Patients In Hemodialysis Unit Research Articles

TREATMENT ADHERENCE AMONG PATIENTS UNDERGOING HEMODIALYSIS IN HOSPITALS PROVIDING DIALYSIS SERVICE OF BHARATPUR NEPAL

Background: Chronic kidney disease is a worldwide public health problem. In Nepal, chronic kidney disease patients are increasing and the management of this disease is very expensive compared to other chronic diseases. The objective of this research was to assess the treatment adherence among the patient’s undergoing hemodialysis. Methods: A descriptive cross-sectional study was conducted among the hemodialysis patients in Hemodialysis unit of College of Medical Sciences-Teaching hospital, Bharatpur. Semi-structured interview schedule was used. Data was entered and analyzed using in statistical package for social science (SPSS) version 20 using descriptive statistical tools. Results: The Mean ± SD of age was 48.4 ± 13.5 years, 50% of the respondents were adherent with hemodialysis schedule, 69.69% were adherent in diet restriction, 72.73% were adherent with fluid restriction, 43.94% adherent to medication and 63.6% of the respondents were Hemodialysis adherence. Conclusions: Based on the finding of this research the hemodialysis adherence among the patients was good in others except diet and medication. Hemodialysis adherence is influenced by type of family, level of education, Time taken for hemodialysis, no. of days to receive hemodialysis treatment in a week.

Quality of Life and Associated Risk Factors in Hemodialysis: Perspective from a Center in the Dominican Republic

Background: Chronic kidney disease has an overall prevalence of 10?%. It can progress to a condition called end-stage renal disease. Therapies such as hemodialysis are necessary at this stage. Our study aims to measure the quality of life of patients on hemodialysis. Methods: We conducted an observational, cross-sectional study with 81 patients. Data was collected using a survey that included sociodemographic variables, the Center for Epidemiological Studies Depression Screening Index (CES-D), and the Kidney Disease Quality of Life (KDQOL-SF36). Data were analyzed using the software Epi Info™ 7.2, t-test, ANOVA, and correlation coefficient. Results: The severity of symptoms is more significant in the female sex than in males (65.7117 vs. 74.2874). All of the components of the KDQOL-SF36 showed a negative correlation with the CES-D. Household income had a mild positive correlation with the scale (r = 0.2608, p = 0.0229). Physical activity was shown to be associated with the physical component of the scale (41.6346 vs. 35.7365, p = 0.0412). Patients with partners were associated with higher quality of life scores than single patients (53.6585 vs. 42.6783, p = 0.0348). Conclusion: This is the first study conducted in the Dominican Republic to analyze the variables affecting the quality of life in patients in hemodialysis units. The severity of the symptoms increased in female patients, and patients without a partner are associated with worse quality of life scores.

Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio de Janeiro, Brazil

Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) are more vulnerable to blood-borne viral infections due to frequent invasive procedures. Hepatitis B virus (HBV) infection in this cohort of patients has been a matter of concern worldwide. The objective of this cross-sectional study was to evaluate the frequency of serological markers for hepatitis B, and the occurrence of overt and occult HBV infection (OBI) and its molecular characterization in serum samples from 644 CKD patients in HD units located in Rio de Janeiro, Brazil, from 2013 to 2017. HBV DNA was investigated in HBsAg reactive and “anti-HBc alone” samples to determine infecting genotypes and genetic relatedness between sequences. The prevalence of serological markers HBsAg+, anti-HBc alone, anti-HBc+/anti-HBs+, anti-HBs+, anti-HBc/anti-HBs/HBsAg were 5.9%, 2.8%, 30.7%, 26.6%, 34.0%, respectively. HBV DNA was detected in 39.5% (15/38) of the HBsAg+ and in 5/18 (27.8%) of the “anti-HBc alone” individuals, indicating a high prevalence of OBI within this group. We found a higher prevalence of HBV/A1 (65%), followed by HBV/D3 (20%), and HBV/A2 (15%). Bayesian MCC tree with a highly supported clade, genetic distance comparison, and identical nucleotide sequences suggested a nosocomial spread of HBV in some units. The high prevalence of HBV infection and low number of individuals immune to infection reinforces the need for vaccination in this group. The presence of closely related strains in the same HD unit reinforces the importance of continuous improvement of safety control measures and laboratory surveillance of serological markers to prevent the risk of infection and transmission of HBV.

DETECTION OF TORQUE TENO VIRUS ANTIGEN AND ASSOCIATED RISK FACTORS AMONG HEMODIALYSIS PATIENTS

The aim: To determine the prevalence of TTV in patients undergoing hemodialysis and to evaluate the possible risk factors. Materials and methods: This study was conducted in 93 patients, attending hemodialysis unit at AL-Imammain AL-Kadhimain Medical City Hospital for a period from November 2020 to March 2021. The demographic and clinical characteristics including age, sex, underling medical condition, hepatitis B and C status and laboratory tests such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline Phosphatase (ALP) and total serum bilirubin (TSB) were obtained from the record of the patients in hemodialysis unit in the hospital. Direct detection of TTV-Ag was done by enzyme linked immunosorbent assay (ELISA). Results: TTV-Ag was detected in 38 out of 93 (40.9%) hemodialysis patients. Demographic, clinical and risk factors i.e. sex, age, history of diabetes, history of hypertension, history of blood transfusion, number of blood transfusion, the hemodialysis duration, history of surgery and liver enzymes levels did not show significant relation (P>0.05). Conclusions: This study showed high prevalence of Torque Teno virus in hemodialysis patients, however, TTV did not play a role in liver injury among these patients.

Nephrologists' Attitudes Regarding Psychosocial Care in Hemodialysis Units.

Background:There is a high prevalence of psychosocial issues affecting patients with kidney failure.Objective:We sought to examine Canadian nephrologists’ attitudes and opinions regarding the importance of renal patient psychosocial care, nephrologists’ roles, and experience with psychosocial care in addition to what barriers, if any, prevent these physicians from providing psychosocial care to their patients.Design:A self-administered, survey questionnaire.Setting:Online.Sample:Canadian Society of Nephrology members who predominantly work in clinical care with adult, in-center hemodialysis patients.Measurements:Measurements of the survey include demographics, training, and nephrologists’ opinions regarding their role in administering psychosocial care, potential administrative and patient time constraints, accessibility of other health care workers for this activity, and factors that influence or impede physicians’ ability to address their patients’ psychosocial needs.Methods:A self-administered survey was sent to almost 500 members of the Canadian Society of Nephrology between November 2018 and December 2018. The survey questionnaire was designed to gather opinions and attitudes on psychosocial care delivery as well as potential influencing factors on nephrologists’ ability to provide this care. A univariate statistical analysis was used to analyze survey responses.Results:A total of 30 nephrologists responded to the survey, generating a 6% response rate. Respondents varied across provinces, with the majority being staff nephrologists (80%). While over 94% of respondents either agreed or strongly agreed that focus on psychosocial care improves patient outcomes, only 43% felt that staff nephrologists were suited to provide this care to patients; 97% of respondents believed social workers to be the most suited to provide this. Lack of additional supporting health care members, the need for additional training, too many administrative duties, and empathy fatigue were some of the predominant barriers respondents felt prevented them from addressing the psychosocial care of their patients.Limitations:A low response rate for the survey was obtained, roughly 6%, limiting our ability to draw definitive conclusions. Survey answers by respondents may be different from those by nonrespondents. Answers may be subject to social desirability and/or selection bias.Conclusion:Nephrologists believe that the current psychosocial care of patients in hemodialysis units is inadequate. However, further research is necessary to elucidate the barriers nephrologists face in providing psychosocial care and the changes required to most effectively implement optimal psychosocial care for patients with kidney failure in hemodialysis units.

Predictors of HCV Seroconversion among End-stage renal disease Patients in Hemodialysis Unit

Background: In patients under dialysis, blood borne infections remains one of the mostpublic causes of morbidity, hospitalization and death. Among dialysis patient’s long-term hemodialysis (HD) therapy, frequency of blood transfusions and multiple blood transfusions enhance the risk of acquiring blood-borne infections. Objective: The aim of the study was to identify predictors for HCV sero-conversion in HD patients. Method: Prospective observational study was conducted on 173 Chronic kidney disease (CKD) patients undergoing HD. Anti HCV antibody testing was accomplished at the start of study and every 2-3 months subsequently. To identify seroconversion, patients who were sero-negative for HCV were monitored.Results: Prospective follow-up exposed an occurrence of seroconversion of 12.1% during study duration. On multivariate analysis, both increase in the duration on hemodialysis besides attending more than one centre for HD were significantly associated with anti-HCV positivity (p < 0.05, OR 0.185), (p 40 IU/L also shows significant association for seroconversion (p < 0.05). Conclusion: It is concluded that increase post dialysis incidence of HCV occurs as specific guidelines for HCV infected patients were not followed. Regular surveillance for HCV infection helps dramatically in decreasing the spread of HCV in hemodialysis unit.Keywords: Hepatitis C virus, Hemodialysis, End stage renal disease, Chronic kidney disease

Delivering Dialysis During the COVID-19 Outbreak: Strategies and Outcomes

Abstract Background Haemodialysis (HD) patients are at increased risk of COVID-19 infection. Although all dialysis patients meet government criteria for shielding, only those on home treatment can comply. Patients attending incentre HD units represent a large and vulnerable group, who are unable to rigorously adhere to this advice. The need to adopt strategies to protect these patients is of great importance. We report our experience of delivering dialysis during the COVID-19 outbreak, describing the interventions taken to try to protect patients from virus transmission whilst maintaining optimal treatment. Methods We implemented measures, including use of; a system of active triage and isolation of suspected cases, separate transportation, a dedicated COVID-19 HD unit, personal protective equipment, active repatriation of patients back to base units. We collected data from all COVID-19 positive HD patients in our cohort, between 14/03/2020 - 20/04/2020. Data were compared to national reports of other units, and values obtained from a dialysis-specific Susceptible-Infectious-Removed model which predicted the impact of COVID-19 on our cohort. Results Results showed 76/670 (11.3%) tested positive for COVID-19. The majority were male (61.8%) and from a minority background (61.8%). 7/76 (9.2%) patients died following infection. The model projections overestimated the incidence of COVID-19, 221 vs 76 total number of infections by 20/4/20. Our incidence of COVID-19 and mortality are lower compared to other units across London. Conclusion Implementation of measures to limit the spread of COVID-19, and optimise dialysis, could account for the low infection and mortality rates observed in our cohort of patients.

Professional relationships between nephrology clinicians and patients: a systematic review.

Nephrology nurses and patients expressed that the clinician-patient relationship in a haemodialysis (HD) unit might be best described as being part of an extended family. However, there is a risk that professional boundaries may become blurred due to the perceived closeness of this relationship. This systematic review sought to explore the experiences of nephrology clinicians in establishing and maintaining a professional relationship with people experiencing end-stage kidney disease who are receiving HD treatment. A search strategy was created using JBI systematic review guidelines for six databases (PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library and JBI library). Qualitative studies were eligible for inclusion when the participants were nephrology clinicians who provided HD treatment or management of patients in a hospital outpatient HD unit or a community HD centre. Three studies met the inclusion criteria and the findings were synthesised into two themes (1) establishing a professional relationship and (2) coping mechanisms. All three studies focused on nephrology clinicians realising the importance of treating patients as individuals. Nephrology clinicians demonstrated advanced communication skills, empathy and compassion when interacting with patients, which seemed to contribute to patient satisfaction. This systematic review found some qualitative evidence to explain how nephrology clinicians establish and maintain a professional clinician-patient relationship with patients in the HD unit. This review highlighted a significant gap in research concerning the trajectory of the clinician-patient relationship across all members of the renal multidisciplinary health care team.

Impact of an educational program on knowledge and quality of life among hemodialysis patients in Khartoum state

PurposeThe purpose of this study was to evaluate the effectiveness of an educational program on the knowledge and quality of life among hemodialysis patients in Khartoum state. MethodsThis study was a hospital-based quasi-experimental study with a pre- and posttest design; conducted among patients in hemodialysis units. ResultsThe results revealed that there was a significant increase in the overall mean.knowledge from 48.6% pre-intervention to 86.3% post-intervention.of the program, thus improving the quality of life after its implementation. Specifically, the results revealed that there was a significant improvement in all domains of quality of life. ConclusionsThe educational program was proven to be effective in improving the knowledge of hemodialysis and the quality of life of patients receiving hemodialysis. The implementation of the educational program had a positive effect on the patients' overall knowledge regarding the concept of hemodialysis, vascular access care, complications, the dietary restrictions, fluids restrictions, types of medications and activities that can help the patients to adapt with disease and hemodialysis.

Auditing of Nursing Care for Hemodialysis Patients at Ma,an Governmental Hospitals- Jordan

Nursing auditing is used to evaluate the nursing care given to achieve deserved and feasible quality of nursing care. Aims of this study were to assess current nursing performance for patients undergoing hemodialysis, Develop nursing care standards and identify the gap between the current nursing management and nursing care standards for those patients. Research design: Exploratory research design was used . Setting: The study was conducted in dialysis unit at Ma, an governmental hospitals- Jordan Subjects: The sample in this study is composed of all available nurses (40 nurses) who are providing direct care to patients in hemodialysis units at previously mentioned hospital. Tools of Data Collection: Self-Administered Interview Questionnaire sheet, an observational check, developed Nursing Care Standards for Patients undergoing haemodialysis, and Nursing Care Standards checklist. Results: Around half of nurses their knowledge score ranged between good and fair regarding renal failure and dialysis. Only 25 % of nurses done correctly in nursing standers 4 about patient educated before discharge. Conclusion: about quarter of nurses perform after dialysis steps incorrectly. There was no statistical significant difference between routine care and standers nursing care for patient undergoing hemodialysis. Recommendations: Written standards of care against which to evaluate nursing care. Training for auditors should include a group discussion to see how the group rates the care received using the notes of a patient.

ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN MEKANISME KOPING PASIEN HEMODIALISA RSUD DR. M. YUNUS BENGKULU

Chronic Renal Failure (CRF) disease is a clinical state of progressive kidney damage and variable from various causes of diseases. From the data in some of the nephrology center in Indonesia estimated the incidence and prevalence of chronic kidney disease each ranging from 100-150 / 1 million inhabitants and 200-250 / 1 million population, but were diagnosed with chronic renal failure on dialysis (Hemodialysis) only about 4000 to 5000 alone.This study aimed to determine the factors associated with the dominant coping mechanism on hemodialysis patients in hemodialysis unit of Dr. M. Yunus Hospital Bengkulu 2016.This study is an analytical research using cross-sectional design which use variable measurement or observation at a given moment. This study was conducted in Hemodialysis unit of Dr. M. Yunus Hospital Bengkulu on June 20 to July 20, 2016. The samples in this study were hemodialysis patients who had conducted dialysis over a year of 50 people. The instrument used were questionnaire and checklistsheets.Most respondents31 people from 50 respondents in hemodialysis unit of Dr. M. Yunus HospitalBengkulu adapted coping mechanisms. Almost all of the respondents21 people had little knowledge. Most respondents primary who had education level (primary and junior equivalents) were 21 of 50 respondents. Half of the respondents aged 41-60 were26 people from 50 respondents. The respondents totally 29 people were largely male. Most respondents that had high hopes were 25 respondents.

Assessment of safety measures in hemodialysis units in Menoufia

Objective The aim of this study was to assess the safety measures for patients in hemodialysis units, aiming to improve the quality of medical services provided by the hemodialysis units in Menoufia Governorate and to evaluate hemodialysis units from the safety point of view. Background Hemodialysis is the most well-established form of treatment for end-stage renal failure. Standard precautions with additional measures are recommended specifically for dialysis centers to prevent transmission of bacteria and viruses from patient to patient. Patient and methods The study was conducted on 19 units of hemodialysis. All patients with end-stage renal disease under regular hemodialysis in these units were included. A questionnaire from the ministry of health and population was used. Results The percentage of working machines to total machines ranged from 77.4 to 100%. Practicing routine handwashing was 'good' in 60% of units, application of infection control measures was 'good' in half of the units, application of environmental infection control measures was 'good' in 12 units, and waste management was 'good' in 18 units. Workers were totally vaccinated against hepatitis B virus in eight units. Hepatitis B virus-positive patients had complete isolation. The level of safety in the studied units was 'good' in three units and 'fair' in 16 units. Conclusion More than 25% of the dialysis machines exceeded the recommended working hours/duration. Personal protective clothes and cleaning materials were available with shortage in usage. There was a shortage in the medical staff, especially in governmental hospitals. There was shortage in infrastructure of the most of dialysis units.

The Quality of Life Chronic Renal Failure (CRF) Patients in Hemodialysis Unit at District General Hospital Pringsewu Regency Lampung Province in 2018

The purpose of this study was to determine the factors that affect the quality of life of CRF patients in Hemodialysis Unit at Pringsewu District General Hospital. This study was conducted from February to May 2018 with cross sectional study design. The sampling technique using total sampling technique. Measurement of quality of life using KDQOL-SFTM version 1.3. The results found that quality of life scores were quite low in some domains and subscales. The mean of total score was 55.70 ± 21.30 with mean of Physical Health Composite (PHC) = 38.85 ± 9.26 and mean of Mental Health Composite (MHC) = 36.13 ± 7.08. Regarding the targeted area of ESRD, the scale of renal disease burden and occupational status scale resulted in the lowest score. The sleep quality scale score was 56.18 ± 20.72. Only 61 patients responded to questions of sexual activity with a score of 55.53 ± 27.44 on the scale of sexual function. In the 36-item health survey, the mean total score was 45.90 ± 21.95. The lowest score represented the limitations of roles caused by physical and emotional health problems. The result of statistical test showed that the variables significantly related to the quality of life of CRF patients were age, income, duration of hemodialysis and family support. Thus, family support was the variable that had the greatest impact on determining the quality of life of CRF patients. The CRF patients who lacked family support were 4.6 times more likely to lead poorer life compared to CRF patients who received good family support after being controlled by age, income, duration of hemodialysis, gender, working status, and diabetes mellitus variables.

A Province-wide, Cross-sectional Study of Demographics and Medication Use of Patients in Hemodialysis Units Across Ontario.

Background:Hemodialysis patients are at an increased risk of polypharmacy as they have the highest pill burden of all chronically ill patient populations, with an estimated average of 12 medications per day.Objectives:The aim of this study was to evaluate prescribing patterns of outpatient medications in patients receiving in-center hemodialysis. This was done to identify potential candidate medications for future quality improvement initiations to optimize prescribing.Design:We conducted a descriptive retrospective cross-sectional study in the province of Ontario, Canada, using several linked health care databases housed at the Institute for Clinical Evaluative Sciences (ICES).Setting:We considered outpatient medications dispensed to patients eligible for the Ontario Drug Benefit program.Patients:Patients were receiving chronic in-center hemodialysis at one of the 69 facilities in the province of Ontario, Canada as of October 1, 2013.Measurements:We assessed whether any of our 28 study medications of interest were recently dispensed (within the prior 120 days), the type of prescribing physician, and the associated medication costs. The 28 included medications of interest (ie, proton pump inhibitors, benzodiazepines) were selected because they may not have a true indication for dialysis patients and/or there are safety concerns with their use in this population. Results are presented as median (25th, 75th percentile).Methods:We conducted this study at ICES according to a prespecified protocol approved by the Research Ethics Board at Sunnybrook Health Sciences Centre (Toronto, Ontario).Results:A total of 3094 patients on chronic in-center hemodialysis received a study drug of interest (age: 76.5 years [SD: 7.3]), 44% women). Patients were dispensed 11 (8, 14) unique medication products with more than two-thirds of patients dispensed 9 or more different medications. The median number of annual health care visits was 7 (3-15) with more than half the cohort receiving prescriptions from 3 or more specialists. The 10 most commonly dispensed study medications cost more than 3 million dollars in direct costs in 1 year.Limitations:Our study was also subjected to some limitations of health care databases.Conclusions:Polypharmacy is frequent in in-center hemodialysis patients. To decrease polypharmacy and its associated negative outcomes, health care providers need to implement tools to optimize medication use and deprescribe medications that lack evidence for efficacy and safety in hemodialysis patients. Therefore, strategies to improve prescribing and discontinue ineffective medications warrant testing for better patient outcomes and reduced health care costs.

Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt.

Worldwide, hemodialysis (HD) constitutes the most common form of renal replacement therapy. Many studies have shown strong correlation between HD dose and clinical outcome. The cross-sectional study was conducted on 100 patients in Hemodialysis Unit at Tanta University Hospital, Egypt. Data were collected using a reliable questionnaire (including clinical, demographic, dialysis, laboratory, and radiological data). SpKt/V was used to assess the adequacy of HD. The results revealed inadequate HD dose among 60% of the study population. The results also showed that increasing time and frequency of dialysis, blood flow rates, low recirculation percentages, reduction of intradialytic complaints, and well-functioning vascular access are associated with better HD adequacy. Our findings showed a positive correlation between dialysis dose and hemoglobin, serum albumin, normalized protein catabolic rate, and physical health. A great percentage of patients had inadequate HD. HD adequacy was influenced by several factors such as duration and frequency of dialysis session, patients’ complaints, and well-functioning vascular access.

PREVALENCE AND RISK FACTORS OF HEPATITIS C VIRUS INFECTION IN HAEMODIALYSIS PATIENTS: TESTING ANTIBODIES, RNA AND GENOTYPES

Hepatitis C virus (HCV) infection is an important global public health problem affecting approximately 180 million people. Multiple risk factors are associated with HCV transmission among haemodialysis (HD) patients leading to an increased risk for liver-related mortality. Patients undergoing HD may show a decreased humoral and cellular immunity, which lowers the sensitivity of the HCV antibodies (Abs) test resulting in false negative antibody test, thus requiring HCV RNA testing. Our study is to determine the prevalence of HCV markers (antibody RNA and genotype) and risk factors of HCV infection among patients in HD unit in Baghdad. A sample of 54 patients were interviewed. HCV Abs (anti-HCV) was tested using third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia-Tek III) as screening and confirmatory test respectively. Sera of 46 patients (irrespective to anti-HCV results) were subjected to molecular analysis, using the most developed RT-PCR and DNA Enzyme immunoassay (DEIA) method. Seropositive rate of anti-HCV and HCV-RNA were (66.6%) and (60.9%) respectively. Anti-HCV seropositive rate was significantly higher in males (77.1%), and history of blood transfusion (85%). Blood transfusion acts as a significant risk for acquiring HCV (OR 44.2, 95% CI 7.6-256.9). Genotype 4 was the most prevalent (33.3%), followed by genotype 1a (25.9%) and genotype 1b (22.2%). We concluded that, the prevalence of HCV among the haemodialysis patients is high. It is significantly related to gender, duration of dialysis and number of blood transfusion. Blood transfusion acts as a significant risk factor. Molecular test for detection for HCV RNA is necessary and proper nosocomial prevention program should be implemented to prevent HCV transmission.

Detection of hepatitis C virus in patients with terminal renal disease undergoing dialysis in southern Brazil: prevalence, risk factors, genotypes, and viral load dynamics in hemodialysis patients.

Hepatitis C (HCV) is a serious public health issue, and it is estimated that 3% of the world’s population is infected. Patients in hemodialysis units have an increased risk for contracting HCV, and high prevalence rates have been found in hemodialysis units around the world. This study is aimed at determining the prevalence of HCV in patients with terminal chronic renal disease (tCRD) who have been submitted to hemodialysis and peritoneal dialysis in southern Brazil to characterize the most prevalent genotypes, the viral load, and possible risk factors and to assess the validity between the ELISA and RT-PCR detection methods. Of 320 patients from three dialysis units, 318 participated in this study. According to the medical records, 55 patients were reactive to HCV, as determined via ELISA. All 318 samples were submitted to RT-PCR and genotyped using an Abbott Realtime® m2000 system. Data obtained through a questionnaire and chemical variables were associated with the HCV. Results: The prevalence of HCV was 18.24% (58), and the concordance between the HCV serology and the RT-PCR was 94%. Three patients were diagnosed to be negative for HCV using the ELISA assay but positive when using RT-PCR. Genotype 1 was the most prevalent (46.7%) genotype, within which subtype 1a was the most frequent (74.1%). One of the risk factors associated with HCV infection was the length of time that the patient had been undergoing hemodialysis treatments (p < 0.001). Additionally, the viral load was found to vary when tested before and after hemodialysis (p < 0.001). Conclusion: The prevalence of HCV in dialysis units continues to remain high, indicating nosocomial contamination. RT-PCR detected the presence of the hepatitis C virus in patients with a non-reactive serology, which highlights the importance of performing molecular tests on dialysis patients. The variation in the viral load in patients submitted to hemodialysis indicates a possible destruction or gripping of viral particles to the dialyzer membrane.Electronic supplementary materialThe online version of this article (doi:10.1186/s12985-015-0238-z) contains supplementary material, which is available to authorized users.

Effect of end-stage renal disease on oral health in patients undergoing renal dialysis: A cross-sectional study

Aims and Objectives:To evaluate the effect of chronic renal failure on oral health in renal dialysis patients. To assess and improvise awareness of staff regarding oral health care of the patients in hemodialysis unit.Materials and Methods:A cross-sectional questionnaire survey and oral health examination study were conducted on 206 end-stage chronic renal failure patients (stage V) who were undergoing renal dialysis in Guntur city. The study included the questionnaire form and modified WHO proforma to record their oral health status. Oral examination was done in American Dental Association (ADA) type III method by using mouth mirror and community periodontal index (CPI) probe. Questionnaire survey was conducted among the nursing staff in the hemodialysis unit.Results:Mean age of the study subjects was 46.79 ± 12.78 years; 81.1% were males and 18.9% were females. Candidiasis (8.3%) was the most frequently seen oral mucosal condition in these subjects. Majority of the subjects (44.2%) showed periodontal diseases (CPI score 3: Pocket depth of 4-5 mm). Caries prevalence of 56.3% was seen in this study group. Higher incidence of hepatitis C was significantly associated with higher duration of dialysis. There was very little awareness among the nursing staff regarding dental care.Conclusion:There is greater deterioration of periodontal health among dialysis patients with chronic renal disease. Awareness regarding dental care is very less among patients undergoing renal dialysis. These patients should be monitored carefully to maintain their oral health. Awareness must be increased among dialysis patients and nursing staff about the need for primary prevention of dental diseases.

Staphylococcus aureus nasal carriage in a Moroccan dialysis center and isolates characterization

Staphylococcus aureus, which has its ecological niche in the anterior nares, has been shown to cause a variety of infectious diseases mainly for patients in hemodialysis units. We performed this study to evaluate the prevalence of nasal S. aureus carriage among hemodialysis outpatients, to determine the antimicrobial susceptibility of isolates, to characterize the virulence genes, and to identify associated risk factors. Nares swab specimens were obtained from 70 outpatients on hemodialysis between March and June 2010. Samples were plated immediately onto S. aureus specific media and pattern of antibacterial sensitivity was determined using disk diffusion method. Polymerase chain reaction was used to detect nuc, mecA, and genes encoding staphylococcal toxins. Medical record of patients was explored to determine S.aureus carriage risk factors. Nasal screening identified 42.9% S. aureus carriers with only one (3.3%) methicillin-resistant S. aureus isolate. Among the methicillin-susceptible S. aureus isolates, high rate of penicillin resistance (81.8%) has been detected. The identified risk factors were male gender and age ≤ 30 years. Research of virulence factors showed a high genetic diversity among the 30 S. aureus isolates. Twenty-one (70%) of them had at least one virulence gene, of which 3.3% were Panton-Valentine leukocidin (lukS/F-PV) genes. S. aureus carriage must be screened for at regular intervals in hemodialysis patients. Setting up a bacterial surveillance system is one of the strategies to understand the epidemiology of methicillin-resistant S. aureus, to guide local antibiotic policy and prevent spread of antibiotic-resistant S. aureus.

Evaluation of Nurses’ Practices throughout Hemodialysis Treatment for Patients in hemodialysis unit at Baghdad teaching hospitals

Objectives: Evaluation of nursing staff practices throughout hemodialysis treatment for patients in hemodialysis units and to determine the relationship between nurses’ practices and their demographical characteristics. Methodology: A descriptive study was carried out at hemodialysis units of Baghdad teaching hospitals started of December 25th, 2011 until May, 9th, 2012. Non-probability (purposive sample) of (30) nurses, who were working in hemodialysis units, were selected in Baghdad teaching hospitals. The data were collected through the use of constructed questionnaire, which consist of two parts (1) Demographic data of that consist 10-items and (2) Nurses’ practices that consist of 25 items, by means of direct interview technique and visualization of the nurses. Reliability of the questionnaire was determined through a pilot study and the validity through a panel of (9) experts. Descriptive statistical analysis procedures (frequency, percentage, mean of score) and inferential statistical analysis procedures (person correlation coefficient, contingency coefficient) were used for the data analysis. Results: The findings of the study indicated that there was a deficit in the nurses’ practice that should be applied to the patient throughout hemodialysis treatment. No significant relationship was found between nurses’ practice and their gender, level of education, years of experience in hemodialysis units, while significant relationship was found between nurses’ practice and their marital status. Recommendations: The study recommended that the importance of employing Academic nurse in Hemodialysis units, a booklet should be designated and distributed to all nurses who were working in hemodialysis units including the standard actions that should be applied and followed to care for patients in hemodialysis units, and an educational program should be designated to the nurses who were working in hemodialysis units including the standard actions that should be applied to care for patients in hemodialysis units