the populations were affected by CKD and millions of them die each year because they could not afford the treatment. Hemodialysis has been proved to be the effective treatment modality. It results in a marked change in the QOL, due to number of modifications and restrictions, which affect patient’s psychological and physiological wellbeing. Dialytic nurses can play a crucial role in enhancing quality of life and reducing fatigue level through exercises and teaching. Aim: The aim of the study was to evaluate the effectiveness of selected nursing interventions on fatigue and quality of life (QOL) among chronic renal failure patients undergoing hemodialysis in a selected hospital at, Madurai. Methodology: Quasi experimental non-equivalent pretest and post-test control group design was used for the study. The study was conducted in patients undergoing hemodialysis in selected hospital at Madurai. A total of 100 patients were selected using convenient sampling technique. Tools used were Piper Fatigue Scale (PFS) and SF 36 World Health Organisation BREF QOL (SF36 WHO BREF QOL) interview scale. The therapeutic nursing intervention which includes planned teaching about care of patient with haemodialysis, demonstration of dialytic exercises, dietary management, adherence to medication, follow up, teaching on sexual relationship were administered over 4 days in a week for 4 consecutive weeks. Data was analysed using descriptive and inferential statistics. Results: The therapeutic nursing interventions were effective in improving quality of life and reducing fatigue level. Pre-test with 15th day post-test fatigue scores comparison [t =23.05, P(&lt; 0.001)] , Comparison of pre-test with 30th day post-test fatigue scores [t =41.19, P(&lt; 0.001)], Comparison between 15th and 30th day post-test fatigue scores [t= 25.58, P(&lt;0.001)], Comparison of pre-test with 15th day post-test level of quality of life score [t =16.32, P(&lt;0.001)], Comparison of pre-test with 30th day post-test level of quality of life score [t=23.76; P(&lt;0.001)], Comparison between 15th and 30th day post-test quality of life score [t = -15.19, P(&lt;0.001)]. The problems reported by the people were, physiological problems such as anaemia, muscle cramping, difficulty sleeping, itching, fatigue, neurological disturbances, cognitive impairment, Sexual dysfunction and psychological problems such as depression, feeling of loneliness, sadness, problems with adjustment, lack of love and affection, suicidal behaviour, delirium, anxiety and panic symptoms. The post tests in experimental group, the correlation between fatigue and quality of life in post-test-1 (15th day) was r = - 0.372 and it was significant at p = 0.008. Similarly, the correlation between fatigue and quality of life in post-test - 2 (30th day) was r = -0.370 and it was significant at p=0.008. Conclusion: The problems of the people vary from person to person, study findings concluded that, selected nursing interventions are effective intervention to improved Quality of life and reduced fatigue level. There is a real need for nurses to provide physical, mental and social support to treat the health problems and to heighten their spirit.

Effect of Computer-Assisted Instructions on Staff Nurses about Renal Dialysis for Chronic Renal Failure Patients

Background: The present study was conducted to assess the effect of computer-assisted instructions on the knowledge gain of the staff nurses on renal dialysis for chronic renal failure patients. Methods: An experimental design was chosen with pre-test and post-test of the experimental and control group. The sample comprised 60 registered staff nurses divided into two groups - 30 in experimental group and 30 in control group. The tools used for conducting the study included demographic variables, and self-structured questionnaire to assess knowledge of experimental and control group. The experimental group was given computer-assisted instructions as an intervention and the control group was used only for comparison. The data was analysed with the help of descriptive and inferential statistics. Result: The study clearly shows that there was a significant gain in the knowledge of staff nurses in experimental group with computer-assisted instructions regarding renal dialysis for chronic renal failure patients.Conclusion: The staff nurses can be benefited by computer-assisted instructions to improve their knowledge and practice on renal dialysis for chronic renal failure patients and they can practice these interventions in clinical area in the future.

Benefits of Tocilizumab in patients with a severe form of SARS-CoV-2 infection: Experience of the intensive care unit of the Mohammed VI university hospital, Oujda

BackgroundCOVID-19 is a new disease that appeared in December 2019. Millions of people have been infected and died from this infection. Until today, the pathophysiology and treatment of this infection remain unknown, but a lot of studies are trying to solve the mystery. The trail of inflammation remains the most convincing, especially the Interleukin 6 (IL-6) which could play an important role in a reaction cascade leading to a cytokine storm. According to studies, although few in number, the Tociluzimab (TCZ), which is an anti-IL6, could prevent or even suppress this storm, leading to a less severe clinical state of the disease and a faster recovery. This could decrease the use of oxygen, avoid the risk of intubation and mortality. Patients and methodsThis single-center retrospective observational case review brought together 557 COVID-19 seriously ill patients (pulmonary involvement> 25% + SatO2AA <90%) admitted to the intensive care unit of our university hospital from March 1st, 2020 to February 28th, 2021. They were divided into 2 groups a Tociluzimab group (TCZ group) and a Non Tociluzimab group (NON TCZ) to facilitate the comparison. The aim of the study was to compare the length of hospital stay, the use of mechanical ventilation and the mortality in the TCZ group versus the NON TCZ group. ResultsThe average age of our patients was 62,05 years (±13.51) and 62.61 years (±16.33) respectively in the TCZ versus NON TCZ group. 76 (76%) were men while 24 were women (24%) in the TCZ group; and there was 313 (68.49%) men and 144 (31.51%) women in the NON TCZ group. Their average BMI was 28 kg/m2 (±4.52) in the TCZ group versus 27.89 kg/m2 (±4.73) in the NON TCZ group. Among them, the TCZ group included 38 (38%) diabetic patients, 38 hypertensive (38%), 12 heart disease (12%) and 2 chronic renal failure (2%), while the NON TCZ group regrouped 35 (7.65%) diabetics, 33 (7.22%) hypertensive, 12 heart disease (2.67%), and 5 chronic renal failure (1.09%) patients. The mean time to consultation of patients was almost similar in the two groups: 8.86 (±7,28) days for TCZ and 8.83 (±7,03) days for NON TCZ group. The mean length of ICU hospital stay was 9 days (4,94) for the TCZ group and 8,75 days (4,73) for the other one. The saturation at admission was at 74.92% (10.45) for the TCZ group ranging from 40% to 92%, and at 73,56% for the NON TCZ group. Lung damage from COVID-19 was extensive in 12%, severe in 32%, and critical in 56% of TCZ group enrolled cases. Meanwhile it was extensive in 23.63%, severe in 41,35%, and critical in 35,01% of the NON TCZ group. The biological findings found average of white blood cells at 12256/12082 e/mm3, lymphocytes at 761/842 e/mm3, CRP at 181/199 mg/L, ferritin at 1747/528 μg/L, and fibrinogen at 6.92/6.27 g/L for the TCZ group versus NON TCZ group. Medical care was based on isolation, oxygenotherapy, azithromycin, vitamin C, zinc, vitamin D, salicylic acid, dexamethasone followed with methylprednisolone, and anticoagulation for all hospitalized patients. The TCZ group received at least 1 course of Tociluzimab dosed at 400 mg (2 patients received 2 doses and 1 patient received 3 doses). The indication of a Tociluzimab course in our department was based on a set of arguments: an increase in oxygen requirements, a progression of lesions on chest-computed tomography and an increase in inflammation markers including IL-6, CRP, ferritin, fibrinogen, and a decrease in the percentage of lymphocytes. The invasive mechanical ventilation was indicated for 4 (4%) patients in the TCZ group versus 192 (42,01%) in the NON TCZ. Among the 100 patients included in our cohort in the TCZ group, 40% died in intensive care unit and 60% had a favorable evolution with a decrease of the biological markers of inflammation. However, in the NON TCZ group, 197 (43,10%) passed away. ConclusionThe use of Tociluzimab in ICU patients with severe COVID-19 pneumonia did not contribute to a significant difference in the reduction of hospital stay. However, the invasive mechanical ventilation was less needed in patients receiving Tociluzimab than the others. Moreover, there was a mortality benefit associated with the use of Tociluzimab, but only before 10 days of hospitalization.

Effect of Video Assisted Teaching on Knowledge of BSc Nursing Students regarding Renal Dialysis for Chronic Renal Failure Patients

Background: The present study was conducted to assess the effect of video assisted teaching on the knowledge gain of BSc Nursing students on renal dialysis for chronic renal failure patients. Methods: An experimental design was chosen with pre test and post test of experimental and control group. The sample size was 60 registered BSc Nursing students divided into two groups - 30 in the experimental and 30 in the control group. The tools used for conducting the study included demographic variables, self structured questionnaire to assess knowledge of experimental and control group. The experimental group was given video- assisted teaching as an intervention and the control group was used for comparison only. The data were analysed with the help of descriptive and inferential statistics. Result: The study clearly shows that there was a significant gain in knowledge of BSc Nursing students in experimental group with video assisted teaching which emphasises that renal dialysis for chronic renal failure patients is good for their health. Conclusion: The BSc Nursing students can be benefited with video assisted teaching to improve knowledge and practice on renal dialysis for Chronic Renal Failure Patients and they can practice these interventions in clinical area in future.

Gambaran Pemenuhan Kebutuhan Spiritual Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisa di Rumah Sakit Bhayangkara Kota Jambi

Gagal ginjal kronik (GGK) merupakan penyakit terminal yang mempengaruhi kualitas hidup pasien. GGK menimbulkan ketidakseimbangan biologi, psikologi, sosial dan spiritual. Gangguan spiritual dapat berupa hubungan dengan tuhan dan hal-hal seperti kepuasan hidup, arah hidup, dan tujuan hidup. Jika kebutuhan spiritual buruk maka dapat berdampak pada gangguan psikologis berat seperti bunuh diri. Penelitian ini bertujuan untuk mengetahui gambaran pemenuhan kebutuhan spiritual pada pasien gagal ginjal kronik yang menjalani hemodialisa. Penelitian ini merupakan penelitian kuantitatif dengan metode penelitian Deskriptif. Populasi dalam penelitian ini adalah seluruh pasien GGK yang menjalani hemodialisa di Ruang Hemodialisa Rumah Sakit Bhayangkara Kota Jambi pada bulan Agustus tahun 2020 yang berjumlah 35 pasien dan pengambilan sampel dilakukan dengan teknik total sampling yaitu berjumlah 35 pasien. Pengumpulan data dilakukan dengan lembar kuesioner dan hasil penelitian dianalisis secara univariat. Hasil penelitian menunjukkan bahwa 31 (88,6%) responden memiliki pemenuhan kebutuhan spiritual berupa religious well-being (RWB) dalam kategori sedang dan terdapat 19 (54,3%) responden memiliki pemenuhan kebutuhan spiritual berupa existential well-being (EWB) dalam kategori rendah pada pasien gagal ginjal kronik yang menjalani hemodialisa. Diharapkan pihak Rumah sakit khususnya perawat yang bertugas di ruang hemodialisa hendaknya membuat program yang mendukung kegiatan spiritualitas secara berkelompok sesuai dengan kepercayaan masing-masing klien (support group). Perawat diharapkan mampu memberikan asuhan keperawatan dengan pendekatan spiritual (spiritual care) dan secara holistic

HUBUNGAN HIPOTENSI INTRADIALISIS DENGAN TINGKAT FATIGUE PADA PASIEN GAGAL GINJAL KRONIS (GGK) YANG MENJALANI HEMODIALISIS DI RUANG HEMODIALISA RSUD RATU ZALECHA MARTAPURA

Hemodialysis is a modality of life-saving therapy for patients with chronic renal failure (CRF). However, this therapy can cause various complications. One of the most common complication is intradialysis hypotension of up to 20-30%. The chronic effect of hemodialysis is fatigue that has a high prevalence reaching 60-97%. Fatigue will also be felt when the patient has intradialysis hypotension. &#x0D; This research aims to determine the correlation between intradialysis hypotension with fatigue level in CRF patients undergoing hemodialysis at Hemodialysis Room Ratu Zalecha Martapura Hospital. This research method is cross sectional. The population were CRF patients who undergoing hemodialysis as many as 71 people. The research sample was taken using by Purposive Sampling as many as 45 people, analyzed by Spearman Rank test using software program SPSS version 23 year 2015. The research instrument uses observation sheet of blood pressure per hour during intradialysis and Fatigue Measurement Scale (FAS). &#x0D; Univariate analysis result from 45 respondents, there were 25 people (56%) who get decreased normal systolic BP (&lt; 20 mmHg) and 29 people (64%) who experienced the tiredness fatigue level (score ³ 22). Bivariate analysis result showed there was the correlation between intradialysis hypotension with fatigue level in CRF patients with the value of p-value &lt; 0.05 is 0.044 and the correlation coefficient value is r: 0.257 which showed the weak correlation. &#x0D; The conclusion is patients with decreased systolic BP will probably experience the tiredness fatigue level. Suggestions for nurses to further improve monitoring during HD progress and evaluate patient complaints periodically.

Clinical features, management, and outcome of hemodialysis patients with SARS-CoV-2.

The aim of the study was to evaluate the clinical features of the patients on HD with COVID‐19 and determine the prognostic factors. In this single‐center prospective study, a total of 58 chronic renal failure patients on HD and diagnosed COVID‐19 infection were enrolled in the study. The patients were divided into two groups according to their need for intensive care unit referral. Demographic features of the patients, clinical manifestations, laboratory data, treatments, and clinical outcome were evaluated. The mean age of 58 HD patients was 63.2 ± 13.8 (30–93) years and female–male ratio was 0.34. SARS‐CoV2‐PCR positivity rate was 32.8%. 85.2% of patients (n = 46) had bilateral lesions and 14.8% (n = 8) had unilateral one lesion in chest CT. The most common symptoms were fatigue (in 44 patients, 80%) and dyspnea (in 31 patients, 56.4%). The most common comorbidity was HT (in 37 patients, 67.3%). The patients who need intensive care and died were older (p = 0.015). We observed lower platelet and eosinophil counts, potassium levels, higher AST, troponin and CRP levels in the group of patients who need intensive care and died than the group who survived (p = 0.043, 0.005, 0.033, 0.007, 0.001, <0.001, respectively). 15.5% of the patients (n = 9) were transferred to intensive care unit. Among them, two were discharged with cure and seven patients died. Mortality rate was 12.1%. Older age, lower platelet and eosinophil counts and higher AST, troponin and CRP levels were prognostic risk factors in our HD patients who needed intensive care.

Sonographic Evaluation of Chronic Kidney Disease Correlating with Serum Creatinine Level

Background: Chronic kidney disease is defined as abnormality of urinary system, there is persistent abnormality of structure and upward renal excretory function that is sign of irreversible damage to function of nephron. It is a public health problem world widely and it is 12 th most common cause of mortality and morbidity, respectively. Objective: To evaluate chronic kidney disease (CKD) sonographically in addition correlating echogenicity with the level of serum creatinine. Study Design: An analytical Cross sectional prospective study. Settings: Life Care Hospital, Radiology department Lahore. Period: 20 th December 2020 till 10 th April 2021. Material & Methods: In our study all those patients with age above 18, patients suffering from chronic kidney disease, patient on hemodialysis, diabetic and hypertensive were included. While patient below 18 age, patients on peritoneal dialysis were excluded in which 71 patients were enrolled in the research. All the patient’s data had been composed from indoor of hospital, outdoor of hospital, and emergency department of Life Care Hospital, Lahore. After informed consent, data was composed through ultrasound machine Toshiba Xario Prime. Results: The findings revealed that there were 71 Chronic Renal Failure patients, 45 of whom were male and 26 of whom were female, with ages ranging from 20 to 73. Since the P value is > 0.05 of the relevance indicators, there is no important relationship between the two variables. Conclusion: The ideal sonographic parameter that can be used to correlate the level of serum creatinine with kidney parameter within ultrasound is kidney cortical echogenicity. As kidney cortical echogenicity does not reverses as the disease progress even after the treatment, so it is the most accurate parameter that can be used. Keywords: Chronic kidney disease, Echogenicity grade, Serum creatinine, Ultrasound, estimated Glomerular Filtration rate. DOI: 10.7176/JHMN/90-05 Publication date: June 30 th 2021

Comparison of Jaw Elevation Device vs. Conventional Airway Assist during Sedation in Chronic Kidney Diseases Undergoing Arteriovenous Fistula Surgery: A Randomized Controlled Trial.

Patients with chronic renal failure (CRF) are likely to have obstructive sleep apnea (OSA) underdiagnosed, and maintaining airway patency is important during sedation. This study compared Jaw elevation device (JED) with conventional airway interventions (head lateral rotation, neck extension, oral or nasal airway insertion, and jaw thrust maneuver) during sedation and hypothesized that JED may be effective to open the airway. A total of 73 patients were allocated to a conventional group (n = 39) and a JED group (n = 34). The number of additional airway interventions was the primary outcome. Percentage of patients with no need of additional interventions and apnea-hypopnea index (AHI) were secondary outcomes. The number of additional interventions was significantly less in the JED group compared to the conventional group (0 (0–0) vs. 1 (0–2); p = 0.002). The percentage of patients with no requirement for additional interventions was significantly higher in the JED group compared to the conventional group (76.5% vs. 43.6%; p = 0.004). AHI was significantly lower in the JED group compared to the conventional group (4.5 (1.5–11.9) vs. 9.3 (3.8–21.9), p = 0.015). In conclusion, JED seems to be effective in opening the airway patency during sedation in CRF patients.

Effectiveness of Guided Imagery Technique in Reduction of Stress Level among Chronic Renal Failure Patients

Background: A quasi experimental study to evaluate the effectiveness of guided imagery technique inreduction of stress level among chronic renal failure patients. The aim of the study wasto determine thestress level among patients with chronic renal failure in experimental group after introduction of guidedimagery. Methods and Material: A true experimental two-group pre-test - post-test design was used for thepresent study. The sample consisted of 100 chronic renal failure patients undergoing dialysis were randomlyassigned to experimental group and control group (N=50+50=100). Data was analysed using paired andunpaired‘t’ test, chi-square test, Karl Pearson correlation co-efficiency, and Spearman’s correlation coefficiency. Results: In experimental Group 62% of the samples had moderate level of stress, 20% of thesamples had severe level of stress and 18% of the samples had mild level of stress with mean and SD of64.02, 5.88. There was a significant reduction in the mean post test stress score of experimental groupcompared to mean pre test stress score of experimental group at 0.05 level of significance. (t49 = 6.526, P&lt; 0.05). The results showed that chronic renal failure patients had significant level of stress related to theirillness and guided imagery is an effective intervention for reduction of stress. Conclusion: Guided imageryis a simple non-invasive, cost effective, method that can be used for reduction of stress without any adverseeffects on the patients. Patients themselves can practice their own imagery without any assistance.

The Study of Hemodialysis on the Change Rate of Serum Osteopontin, Sialic Acid, and Nitric Oxide Levels

Objective : Chronic renal failure (CRF) is one of the most prevalent diseases of human societies, especially in Iraq. Despite all advances that have been made so far, hemodialysis with all its complications is being applied as the novel treatment strategy for such individuals.Osteopontin (OPN) is a multi-functional secreted glycoprotein that plays a crucial role in and inflammatory process.Our aim was to ascertain whether circulating osteopontin,sialic acid ,and NO levels are altered in patients with CRF before and after dialysis.Design and Methods: A total of 126 patients with HD were enrolled in this study. Serum OPN levels were measured using a commercial enzymelinked immunosorbent assay kit.Results: Osteopontin and Sialic acid levels were significantly higher in haemodialysed CKD patients than predialysed CKD patients and normal healthy controls. The levels of NO was significantly lower in CRF patients pre HD when compared with healthy controls and significantly increased in post HD as compared to pre HD. Conclusion: In our study, OPN SA, NO were found to be a valuable marker of severity of CKD.

Yemen'de Hepatit C Virüsü Epidemiyolojisi: Sistematik İnceleme

Aim: To identify and well-characterize the prevalence of hepatitis c virus infection in different populations in Yemen. Also, to determine the future epidemiological study areas in Yemen. &#x0D; Methods: A systematic review was conducted with the use of the PRISMA guidelines. Between 1980 to 2020, a comprehensive search was done for any epidemiological data on hepatitis C in Yemen that were conducted in each PubMed, web of Science, Scopus, and Google Scholar.&#x0D; Results: Forty-nine (49) studies were matching the inclusion and exclusion criteria from the four databases. After analyzing these 49 studies we found that In the general group of the population the prevalence was ranged between 0.07%-8.5%. Where the highest prevalence was in pregnant women (up to 8.5%) then the public (up to 6%) then blood donors and children up to 3% and 2.8% respectively. In the intermediate-risk group, HCV prevalence was ranged between 1.03%-3.5% where all population was from the health department workers. In the high-risk group, the range was between 6.4%-62.7%, and the highest prevalence was recorded in liver disease patients .in the patient's group the range of HCV prevalence was between 0%-46%, while the sickle cell anemia patients were the lowest prevalence the chronic renal failure patients had the highest prevalence. &#x0D; Conclusion: This systemic review demonstrates a high prevalence of hepatitis C infection in Yemen. There is also a need to expand the scope of research and pay attention to new research groups and other cities to get a more comprehensive idea of the prevalence of the hepatitis C virus in Yemen.