• Title/Summary/Keyword: 신투석

Search Result 60, Processing Time 0.025 seconds

Current Status of Children on Peritoneal Dialysis in Korea : A Cross-Sectional Multicenter Study (소아복막투석의 현황: 다기관 공동연구 결과보고)

  • Youn, Ji-Seok;Lee, Joo-Hoon;Park, Young-Seo;Yim, Hyung-Eun;Paik, Kyung-Hoon;Yoo, Kee-Hwan;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
    • /
    • v.13 no.2
    • /
    • pp.176-188
    • /
    • 2009
  • Purpose : Peritoneal dialysis (PD) is the major form of dialysis in use for infants and children with end-stage renal disease (ESRD). The aim of this study was to gain insight into the current status of children on PD in Korea. Methods : In May 2008, questionnaires were sent to the pediatric nephrologists via e-mail. Four centers replied and those data were reviewed. Results : A total of 103 patients were included in this study. Male to female ratio was 1.6:1. Mean age was $11.5{\pm}4.9$ years (0-19 years). Primary renal diseases diagnosed were as follows: primary glomerular disease (34%), chronic pyelonephritis-reflux nephropathy (14.6%), systemic disease (9.7%), renal hypoplasia/dysplasia (8.7%), heredofamilial disease (6.8%), vascular disease (3.9%), drug-induced nephropathy (1.0%), and unknown (12.6%). PD modalities were as follows: CAPD (42.7%), CCPD (27.2%), NIPD (11.7%), and Hybrid (18.4%). Weekly total Kt/V was $2.1{\pm}0.7$ (0.3-4.1). Results of peritoneal equilibrium test were as follows: low 36.8%, low average 31.6%, high average 19.7%, and high 11.8%. Z-score for weight was $-1.00{\pm}1.20$ (-4.54~+2.50). Z-score for height was $-1.55{\pm}1.65$ (-9.42~+1.87). Growth hormone was administered in 24.3% of patients. Anti-hypertensive drugs were administered in 64.0% of patients. Laboratory findings were as follows: hemoglobin $10.5{\pm}1.4$ g/dL, calcium $9.7{\pm}0.7$ mg/dL, phosphorus $5.4{\pm}1.4$ mg/dL, and parathyroid hormone $324.2{\pm}342.8$ pg/mL. Conclusion : Primary glomerular disease was the most common cause of ESRD. CAPD was the most prevalent PD modality. Low and low average peritoneal transport type were common. Growth disturbance were noted in many patients. Some patients had hypertension even with anti- hypertensive drugs. Calcium-phosphorus levels were maintained adequately, but many patients had secondary hyperparathyroidism.

Chronic Renal Failure in Children: A Nationwide Survey in Korea (소아 만성 신부전증의 전국적인 조사연구)

  • Kim, KyoSun;Jeon, Jeong-Sik;Lee, Ik-Jun;Go, Dae-Gyun;Lee, Gyeong-Il;Yun, Hui-Sang;Gu, Ja-Hun;Go, Cheol-U;Jo, Byeong-Su;Kim, Jun-Sik;Son, Chang-Seong;Yu, Gi-Hwan;An, Yeong-Ho
    • Childhood Kidney Diseases
    • /
    • v.4 no.2
    • /
    • pp.92-101
    • /
    • 2000
  • Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

  • PDF

In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
    • /
    • v.40 no.1 s.270
    • /
    • pp.32-36
    • /
    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

Influence of Illness Perception and Physiological Indicators on Self Management of Hemodialysis Patients (혈액투석환자의 질병지각과 생리적 지표가 자기관리에 미치는 영향)

  • Kang, Bomi;Lee, Yoonshin;Sok, Sohyune
    • The Journal of the Korea Contents Association
    • /
    • v.20 no.4
    • /
    • pp.464-474
    • /
    • 2020
  • This study provides basic data for nursing intervention to increase self management of hemodialysis patients by identifying the relation among their illness perception, physiological indicators, and self management. The participants were 134 patients receiving hemodialysis at a general hospital in Seoul. Data were collected by using a structured questionnaire and medical records. The collected data were analyzed by using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient and multiple regression analysis with the SPSS/WIN 23.0 program. The significant factors influencing self-management of hemodialysis patients have been identified with 8 variables. The first one is registration for kidney transplantation (β=-.20, p=.034). Among sub items of illness perception are consequence (β=-.20, p=.031), treatment control (β=.19, p=.040), and illness coherence (β=-.18, p=.049). In addition, among physiological indicators are hematocrit (β=.38, p<.001), hemoglobin (β=.29, p=.005), BUN (β=-.25, p=.010), and phosphorous (β=.22, p=.033). These variables explained 26.3% for self-management of hemodialysis patients. In order for hemodialysis patients to improve their self-management, a concrete nursing intervention improving the treatment control among illness perception as well as improving the understanding of physical indicators needs to be provided.

Fatigue Associated with Kidney Disease Symptoms in Female Patients Undergoing Hemodialysis (혈액투석을 받는 여성의 피로와 신 질환증상의 관련성)

  • Song, Hyo-Jeong;Kim, Hyeon-Ju
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.14 no.4
    • /
    • pp.474-482
    • /
    • 2007
  • Purpose: This study was done to provide fundamental data for nursing interventions to prevent and reduce fatigue and to identify fatigue and kidney disease symptoms in female patients on hemodialysis and evaluate factors associated with this fatigue. Method: A cross-sectional study design was used with self-administered questionnaires which included general characteristics and the fatigue scale developed by Brown, Dittner, Findly, & Wessely(2005)(Cronbach's $\alpha=0.98$ and for present study $\alpha=0.96$) and a review of laboratory data. From eight dialysis units, 84 women were enrolled. Data were analyzed using the SAS program. Results: Mean score for fatigue was 49.4(range $16{\sim}78$) and fatigue by research variables was significantly different by age(0.046), employment status(0.041), menopause(0.009), hypoalbuminemia(0.022), length of time on dialysis(0.48) and kidney disease symptoms(0.000). Correlations between fatigue and lack of strength, dizziness, and cramps after dialysis were significantly higher. Factors affecting fatigue were kidney disease symptoms and length of time on dialysis, explaining 49.2% of fatigue. Conclusion: A comprehensive approach considering kidney disease symptoms, length of time on hemodialysis, age, menopause, and hypoalbuminemia are required for interventions to reduce fatigue in female patients on hemodialysis.

  • PDF

Psychiatric Comparison Study of Kidney Transplantation Patient and Hemodialysis Patients (신투석 환자와 신장 이식 환자의 정신의학적 비교 연구)

  • Cho, Dong-Hwan;Park, Bum-Yong;Kong, Jin-Min;Kim, Jeong-Gee
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.6 no.1
    • /
    • pp.59-69
    • /
    • 1998
  • Objectives: This research was performed to know severity of depression and anxiety, the psychopathology of hemodialysis patients and kidney transplantation patients using Minneesota Multiphasic Personality Inventory(MMPI) and Zung's Self-rating Depression Scale (SDS), Zung's Self-rating Anxiety Scale(SAS), MMPI Subscales. Methods: We surveyed 31 hemodialysis patients and 119 kidney transplantation patients. 119 kidney transplantation group(KT) was investigated at ; 1) Before kidney transplantation (KT-1), 2) Three days after kidney transplantation(KT-2), 3) Three weeks after kidney transplantation(KT-3),4) Follow up at OPD(F/U). Results: 1) According to dermographic data, mean age was KT 33.1, HD 42.2, Control 33.1 years old and KT, HD were belonged to lower economic states and lower educational level than Control. 2) In the depression scale for SDS, KT-1 was more depressed than F/U and Control but depression scale was significantly decreased at KT-2 in comparison with HD. In the anxiety scale for SAS, KT-1 was more anxious than Control but anxiety scale was not different within IT subgroups and in comparison with HD. 3) In comparison of MMPI scales, Hs, D, Pt, Ma at KT-1, Pd, Pa, Pt, Ma at KT-2, F, D, Pd, Pt, Pa, Sc, Ma at KT-3, Pt at F/U were more high scores than Control.

  • PDF

자기조합형 세리신-PEG 나노입자의 합성과 특성

  • 조광용;문재유;김진국;정의수;엄상영;이용우;이광길;여주홍;조종수
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.28 no.1
    • /
    • pp.116-134
    • /
    • 2002
  • 세리신은 누에고치의 고치실에서 추출되는 천연 단백질로서 많은 수산화기를 가지고 있어 뛰어난 보습성을 가진다. 이에 화장품에의 응용이 기대되나, 물에 잘 녹지 않는 특성을 가지고 있어서 화장품 원료로 사용하기에 어렵다는 단점이 있다. 본 연구에서는 친양쪽성 화합물인 poly(ethylene glycol)(PEG)을 세리신에 도입하여 수용성이며 자기조합형(self-assembled) 세리신-PEG 결합체를 합성하였다. 세리신내의 tyrosine 잔기의 방향 족 수산화기가 반응사이트임을 $^1$H-NMR 분석으로 알 수 있었으며, IR과 CD 측정으로 PEG 사슬의 도입으로 세리신의 구조가 불규칙한 coil구조에서 $\beta$-sheet구조로 구조적 변화가 일어남을 알 수 있었다. 또한 DSC 분석에서 세리신-PEG결합이후 각각의 녹는점이 떨어지는 것을 확인하여 상호 결정성에 영향을 주는 것을 확인하였다. 세리신-PEG 결합체는 자기조합하여 소수성 상호작용을 통해 200-400nm의 구형 나노입자를 이루며 투석방법을 통하여 얻을 수 있었다. 또한, 세리신-PEG 나노입자는 세리신자체보다 더 높은 보습력을 가지는 것을 확인하였다. 세리신-PEG 결합체의 cytotoxicity는 MTT assay에 의해 독성이 없음을 확인하였으며, 동물실험에 의한 독성도 전혀 나타내지 않음을 알 수있었다. 나노입자의 특성과 세리신의 보습성, 세리신-PEG의 친양쪽성 특성으로 세리신-PEG결합체 나노입자는 그 자체로도 원료로 사용 될 수 있을 뿐 아니라 생리 활성성분의 운반체로의 개발이 기대되어 진다.

A Comparative Study in the Cognitive Functions of Peritoneal Dialysis, Hemodialysis and Normal Kidney Function Groups (복막투석, 혈액투석 및 정상 신 기능 집단간의 인지기능 비교 연구)

  • Lee, Gi-Sook;Choi, Song-Hee
    • Korean Journal of Adult Nursing
    • /
    • v.13 no.3
    • /
    • pp.451-462
    • /
    • 2001
  • This study was conducted to examine and compare the characteristics in the cognitive functions of peritoneal dialysis, hemodialysis and normal kidney function groups as basic data for effectively educating dialysis patients. The data were collected from May 10 to October 30. 2000, collected from each of 20 patients with peritoneal dialysis, hemodialysis and normal Kidney function and who registered for the dialysis room at a general hospital affiliated to a university in Seoul and sampled by age and educational level through personal interviews with the researchers of this study. As a measuring tool, MMSE developed by Folstein et al.(1975) to measure cognitive function disorder was used, slightly revised for hemodialysis patients. Collected data were processed into frequency, percentage, mean, and standard deviation by the use of SAS. The results of this study are as follows : 1. With a maximum of 30 points for cognitive function, the mean of the peritoneal dialysis patients was $27.06{\pm}2.06$, while that of the hemodialysis patients was $27.25{\pm}2.76$; that of the normal Kidney function patients was $27.85{\pm}2.00$, indicating no significant difference among those three groups. 2. As for the subjects who scored 23 points, the turning point of confirming the cognitive disorder, the percentage was 5% in the case of the peritoneal dialysis, 10% in the case of the hemodialysis and 5% in the case of the normal Kidney function group. 3. Differences between the peritoneal dialysis and hemodialysis patients by gender, occupation, spouse, diabetes, hypertension, the period of dialysis, number of hospitalizations, and the use of erythropoietin were not significant in the scoring of cognitive function. 4. There was no significant correlation between the level of Hb, Hct, albumin, aluminium, PTH, BUN, Cr, dialysis adequacy and the cognitive function. Considering such results, it is clear that there is no significant difference in the cognitive functions of the sampled subjects. Therefore, the nurse in the dialysis room should continually carry out assessment and intervention against elements degrading the effect of patients' education to improve self- care.

  • PDF

A Case of Conjunctival and Corneal Calcification in a Child on Peritoneal Dialysis (소아 복막 투석 환자에서의 결막과 각막의 석회 침착 1례)

  • Lee, Yeoun-Joo;Lim, Gin-A;Lee, Joo-Hoo;Prak, Young-Seo;Kim, Myoung-Joon
    • Childhood Kidney Diseases
    • /
    • v.12 no.2
    • /
    • pp.239-244
    • /
    • 2008
  • Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification(CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high Ca$\times$P value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.