Chronic Renal Failure Patients Research Articles

Determination of Oxidative Stress Levels and Some Antioxidant Activities in Acute and Chronic Renal Failure Patients

Determination of Oxidative Stress Levels and Some Antioxidant Activities in Acute and Chronic Renal Failure Patients

Path Analysis on Factors Affecting the Use of Hemodialysis in Patients Chronic Renal Disease at Dr. Soehadi Prijonegoro Hospital Sragen, Central Java

Background: Patient adherence can be influ­enced by several factors that can affect com­pli­ance with hemodialysis treatment. Adherence is highly treated while undergoing hemodialysis in order to achieve success in hemodialysis (HD) treatment. Adherence is one of the beha­viors of a person in achieving successful HD treatment. The success of a treatment can be influenced by several fac­tors, one of which is the use of HD. This study aimed to determine the effect of compliance with hemodialysis. Subjects and Method: The was an obser­vational analytic study with a cross-sectional design. The study was conducted in January 2020. The sample used was 120 chronic kid­ney failure patients undergoing hemodialysis at Dr. Soehadi Prijonegoro Sragen Hospital. The de­pendent variable was compliance with hemo­dialysis. The independent variables are: know­ledge, length of care, family income. Data were collected by means of a question­naire. Data analysis was performed using path analysis with Stata 13. Results: The use of HD in patients with chro­nic renal failure had a positive associa­tion with high HD knowledge (b= 1.22; 95% CI= 2.21 to -3.98; p= 0.027), length of stay (b= 2.09; 95% CI= 4.29 to 3.05; p<0.001), and has no positive relationship with family income (b = 0.40; 95% CI = 0.80 to 1.41; p = 0.426). The use of HD in patients with chro­nic renal failure is influenced indirectly by family income and length of treatment. Conclusion: The use of HD in chronic renal failure patients has a direct relationship with knowledge of HD and length of treatment, and has no direct relationship with family income. The use of HD in patients with chro­nic renal failure is influenced indirectly by family income and length of treatment. Keyword s : hemodialysis, chronic renal failure Correspondence: Anisa Andriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­tami 36A, Surakarta 57126, Central Java. Email: andrianianisa390@gmail,com. Mo­bile: +6282220826660. Journal of Health Policy and Management (2021), 06(01): 13-20 https://doi.org/10.26911/thejhpm.2021.06.01.02

Secondary Hyperparathyroidism in Patients with Chronic Renal Failure Attending a Tertiary Health Care Hospital- A Cross-sectional Study in Saurashtra Region of Gujarat, India

Introduction: Secondary hyperparathyroidism is a known and early complication of Chronic Renal Failure (CRF) patients. Renal hyperparathyroidism leads to a host of bone and cardiovascular problems that ultimately can cause fractures, decreased quality of life, and an increased risk of death. Aim: To determine the hospital-prevalence of secondary hyperparathyroidism in CRF patient and establish the correlation between Serum Parathyroid Hormone (PTH) level, Serum calcium and Serum phosphorus level. Materials and Methods: It was a cross-sectional study conducted on 50 patients with CRF at Government Hospital of Bhavnagar, Gujarat. Detailed medical history and blood investigations were done as a tool for data collection. The study variables were described by using statistical parameters like proportion, mean and standard deviation. Correlation coefficient was used for analysing relationship between Serum PTH, calcium and phosphorus. Results: Mean age of the patients was 42.57 (SD 15.19) years with almost equal representation of both genders. Hypertension was the most common aetiological morbidity (62%) among the study participants followed by diabetes (20%). The hospital prevalence of secondary hyperparathyroidism was 86% in Chronic Kidney Disease (CKD). Serum PTH negatively correlated with serum calcium and positively correlated with serum phosphorus with correlation coefficient value of -0.32 and 0.15, respectively. Conclusion: Parathyroid abnormalities and disorders of mineral metabolism are common among patients with CKD. Parathyroid abnormalities detected early may prevent future long term extra-renal complications.

The relationship of depression levels and arterial stiffness in hemodialysis patients

Aim: The most common psychiatric disorder in hemodialysis (HD) patients is depression and is associated with morbidity and mortality. The relationship between depression and arterial stiffness in this patient group is a new field of study and data are limited. The aim of this study is to examine depression, arterial stiffness and other potentially relevant laboratory parameters in HD patients.Materials and Methods: The study included 58 chronic renal failure patients who underwent hemodialysis for at least 3 months, and the Beck Depression Inventory (BDI) was applied to the participants by the researcher. Pulse Wave Velocity (PWV) figures of the patients were measured on the day the inventory was applied, and laboratory results were obtained within the same month.Results: Depressive symptoms were determined in 27.6% of the patients, and the severity of depression was 25.9% moderate, 5.2% severe. When patients with and without depressive symptoms were compared, PWV (9.3 ± 1.9 vs. 7.8 ± 2.5, P = 0.04) and phosphorus (5.4 ± 1.5 vs. 4.4 ± 1.1 p = 0.008) levels were significantly higher in the depressive group, while calcium (8.3 ± 0.9mg / dL vs.8.8 ± 0.5mg / dL p = 0.018) levels were significantly lower. Phosphorus level (odds ratio [OR] 2.163; 95% CI 1.174--3.982; p = 0.013) and PWV (OR 1.403; 95% CI 1.018--1.932; p = 0.038) were found as independent predictors for depression in multivariate analysis. Conclusion: One of the serious problems affecting the quality of life in HD patients is depression. In our study, it has been shown that there is an irrelevant relationship between depression and arterial stiffness and phosphorus levels in HD patients.

A Comparative Study of Lipid Profile in Chronic Renal Failure Patients on Dialysis

Chronic renal failure (CRF) is characterized by loss of kidney function due to lasting damage to nephrons resulting in decreased estimated glomerular filtration (eGFR) and suppressed urine formation. Disturbance of lipid profile in CRF has been found associated with increased triglycerides (TG) and low high-density lipids while the normal level of total cholesterol (TC) and low-density lipids (LDL). Dislipidemia in CRF patients induces cardiovascular diseases (CVD); in addition, CVD in turn leads to the more rapid destruction of the kidney. Therefore the present study was designed to evaluate the lipid profile in CRF patients with and without dialysis. This was a prospective type of study conducted in the Department of Medicine of a tertiary care centre from July 2019 to December 2019. A total of 100 patients of CRF patients and 40 normal control subjects were recruited for the study. CRF patients were divided into two groups. Group, I consisted of CRF patients with dialysis and group II included CRF patients without dialysis. Normal subjects were kept under a group III control group. The study revealed that there was a significant difference between TG, HDL and VLDL of group I (p&gt;0.01) and group II (p&gt;0.01) in comparison to group III. On the other hand, no significant variation was seen in the TC and LDL levels of the groups mentioned. CRF patients either with dialysis or without dialysis have a great possibility of developing dyslipidemia as well as CVD. Dialysis has been found effective in reducing nitrogenous waste products in the blood; however, it is not able to decrease the lipid profile in CRF patients.

KEPATUHAN MENJALANI TERAPI HEMODIALISA DENGAN KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIK

Chronic renal failure is a condition of decreased kidney function gradually or overall and requires kidney replacement therapy to maintain life. Hemodialysis is a therapy for patients with chronic renal failure. Compliance with hemodialysis therapy is one of the important things to note, if the patient is not compliant it can cause a buildup of harmful substances in the body that will have an impact on the quality of life of the patient. This study aimed to analyze the correlation between compliance undergoing hemodialysis therapy and life quality of patients with chronic renal failure in the hemodialysis ward of Tabanan Regional Hospital. This study was quantitative by using a descriptive correlational design method with cross sectional approach. The population in this study was chronic renal failure patients who underwent hemodialysis in the hemodialysis ward of Tabanan Regional Hospital. as many as 260 respondents. The sampling technique was by using non-probability sampling technique with purposive sampling technique with a total sample of 72 respondents. Data collection used questionnaire sheets. Lambda test results obtained p-value = 0.005 (p &lt;0.05) then H0 was rejected, which means that there was a correlation between compliance undergoing hemodialysis therapy and life quality of patients with chronic renal failure in the hemodialysis ward of Tabanan Regional Hospital. The closeness of the correlation between variables can be seen from r-value = 0.238 which had a weak correlation.

Literature Review: Pengaruh Relaksasi Otot Progresif terhadap Kualitas Tidur pada Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis

Pasien PGK merasakan kelelahan setelah melakukan hemodialisis, sehingga pasien mengalami gangguan dalam bekerja dan kegiatan sehari-hari. Pasien dengan penyakit PGK yang sudah mencapai derajat 5 atau tahap akhir akan mengalami gangguan, tidak hanya terbatas pada sistem ginjal, namun tubuh lain juga dapat dipengaruhi yang dapat menyebabkan penurunan status kesehatan dan kualitas tidur. Tujuan penelitian ini adalah untuk mengkaji dengan literature review pengaruh teknik relaksasi otot progresif terhadap kualitas tidur pasien penyakit ginjal kronik. Literatur Review dengan menggunakan 4 database (Scopus, Science Direct, Google Scholar, dan Pubmed ) untuk mencari jurnal dengan kriteria jurnal yang terbit tahun 2015-2020, fulltext, jurnal yang sesuai dengan topik, terdapat ISSN, volume, dan nomer jurnal, merupakan jurnal intervensi relaksasi otot progresif pada pasien penyakit ginjal kronik. Setelah mengumpulkan data, semua data diseleksi sesuai dengan kriteria inklusi dan eksklusi, kemudian diseleksi studi dengan menggunakan flow diagram PRISMA 2009. Berdasarkan 10 artikel yang terpilih didapatkan hasil terapi relaksasi otot progresif dapat meningkatkan kualitas tidur pasien penyakit ginjal kronik. Berdasarkan 10 artikel terpilih sesuai kriteria inklusi yaitu terapi relaksasi otot progresif dapat diterapkan pada pasien penykit ginjal kronik untuk meningkatkan kualitas tidur pasien.

Contributing Factors to Non-adherence among Chronic Renal Failure Patients undergoing Haemodialysis Sessions

AbstractBackground: Non-adherence to dialysis is a cause for concern as it leads to several life-threatening complications. Several factors can contribute to non-adherence in dialysis patients. The aims to identify factors contributing to non-adherence among chronic renal failure patients undergoing haemodialysis sessions. Methods: Research design: Descriptive research design.Setting : Dairout General Hospital at haemodialysis unit. Subjects :A purposive sample of 95 adults patients, male & female, their age ranged from 18-65 years, undergoing haemodialysis and agreed to participate in the study. Tools : Tool (1):Patient assessment. Tool (2):Non-adherence contributing factors questionnaire among chronic renal failure patients. Results : Six categories of factors contributing to non-adherence among chronic renal failure patients undergoing haemodialysis sessions were identified. These were patient related factors, sociodemographic factors, psychological factors, therapy related factors, disease related factors and health care related factors.Conclusion: Non-adherence remains a major obstacle in the effective management of chronic kidney disease (CKD) patients. Recommendations:There is need for collaborative approach to devise measures that eliminate relevant contributing factors to non-adherence among chronic renal failure (CRF)patients.

Evaluation of Fatigue, Sleep Quality and Activities of Daily Living in Patients with Chronic Renal Failure

Introduction: Patients receiving hemodialysis treatment for chronic renal failure (CRF) develop various symptoms and experience lifestyle changes. CRF is a progressive disease characterized by irreversible loss of nephrons. Objective: The aim of the study was to evaluate fatigue, sleep quality and activities of daily living in patients with chronic renal failure. Method: This was a descriptive cross-sectional study. Sixty-seven CRF patients aged over 18 years who admitted to a private dialysis center for hemodialysis treatment were included. Sociodemographic information was recorded and the 'Visual Analog Scale for Fatigue' was used to evaluate fatigue, the 'Pittsburgh Sleep Quality Index' for assessment of sleep quality and the 'Katz Activities of Daily Living Scale' for evaluation of activities of daily living for all patients. All evaluations were conducted by the same investigator before hemodialysis session. Fatigue level assessment was repeated after hemodialysis session. The data obtained were analyzed using the SPSS 24.0 software package. Results: Thirty (44.8%) females and 37 (55.2%) males were enrolled in the study. The mean age of the study population was 55.8 ± 15.75 years. 74.6% of the patients had poor sleep quality. The mean fatigue score of the patients was 4.82 ± 2.02 before hemodialysis and 8.79±1.67 after hemodialysis, as assessed by VAS-F. All participants were independent in activities of daily living. The average of Katz ADL Scale was 16.80 ± 1.76. Discussion and Conclusion: In line with former studies, fatigue was the most common symptom in the study patients undergoing hemodialysis treatment for chronic kidney failure. Additionally, poor sleep quality and reduced performance in the activities of daily living in the study participants are noteworthy. Hemodialysis causes a number of symptoms that patients have to cope with in their daily lives. It is important to guide patients about individualized rehabilitation programs in the treatment of chronic renal failure.

Hybrid Blood Purification Therapy Based on Camel Nanoantibody Immunoadsorbent on Patients with Chronic Renal Failure in Nephrology Department

This paper proposes a study on the effect of hybrid blood purification therapy based on camel nanoantibody immunoadsorbent on chronic renal failure patients in nephrology department. In this paper, the hybrid blood purification therapy based on camel nanoantibody immunoadsorbent was applied to patients with chronic renal failure, and the curative effect of the patients was studied. In order to highlight the effect, a control group was set up for comparison. In this paper, the clearance effect of small molecule toxin, middle molecular toxin, and dialysis adequacy was analyzed. This study found that the average dialysis adequacy of the control group was 1.23% and that of the experimental group was 1.26%. The dialysis adequacy of the experimental group was significantly better than that of the control group. In addition, the clearance effect of small and medium molecular toxins in the experimental group was significantly better than that in the control group. It can be seen that the hybrid blood purification therapy based on camel nanoantibody immunoadsorbent is effective in the treatment of chronic renal failure patients in the department of nephrology. Therefore, it is of great value to apply camel nanoantibody in the clinical treatment of renal failure.

Genotyping and prevalence of hepatitis c virus in dialysis patients in Gandhi general hospital - A tertiary care centre

Context: The present study was undertaken to determine the genotyping and prevalence of hepatitis c virus in dialysis patients as HCV genotyping has become a part of the pre-treatment evaluation. Studies correlating risk factors and genotypes of HCV infection prevalent in Haemodialysis patients are scanty. Therefore our study is conducted to study the prevalence, genotypes and risk factors in order to detect and try to curb HCV infection. Aims: To study the genotypes of hepatitis C infection and its prevalence in hemodialysis patients. Settings and Design and Period: Study was conducted in Gandhi hospital Secunderabad in 1 year period as Cross-sectional study. Materials and Methods: A total of 225 serum samples were collected from chronic renal failure patients who were undergoing Haemodialysis over a period of 1 year. The samples were screened for anti HCV antibodies by third generation ELISA test. 25 anti-HCV positive samples and 40 anti-HCV negative samples were randomly selected for HCV RNA detection using Trizol-Chloroform-Isopropyl alcohol method, HCV RNA was reverse transcribed with 200 U of maloney murine leukemia virus reverse transcriptase and random hexamers. Nested PCR was done. HCV RNA positive samples were genotyped with primers specific for core region of different HCV types by type specific PCR. Statistical Analysis Used: Statistical analysis of the data was done by chi-square (c2) test using EPIINFO 2000 software. The values of chi square test are interpreted as not significant >0.05, highly significant < 0.001. Results: Out of 225 hemodialysis patients 38 (16.8%) patients were anti HCV positive. Duration of dialysis was significantly longer in anti-HCV antibodies positive group with dialysis duration more than 2 years. Seropositivity is more in HD patients having dialysis at more than one centre. HCV RNA was detected in randomly selected 13/25 (52%) anti HCV positive patients and in 5/40 (12.5%) anti HCV negative patients. The genotype distribution

Role of intradialytic oral nutrition therapy in Indian patients

Malnutrition is common in patients with chronic renal failure (CRF), and its prevalence before the initiation of dialysis is poorly characterized in these patients in developing countries. There is a paucity of data on the quantification of malnutrition and inflammation in undialyzed patients of CRF from India. Besides the medical condition like anorexia, nausea, vomiting, uraemia etc there are some vegetarian diet pattern and religious factors which abstinence the patients from consuming high biological value protein. This enhances the gap between daily nutrition requirement and fulfilment of the same. Here the oral nutritional supplement appears to be a sustainable effort toward addressing malnutrition in maintenance haemodialysis patients. Keywords: CRF, Dialysis, Malnutrition, Oral nutrition supplements, Albumin.

Similarity Learning Algorithm Selection for Chronic Renal Failure Patients Treatment Strategy Optimization

One of the main methods on which the personalized approach in medicine is based is finding a pair of patients who are similar in the properties of the disease. The objective of the study is to select the most effective similarity learning instrument amongst three options anaemia treatment and phosphorus-calcium balance recovery in dialysis patients, ranked according to the highest similarity to the particular patient. As soon as methods for comparing instruments will achieve the goal, the algorithm of weight tagging is used, modified by the authors by adding more weights values to important features — the cosine measure, the soft cosine measure, considering the similarity of drug alternative and their bioavailability. As a metric that evaluates the quality of algorithms, a combined metric is used that takes into account the quality of treatment classification as effective and the rank order of the greatest correspondence of therapy to a specific patient. As a result, using the opinions of nephrologists as experts, it was shown that the best measure of similarity is the soft cosine measure.

Alteration of thyroid physiology in chronic kidney disease

Introduction: Endocrine abnormalities are very common in CKD and among them thyroid dysfunction is most commonly occurring in CRF patients. Hyperthyroidism, hypothyroidism & euthyroid state have all been reported by various workers but hypothyroidism incidence was found to be more common. Aim: To assess the prevalence of alteration of thyroid physiology among patients chronic renal failure patients and to correlate between the thyroid hormone levels and the severity of chronic kidney disease. Materials and Methods: A cross-sectional observational study was conducted at our hospital for a period of one year. A total of 73 patients with chronic renal failure were included in the study. A detailed clinical history and clinical examination was conducted with preference to thyroid and renal diseases. Serum fT3, fT4 and TSH were measured using standard technique. Results: Majority of the study subjects were in stage V (end stage renal disease) CRF followed by stage IV CRF and only 5 – 8% of the subjects were in stage 1 and stage II CRF. The thyroid profile of our study subjects showed hypothyroidism was present in 43.8% of the CRF patients and in that majority of them had low T3 levels, followed by low T4 levels (36.9%) and an increased TSH levels (19.1%). The correlation between the T3, T4 levels and the various stages of CRF had shown a strong negative correlation, as the stages of CRF increases the number of patients with reduced T3 and T4 levels were found to be increasing and this was found to be statistically significant (p.05). Conclusion: Alteration of thyroid physiology among CRF patients found to be increasingly common and so thyroid screening should be made mandate for all patients with CKD. Keywords: Chronic kidney disease, Thyroid physiology, Free T3, Free T4 and TSH.

The primary care provider's role in providing supportive and palliative care for patients in chronic renal failure.

Primary care providers are at the core of providing supportive and palliative care to patients with chronic kidney disease in South Africa. Although dialysis is not always needed, and sometimes not appropriate, for all patients with end-stage kidney disease, there is always supportive and palliative care that can be provided to patients and families to improve outcomes. This article explores the referral pathways, renal preservation, supportive and palliative care and, finally, health system interventions that can improve comprehensive care. The integration of renal supportive and palliative care is a relatively new concept in the paradigm of care and will require advocacy and research to ensure all South African patients have access throughout the trajectory of illness.

English

BACKGROUND Kidneys are vital organs for excretory and many other biochemical functions in the human body. Most chronic diseases end up damaging the kidneys, acute to chronic, based on the cause and duration. Chronic kidney disease is a sequence of damages to the renal cells and parenchyma leading to progressive deterioration of kidney function, which eventually develops into terminal stage of chronic kidney failure. Chronic renal failure leads to a pro-oxidant state, which leads to damage to the renal cells and parenchyma and the amount of intracellular oxidative stress or extracellular oxidative stress has a relation to the severity of renal failure either directly or indirectly. The study aimed to find the correlation between high sensitivity c-reactive protein (hs-CRP) to lipid peroxidation product, malondialdehyde (MDA). METHODS This prospective study was designed and conducted from January 2018 to December 2019 in the Department of Biochemistry, Government Medical College, Ananthapuramu. The study comprised a total of 70 subjects in the age group of 35 - 65 years. The subjects of the approved study plan were divided into two groups; 35 subjects were healthy controls (group-1), and 35 subjects were chronic renal failure (CRF) patients. A blood sample was collected in Government General Hospital, Anantapuramu. RESULTS The sample was analysed for estimation of blood urea, plasma glucose, serum creatinine, Malondialdehyde (MDA) and C-reactive protein (CRP). The mean value of blood urea, serum creatinine, serum hs-CRP, serum MDA was higher in CRF (group-2) patients when compared to healthy controls (group-1) (p &lt; 0.0001). We observed a positive correlation between serum MDA and serum creatinine (r = 0.46832), hs-CRP (r = 0.0234). CONCLUSIONS In CRF, oxidative stress is obviously evident, but the inflammation induced oxidative stress which can be corrected if detected early will reduce oxidative damage. Our study shows that there is an elevation in hs-CRP and MDA which confirms the presence of oxidative damage, inflammation and probably inflammation induced oxidative damage. KEYWORDS CRF, Oxidative Stress, MDA, Serum Creatinine, hs-CRP

Association between Allelic Variations of -174G/C Polymorphism of Interleukin-6 Gene and Chronic Kidney Disease-Mineral and Bone Disorder in Iraqi Patients

This study designed to examine association between-174G/C polymorphism of interleukin-6 gene and phosphate, calcium, vitamin D3, and parathyroid hormone levels in Iraqi patient with chronic kidney disease on maintenance hemodialysis. Seventy chronic renal failure patients (patients group) and 20 healthy subjects (control group) were genotyped for interleukin-6 polymorphism and genotyping was performed by conventional polymerase chain reaction-restriction fragment length polymorphism. No significant differences in phosphate levels were observed in patients and control with different interleukin-6 genotypes. Control had non-significant differences in calcium levels, while patients with GG and CG genotypes displayed significant elevation with time. Conversely, control and patients with GG and CC genotypes had significant elevation in vitamin D3 levels with time. Regarding parathyroid hormone, control had non-significant differences, while patients with GG and CC genotypes displayed significant elevation with time.&#x0D; Patients with GG genotype displayed significant changes in calcium, vitamin D3 and parathyroid hormone levels with time.

Frequency and predictors of access site complications of the transfemoral diagnostic coronary procedures

Objectives: Access site complications (ASC) remain important and common adverse events after coronary angiography. The aim of this study was to evaluate the frequency and predictors of ASC in patients undergoing diagnostic coronary angiography (DCA) via the femoral artery. Methods: In this prospective analytical cross sectional study, DCA was performed in 3972 patients by transfemoral approach. The femoral access site hemostasis was obtained by manual compression in all patients. Demographic characteristics of the patients, size of the arterial sheaths, duration of compression time, patients blood pressure, medications, hemoglobin and platelet levels were recorded. All patients were evaluated for ASC (pseudoaneurysm, bleeding, dissection, hematoma). The ASC rate was calculated and ASC predictors were determined by multivariate analysis. Results: The ASC rate was 1.3% (53 of 3972 patients). The complications were more frequent in female (female: 29 of 53 [54.7%] vs male: 24 of 53 [45.3%]; p = 0.007) and chronic renal failure (CRF) patients (103 of 3919 [2.6%] vs 4 of 53 [7.5%]; p = 0.02). Hemoglobin level was lower (13.40 ± 1.73 vs 12.86 ± 1.75; p = 0.02) and manual compression time was longer (9.19 ± 3.28 min vs 14.53 ± 6.47 min; p &amp;lt; 0.001) in the ASC group. Clopidogrel (188 of 3919 [4.8%] vs 7 of 53 [13.2%]; p = 0.005) and low molecular weight heparin (LMWH) using were more frequent (37 of 3919 [0.9%] vs 7 of 53 [13.2%]; p &amp;lt; 0.001) in the ASC group. According to multivariate analysis; female gender; OR: 2.13, 95% CI: 1.14-3.99 (p = 0.017), presence of CRF; OR: 3.15, 95% CI: 1.06-9.29 (p = 0.038), manual compression time; OR: 1.23, 95% CI: 1.17-1.30 (p &amp;lt; 0.001) and LMWH using; OR: 15.68, 95% CI: 6.05-40.61 (p &amp;lt; 0.001) were predictors of ASC. Conclusions: The incidence of femoral ASC rate was 1.3% in patients with DCA. Female gender, presence of CRF, using LMWH and long manual compression time were predictors of ASC.

PEMBERDAYAAN KELUARGA DALAM MENURUNKAN TINGKAT KECEMASAN PASIEN GGK DENGAN HEMODIALISA

Chronic kidney failure (CKD) is a pathological condition in the kidney with diverse etiologies, resulting in progressive decline in kidney function, and in general must undergo hemodialysis therapy. In patients with hemodialysis therapy, anxiety often arises with the therapeutic procedures that are given so that the system needs support from the family. This study wanted to determine the effect of family empowerment on anxiety levels of chronic renal failure patients with hemodialysis. The pre-experimental design was the design in this study with a population of 36 patients and a sample size of 22 patients obtained through purposive sampling. This study used a questionnaire instrument and the data obtained were analyzed using the Wilcoxon Sign Rank Test. The measurement results on the level of anxiety before the intervention showed 63% in the level of severe anxiety and after the intervention showed 46% in the category of moderate anxiety. P-value in the statistical test shows 0.003 which means that there is an influence of family empowerment with anxiety level of CRF patients undergoing hemodialysis therapy. Family empowerment can reduce the level of anxiety for patients undergoing hemodialysis in the Hemodialysis Room of RSUD. Mardi Waluyo Blitar. Family empowerment provides assistance, solutions, support, so that it can be used to overcome the anxiety experienced by patients undergoing hemodialysis.

ROLE OF CARDIAC MARKERS IN CHRONIC RENAL FAILURE PATIENTS.

Introduction: Cardiovascular diseases (CVD) are known as important reasons of the increased morbidity and mortality observed in patients with chronic renal failure (CRF). The association of serum Interlukin-6 , homocysteine as well as other cardiovascular risk factors in relation to existence and cause of CVD were investigated. Method: In this study 200 CRF patients were recruited and further stratified into group with Male and Female as case groups. Those without renal failure were assigned as control group (n=200). Results: The patients with CRF showed a significant increase in plasma levels of Cpk-MB homocysteine and C-reactive protein (CRP) compared to control. The positive association were observed between homocysteine, Urea and Hs-CRP, IL_6 . It shows a significant Association of parameters in CRF . Conclusion: The results demonstrated elevation in plasma values IL-6 , homocysteine and HS-CRP in patients with CRF . However, these modifications may be lead to atherosclerosis and consequence CVD event. These parameters may be important with respect to the high morbidity and mortality of CVD found in patients with CRF.