• Title/Summary/Keyword: 혈액 투석

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Influence of Social Support and Health Literacy on Treatment Adherence in Hemodialysis Patients (혈액투석환자의 사회적 지지와 건강정보이해능력이 치료순응도에 미치는 영향)

  • Seo, Nam-Sook;Sim, Eun-Kyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.656-666
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    • 2020
  • This study was a descriptive research study for hemodialysis patients to survey the effects of social support and health literacy on treatment adherence. The subjects of this study were 140 hemodialysis patients aged over 40 years who had been receiving treatment for more 1 year in artificial kidney rooms at two general hospitals in Y city. The data were collected from November 1, 2019 to December 31, 2019 and were analyzed using descriptive statistics, t-tests, one-way ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regression with the SPSS/WIN 26.0 statistical program. The results of this study show that social support (family, friends, medical staff) and health literacy (functional, communication, critical) were positively correlated with treatment adherence. The variables affecting treatment adherence in hemodialysis patients were identified by social support and health literacy with 69.6% explanatory power. To improve the treatment adherence of hemodialysis patients, it is necessary to develop education programs to improve health literacy based on social support.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

Placement of a Subclavian Tunneled Hemodialysis Catheter with the Patient's Arm Raised May Reduce the Risk of Complications: Two Cases Report (쇄골하정맥을 통한 매립혈액투석카테터 삽입시 상지 거상법의 유용성: 2예 보고)

  • Jimin Yoo;Dong Jae Shim;Doyoung Kim;Seung Hwan Baek;Chang Suk Park;Jeong Whee Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.477-482
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    • 2023
  • The subclavian vein is an uncommon route for tunneled hemodialysis catheter (tHDC) placement because of its potency for future dialysis access. However, when favored access routes have been exhausted because of repeated catheterization or limited life expectancy, the subclavian vein can be used for urgent hemodialysis. A subclavian catheterization has a technical problem. The subclavian vein often forms a right angle with the vena cava, and advancing stiff peel-away sheath can cause a vascular injury. However, raising the patient's arm can alter the position of the guidewire and, therefore, change the angle of the vein favorable for tHDC placement. Herein, we report two patients who underwent subclavian catheterization; one experienced an injury to the superior vena cava after undergoing the conventional procedure, whereas the other patient with raised arm during the catheterization procedure had safe catheter placement.

The Effects of the Individual Application of Low Sodium Dialysate on Weight Gain, Blood Pressure, and Intradialytic Side Effects in Patients on Maintenance Hemodialysis (개별적 저나트륨 투석액 적용이 혈액투석 환자의 체중증가, 혈압 및 투석 중 부작용에 미치는 효과)

  • Song, Ji Sook;Kim, Eun Sook;Lee, Yu Na
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.45-56
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    • 2013
  • Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant's serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22) based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG) (n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also, ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %), pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.

The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients (혈액투석 시 투석액 속도가 투석적절도와 피로에 미치는 효과)

  • Cha, Sun Mi;Min, Hye Sook
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.642-652
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    • 2016
  • Purpose: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. Methods: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing. Results: The Kt/V ($M{\pm}SD$) was $1.40{\pm}0.25$ at twice the blood flow rate, $1.41{\pm}0.23$ at 500 mL/min, and $1.46{\pm}0.24$ at 700 mL/min. The URR ($M{\pm}SD$) was $68.20{\pm}5.90$ at twice the blood flow rate, $68.67{\pm}5.22$ at 500 mL/min, and $70.11{\pm}5.13$ at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/ min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate. Conclusion: Increasing the dialy-sate flow rate to 700 mL/min is associated with a significant increase in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

Development and Evaluation of Nursing Practice Guidelines for Water Treatment System in Hemodialysis (혈액투석실 투석용수관리를 위한 간호실무가이드라인 개발 및 평가)

  • Kim, Su-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.4
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    • pp.463-471
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    • 2011
  • Purpose: The purpose of this study was to develop nursing practice guidelines for water treatment system used in hemodialysis and to evaluate the guidelines by applying them in practice. Method: The first draft for the guidelines was developed based on advice and recommendations obtained from procedure review of critical literature. The draft was modified through evaluation by an expert group and pilot application to practice. The final draft was evaluated by the expert group using the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Results: For the pilot test using the draft guidelines, 144 samples were collected from the water treatment system and hemodialysis machines. Results showed no bacteria. Endotoxin tests and chemical tests passed the criteria. After revision of the draft guidelines and additions to the draft guidelines, the final draft was confirmed. The quality of the final draft was evaluated by 4 experts using the AGREE instrument. The mean standard score was 76.9% for the 19 items. Conclusion: The clinical guidelines developed in this research can be utilized as systematic and scientific guidelines for water treatment systems used in hemodialysis. In addition, the results of the research can contribute to improving care services.

Effects of Individualized Education on Knowledge, Compliance, and Physiologic Parameters in Hemodialysis Patients (개별교육이 혈액투석환자의 투석관련 지식, 환자역할행위 이행 및 생리적 지수에 미치는 효과)

  • Kim, Young-Ju;Yoo, Yang-Sook
    • Korean Journal of Adult Nursing
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    • v.18 no.3
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    • pp.367-376
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    • 2006
  • Purpose: This study was designed to explore the effects of providing individualized education for hemodialysis patients on their knowledge of hemodialysis, compliance of patient role behavior, and physiologic parameters. Method: A quasi experimental design with a non-equivalent control group and a non-synchronized design was used. The experiment was conducted with a total of 40 hemodialysis patients (20 in the experimental group and 20 in the control group) at the artificial kidney center, C University Hospital. The experimental group was provided with individualized education, 30 minutes per session, three times per week, for two weeks. Results: The experimental group had significantly higher knowledge of hemodialysis than the control group after the education. The compliance of patient role behavior was more enhanced in the experimental group than the control group. The experimental group showed significantly higher values of blood urea nitrogen, but not the values of blood creatinine, albumin, kalium, and phosphorus. Conclusion: The individualized education was found to be an effective intervention for improving patients' knowledge of hemodialysis and compliance of patient role behavior.

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Intravenous Iron Supplementation in Korean Children on Chronic Dialysis (한국 만성 투석 소아 환자에서 정맥용 철분 제제 투여에 관한 연구)

  • Cho, Hee-Yeon;Hahn, Hye-Won;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.197-206
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    • 2009
  • Purpose : Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis. Methods : Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/$m^2$ ($\leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($\leq$100 mg) through week 0-7. Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group. Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.

Hemodialysis Patients' Experience of Adapting to Dietary Therapy (혈액투석 환자의 식사요법 적응 경험)

  • Yang, Eun Kyung;Kim, Il-Ok
    • Korean Journal of Adult Nursing
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    • v.28 no.3
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    • pp.323-333
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    • 2016
  • Purpose: The purpose of this study was to explore the meaning of the experience of adapting to the dietary treatment for hemodialysis patients. Methods: The data were collected through in-depth interviews of ten hemodialysis patients who have been dialyzed for longer than five months. Giorgi's phenomenological method was used for data analysis. Results: The findings included five constituents and 16 sub-constituents. The five constituents concerning diet therapy were: 'suffering', 'undergoing trial and error', 'understanding the need', 'finding alternatives', and 'realizing the meaning of dietary therapy.' Conclusion: The findings contribute to understanding the process of adapting to diet therapy. The results of this study may be utilized in assisting patients to understand the diet therapy process.