• 대한간호학회지
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• 제42권5호
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• pp.699-708
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• 2012

Purpose: This study was designed to test structural equation modeling of the quality of life of pre-dialysis patients, in order to provide guidelines for the development of interventions and strategies to improve the quality of life of patients with Chronic Kidney Disease (CKD). Methods: Participants were patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic factors, social support, nutritional status, physical factors and biobehavioral factors and quality of life were collected between March 4 and March 31, 2011. Results: In the final analysis 208 patients were included. Of the patients 42% were in a malnourished state. Anxious or depressed patients accounted for 62.0%, 72.6%, respectively. Model fit indices for the hypothetical model were in good agreement with the recommended levels (GFI=.94 and CFI=.99). Quality of life in pre-dialysis patients with CKD was significantly affected by demographic factors, social support, nutritional status, physical factors and biobehavioral factors. Biobehavioral factors had the strongest and most direct influence on quality of life of patients with CKD. Conclusion: In order to improve the quality of life in pre-dialysis patients with CKD, comprehensive interventions are necessary to assess and manage biobehavioral factors, physical factors and nutritional status.

• Journal of Korean Biological Nursing Science
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• 제15권2호
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• pp.82-89
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• 2013

Purpose: To examine the quality of life in pre-dialysis patients with chronic kidney disease. Methods: The subjects were 91 patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic and clinical characteristics, and quality of life (QOL) were collected between July 19 and 23, 2010. The relationship between QOL and various Stages of dependence on glomerular filtration rates (GFRs) and factors related to QOL were investigated. Collected data was analyzed with the SPSS WIN 12.0 program. Results: There was a significant difference in the quality of life of the subjects in different stages (F=18.12, p<.001). The Scheffe post hoc test confirmed that patients at higher stages had a lower level quality of life. In addition, GFRs, uremic symptoms, gender and age predicted value accounted for 38.5% of the variance on QOL (F=25.09, p<.001). Conclusion: Strategies to develop a systematic management program for improving QOL of pre-dialysis patients are urgently needed.

• Journal of Korean Medical Science
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• 제33권53호
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• pp.322.1-322.14
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• 2018

Background: Osteoprotegerin (OPG) plays protective roles against the development of vascular calcification (VC) which greatly contributes to the increased cardiovascular events in patients with chronic kidney disease (CKD). The present study aimed to find the non-traditional, kidney-related cardiovascular risk factors correlated to serum OPG and the effect of serum OPG on the arterial stiffness measured by brachial ankle pulse wave velocity (baPWV) in patients with the pre-dialysis CKD. Methods: We cross-sectionally analyzed the data from the patients in whom baPWV and the serum OPG were measured at the time of enrollment in a prospective pre-dialysis CKD cohort study in Korea. Results: Along with traditional cardiovascular risk factors such as age, diabetes mellitus, pulse pressure, and baPWV, non-traditional, kidney-related factors such as albuminuria, plasma level of hemoglobin, total $CO_2$ content, alkaline phosphatase, and corrected calcium were independent variables for serum OPG in multivariate linear regression. Reciprocally, the serum OPG was positively associated with baPWV in multivariate linear regression. The baPWV in the 3rd and 4th quartile groups of serum OPG were higher than that in the 1st quartile group after adjustments by age, sex and other significant factors for baPWV in linear mixed model. Conclusion: Non-traditional, kidney-related cardiovascular risk factors in addition to traditional cardiovascular risk factors were related to serum level of OPG in CKD. Serum OPG level was significantly related to baPWV. Our study suggests that kidney-related factors involved in CKD-specific pathways for VC play a role in the increased secretion of OPG into circulation in patients with CKD.

• 중환자간호학회지
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• 제16권3호
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• pp.34-47
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• 2023

Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects meta-analysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results : The systematic review included 11 RCTs (n = 591, average age 60.2-76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

• 한국콘텐츠학회논문지
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• 제14권7호
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• pp.367-375
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• 2014

본 연구의 목적은 투석전 만성신장병 환자에게 적용할 타당성 있고 신뢰도 있는 자가관리 도구를 개발하는 것이다. 일개 병원의 143명의 만성신장병 환자에게 설문 조사를 실시하였다. 문헌고찰을 통해 자가관리 영역과 문항을 구성하고, 탐색적 요인분석을 통해 평가하고 신뢰도를 분석하였다. 5개의 요인이 도출되었고, 각각은 치료지시이행과 파트너십, 식이이행, 문제해결, 건강행위, 정신사회적 건강추구로 명명하였다. 5개의 요인은 총 변량의 51.1%를 설명했다. 각 요인은 신뢰도가 0.64-0.79여서 신뢰할 만했다. 개발된 자가관리 도구는 만성신장병 환자에게는 스스로 관리할 수 있는 지침이 되고, 건강관리 전문가들에게는 환자의 관리상태를 평가하고 중재 프로그램을 개발하는 데 유용하게 사용될 수 있다.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1015-1025
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• 2018

Kidney diseases including acute kidney injury and chronic kidney disease are among the largest health issues worldwide. Dialysis and kidney transplantation can replace a significant portion of renal function, however these treatments still have limitations. To overcome these shortcomings, a variety of innovative efforts have been introduced, including cell-based therapies. During the past decades, advances have been made in the stem cell and developmental biology, and tissue engineering. As part of such efforts, studies on renal cell therapy and artificial kidney developments have been conducted, and multiple therapeutic interventions have shown promise in the pre-clinical and clinical settings. More recently, therapeutic cell-secreting secretomes have emerged as a potential alternative to cell-based approaches. This approach involves the use of renotropic factors, such as growth factors and cytokines, that are produced by cells and these factors have shown effectiveness in facilitating kidney function recovery. This review focuses on the renotropic functions of bioactive compounds that provide protective and regenerative effects for kidney tissue repair, based on the available data in the literature.

• 한국임상수의학회지
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• 제32권5호
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• pp.440-444
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• 2015

본 케이스는 요독증이 해소되지 않는 말기 만성 신부전 환자에서의 지속적 신대체요법에 관한 보고이다. 본 원에 내원하여 만성신부전으로 진단 내려진 6마리의 환자에서 수액요법과 같은 일반적인 대증요법에 개선이 없었다. 따라서 혈액투석방법을 진행하였다. 평균 57-72%의 요소감소율을 보인 4마리의 환자와 37.3%의 요소감소율을 보인 1마리의 환자견에서 좋은 개선을 보였다. 하지만 6마리의 환자견에서의 93회 혈액투석 동안 체외흐름 폐색, 항응고제 사용에 의한 과도한 출혈등과 같은 부작용이 12회 발생하였다. 따라서 요독증이 개선되지 않는 만성 신부전 환자에서의 지속적 신대체요법은 유용하다 할 수 있으며 혈액투석동안 면밀한 부작용 관찰이 중요하다 여겨진다.