Issues Related to the Care of Critically Ill Patients with End Stage Renal Failure

1992 ◽  
Vol 3 (3) ◽  
pp. 585-596
Author(s):  
Christy A. Price
Keyword(s):  
Renal Failure ◽  
Intensive Care ◽  
Critically Ill ◽  
End Stage Renal Disease ◽  
Treatment Options ◽  
Nursing Interventions ◽  
End Stage Renal Failure ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End stage renal disease (ESRD) affects every aspect of an individual’s lifestyle. Pharmacologic, dietary, and treatment options and other organ involvement become daily realities for ESRD patients. When ESRD patients are admitted to intensive care units, these realities become concerns for the nurses. This article addresses the considerations that must be included in the nursing interventions for the critically ill ESRD patients

scholarly journals Oral Anticoagulant Therapy in Patients Receiving Haemodialysis: Is It Time to Abandon It?

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Marek Saracyn ◽  
Dorota Brodowska-Kania ◽  
Stanisław Niemczyk
Keyword(s):  
Atrial Fibrillation ◽  
Renal Failure ◽  
Venous Thromboembolism ◽  
End Stage Renal Disease ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
End Stage Renal Failure ◽  
The Moment ◽  
Stage Renal Disease ◽  
End Stage

Oral anticoagulant (OAC) therapy in haemodialysis patients causes a great deal of controversy. This is because a number of pro- and anticoagulant factors play an important role in end-stage renal failure due to the nature of the disease itself. In these conditions, the pharmacokinetic and pharmacodynamic properties of the OACs used change as well. In the case of the treatment of venous thromboembolism, the only remaining option is OAC treatment according to regimens used for the general population. Prevention of HD vascular access thrombosis with the use of OACs is not very effective and can be dangerous. However, OAC treatment in patients with atrial fibrillation in dialysis population may be associated with an increase in the incidence of stroke and mortality. Doubts should be dispelled by prospective, randomised studies; at the moment, there is no justification for routine use of OACs in the above-mentioned indications. In selected cases of OAC therapy in this group of patients, it is absolutely necessary to control and monitor the applied treatment thoroughly. Indications for the use of OACs in patients with end-stage renal disease, including haemodialysis patients, should be currently limited.

scholarly journals Serum metabolomics study of end-stage renal disease with depression: potential biomarkers for diagnosis and promising targets for therapy

2019 ◽  
Author(s):  
Jie Hu ◽  
Dezhi Yuan ◽  
Kuan Tian ◽  
Liping Feng ◽  
Qiuye Zhao ◽  
...  
Keyword(s):  
Renal Failure ◽  
Energy Metabolism ◽  
Renal Disease ◽  
Roc Curve ◽  
End Stage Renal Disease ◽  
Psychological Disorder ◽  
Depression Group ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background End-stage renal disease (ESRD) is the most severe stage during the development of the renal failure. And depression is the most common psychological disorder in patients with ESRD, which in turn aggravates the progression of renal failure and seriously reduce the quality of life in ESRD patients with depression, but its underlying mechanism remains unclear. This study aimed to reveal the pathogenesis and discover novel peripheral biomarkers for ESRD with depression through metabolomics analysis.Methods Ultra-high-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was used to explore changes of serum metabolites among healthy controls (n = 12), ESRD patients (n = 17), and ESRD patients with depression (n = 17). Also, the differential metabolites between groups were subjected to clustering analysis, pathway analysis, receiver operating characteristic (ROC) curve analysis.Results A total of 57 significant serum differential metabolites were identified between the ESRD without depression group and the ESRD with depression group, which were involved in 19 metabolic pathways, such as energy metabolism, glycerolipid metabolism and glutamate-centered metabolism. Moreover, the area under the ROC curve of Gentisic acid, Uric acid, 5-HT, 2-Phosphoglyceric acid, Leucyl-phenylalanine, Propenoyl carnitine, Malaoxon, Pregnenolone, 6-Thioxanthine 5'-monophosphate, Hydroxyl ansoprazole, Zileuton O-glucuronide, Cabergoline, PA (16:0/18:2(9Z,12Z)), PG (18:0/18:1(11Z)), probucol, etc. and their combination was greater than 0.90.Conclusions Inflammation, oxidative stress and metabolic abnormalities in energy metabolism, glycerolipid metabolism and glutamate-centered metabolism may be associated with the pathogenesis of ESRD with depression, which may be promising targets for therapy. Furthermore, the identified differential metabolites may serve as biomarkers for the diagnosis of ESRD patients with depression.

scholarly journals Incidence of end stage renal disease on renal replacement therapy in Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 301-305 ◽  
Author(s):  
R Hada ◽  
S Khakurel ◽  
RK Agrawal ◽  
RK Kafle ◽  
SB Bajracharya ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives: The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 ± 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to find out of cause of ESRD and to institute preventive measures.Key words: End stage renal disease; Renal replacement therapy; Haemodialysis; Intermittent peritoneal dialysis; Incidence of end stage renal disease; Nepal. DOI: 10.3126/kumj.v7i3.2742 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 302-305

scholarly journals End-Stage Renal Disease and Critical Limb Ischemia: A Deadly Combination?

2012 ◽  
Vol 101 (2) ◽  
pp. 138-143 ◽  
Author(s):  
F. Biancari ◽  
E. Arvela ◽  
M. Korhonen ◽  
M. Söderström ◽  
K. Halmesmäki ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
Lower Limb ◽  
End Stage Renal Disease ◽  
Bypass Surgery ◽  
Independent Predictor ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Objectives: This study was planned to evaluate the prognostic impact of end-stage renal disease (ESRD) in patients with critical leg ischemia (CLI) undergoing infrainguinal revascularization. Materials and Methods: 1425 patients who underwent infrainguinal revascularization for CLI were the subjects of the present analysis. Ninety-five patients had ESRD (eGFR < 15 ml/min/m2), and of them 66 (70%) underwent percutaneous transluminal angioplasty and 29 (30%) underwent bypass surgery. Results: ESRD patients had significantly lower overall survival (at 3-year, 27.1% vs. 59.7%, p < 0.0001), leg salvage (at 3-year, 57.7% vs. 83.0%, p<0.0001), and amputation free survival (at 3-year, 16.2% vs. 52.9%, p < 0.0001) than patients with no or less severe renal failure. The difference in survival was even greater between 86 one-to-one propensity matched pairs (at 3-year, 23.1% vs. 67.3%, p < 0.0001). ESRD was an independent predictor of all-cause mortality (RR 2.46, 95%CI 1.85–3.26). Logistic regression showed that age ≥ 75 years was the only independent predictor of 1-year all-cause mortality (OR 4.92, 95%CI 1.32–18.36). Classification and regression tree analysis showed that age ≥ 75 years and, among younger patients, bypass surgery for leg ulcer and gangrene were associated with significantly higher 1-year mortality. Conclusions: Lower limb revascularization in patients with CLI and end-stage renal failure is associated with favourable leg salvage. However, these patients have a very poor survival and this may jeopardize any attempt of revascularization. Further studies are needed to identify ESRD patients with acceptable life expectancy and who may benefit from lower limb revascularization.

Renal therapy techniques

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Replacement Treatment ◽  
Post War ◽  
The 1960S ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Haemodialysis 64Haemo(dia)filtration 68Peritoneal dialysis (PD) 70The first human haemodialysis was performed in 1943 by Willem Kolff in The Netherlands for the treatment of acute renal failure. Following this, haemodialysis was adopted for the treatment of acute renal failure in the immediate post-war years and then for chronic renal failure from the 1960s. Currently haemodialysis is the most common form of replacement treatment for end-stage renal disease (ESRD). Haemodialysis is one method used for treatment of acute renal failure, and ESRD patients will develop critical illness. An understanding of the principles of haemodialysis and how it is carried out is therefore essential....

The Effect of Somatostatin on the Hormonal Abnormalities of End Stage Renal Disease

1981 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Thomas G Murray ◽  
Carol Eisen ◽  
Morris Grabie ◽  
Ellen Buerklin ◽  
Barry R Walker ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Control Period ◽  
Thyroid Stimulating Hormone ◽  
Dialysis Patients ◽  
End Stage Renal Failure ◽  
Stage Renal Disease ◽  
End Stage

Patients with end stage renal disease who are maintained on haemodialysis have elevated levels of many hormones, some of which may play a role in the pathogenesis of the complications of uraemia. The infusion of synthetic somatostatin reduces the circulating level of many of these same hormones in patients with normal renal function. If the elevated hormone levels in dialysis patients could be similarly lowered, study of the pathogenitic significance of the various hormonal abnormalities would be facilitated. With this in mind, the effect of synthetic somatostatin on the circulating level of growth hormone, glucagon, insulin, gastrin, parathyroid hormone, and thyroid stimulating hormone in dialysis patients was investigated. In pilot protocol, a dose of 2 mg of somatostatin infused over 24, 18, or 12 hours (two patients each) was found to have no effect on any hormonal level. Infusion of 2 mg of somatostatin over 4 hours, however, was associated with consistent fall in the level of growth hormone (13.6 ± 6.2 to 6.53 ± 2.9, p = 0.15) and glucagon (595.0 ± 73 to 441 ± 28, p < 0.05) in each of four patients. The percentage change in the level of growth hormone and glucagon during the 4-hour somatostatin infusion was significantly different from the change occurring during a 4-hour timed control period (growth hormone —45 ± 18% vs +9 ± 7%, [p < 0.05]), (glucagon −27% ± 2% vs + 8 ± 2%, [p < 0.01]). There was no change in the level of any other hormone during the 4-hour infusion. No significant adverse effects were seen. This study suggests that the intravenous infusion of somatostatin can, at least on an acute basis, lower the level of growth hormone and glucagon in patients with end stage renal failure; and, therefore, it may be useful in further study and possibly the treatment of the hormonal abnormalities of end stage renal disease.

scholarly journals Penile calciphylaxis: a conservative approach

2020 ◽  
Vol 102 (2) ◽  
pp. e36-e38 ◽  
Author(s):  
O El-Taji ◽  
J Bondad ◽  
S Faruqui ◽  
J Bycroft
Keyword(s):  
Renal Failure ◽  
End Stage Renal Disease ◽  
Multidisciplinary Approach ◽  
Renal Dialysis ◽  
Conservative Approach ◽  
End Stage Renal Failure ◽  
Calcific Uremic Arteriolopathy ◽  
Individual Entity ◽  
Stage Renal Disease ◽  
End Stage

Penile calciphylaxis or calcific uremic arteriolopathy is a rare urological condition often associated with patients undergoing renal dialysis for end-stage renal disease. The majority of cases are associated with systemic calciphylaxis. The pathophysiology, diagnosis and management of penile calciphylaxis as an individual entity has brought little attention. The rates of comorbidity and mortality of these patients are often particularly high. Early diagnosis and a multidisciplinary approach are therefore essential. We report a case of penile calciphylaxis in a 59-year-old man with end-stage renal failure on haemodialysis who was successfully managed conservatively.

scholarly journals HARAPAN PADA PENYAKIT GINJAL KRONIS TAHAP AKHIR (PGKTA) : SYSTEMATIC REVIEW

2019 ◽  
Vol 2 (2) ◽  
pp. 41
Author(s):  
Nining Puji Astuti
Keyword(s):  
Systematic Review ◽  
Renal Failure ◽  
Renal Disease ◽  
Full Text ◽  
End Stage Renal Disease ◽  
End Stage Renal Failure ◽  
Herth Hope Index ◽  
Trait Hope ◽  
Stage Renal Disease ◽  
End Stage

Latar belakang:. Harapan merupakan faktor prediktor independen yang berhubungan langsung dengan kualitas hidup PGKTA. Harapan memiliki peran penting untuk meningkatkan motivasi, koping, kemauan menjalani pengobatan dan outcome positif PGKTA.Tujuan: Tujuan dari sistematic review ini adalah untuk mengidentifikasi konsep harapan berdasarkan definisi dan instrumen yang dapat digunakan untuk mengukur harapan PGKTA, mengidentifikasi faktor yang mempengaruhi harapan PGKTA.Metode: Metode pencarian melalui PUBMED dan Google Schoolar dengan kata kunci “hope, End Stage Renal Disease, End Stage Renal Failure, Hemodialysis”. Hanya jurnal dalam Bahasa Inggris, full text, dipublikasikan tahun 2000-2019 dan menggunakan harapan sebagai tema utama dalam pembahasan yang digunakan dalam pembuatan sistematik review ini.Hasil : Harapan di definisikan sebagai kekuatan dalam diri individu yang membantu pasien keluar dari zona sakitnya dan meningkatkan derajat kesehatannya. Alat ukur yang dapat dipakai antara lain Herth Hope Index, The Trait Hope Scale, Adult Hope Scale, Miller Hope Scale, Basic Hope Inventory.Kesimpulan: Perlu kajian lebih dalam mengenai faktor dominan yang mempengaruhi harapan untuk membantu penentuan asuhan keperawatan yang tepat terkait harapan.

Treatment with Cinacalcet in Hemodialysis Patients with Severe Secondary Hyperparathyroidism, Influences Bone Mineral Metabolism and Anemia Parameters

2020 ◽  
Vol 15 (3) ◽  
pp. 249-263
Author(s):  
Maria Aktsiali ◽  
Theodora Papachrysanthou ◽  
Ioannis Griveas ◽  
Christos Andriopoulos ◽  
Panagiotis Sitaras ◽  
...  
Keyword(s):  
Bone Mineral ◽  
Mineral Metabolism ◽  
Treatment Options ◽  
Dry Weight ◽  
Chronic Hemodialysis ◽  
Protective Agent ◽  
Positive Correlation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Due to the premium rate of Chronic Kidney Disease, we have increased our knowledge with respect to diagnosis and treatment of Bone Mineral Disease (BMD) in End- Stage Renal Disease (ESRD). Currently, various treatment options are available. The medication used for Secondary Hyper-Parathyroidism gives promising results in the regulation of Ca, P and Parathormone levels, improving the quality of life. The aim of the present study was to investigate the relation of cinacalcet administration to not only parathormone, Ca and P but also to anemia parameters such as hematocrit and hemoglobin. Materials and Methods: retrospective observational study was conducted in a Chronic Hemodialysis Unit. One-hundred ESRD patients were recruited for twenty-four months and were evaluated on a monthly rate. Biochemical parameters were related to medication prescribed and the prognostic value was estimated. Cinacalcet was administered to 43 out of 100 patients in a dose of 30-120 mg. Results: Significant differences were observed in PTH, Ca and P levels with respect to Cinacalcet administration. Ca levels appeared to be higher at 30mg as compared to 60mg cinacalcet. Furthermore, a decreasing age-dependent pattern was observed with respect to cinacalcet dosage. A positive correlation was observed between Dry Weight (DW) and cinacalcet dose. Finally, a positive correlation between Hematocrit and Hemoglobin and cinacalcet was manifested. Conclusions: Cinacalcet, is a potential cardiovascular and bone protective agent, which is approved for use in ESRD patients to assist SHPT. A novel information was obtained from this study, regarding the improvement of the control of anemia.

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