• 대한핵의학회지
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• 제23권2호
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• pp.231-236
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• 1989

Continuous ambulatory peritoneal dialysis (CAPD) is a well established method of treating end stage renal failure, and is commonly used as an alternative to hemodialysis. Several complications have been observed. These include catheter malfunction, abdominal and inguinal hernia, and peritonitis. A relatively frequent complication is swelling of external genitalia, due to bowel fluid passing through a patent processus vaginalis. Special diagnostic procedures are necessary to determine the nature of the abnormality and to guide the surgical correction. We reported two cases of patent processus vaginalis in patient on CAPD proved by radionuclide peritoneal scintiscan using Tc-99 m-tin colloid.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.255-263
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• 2007

목 적 : 단일 기관에서 만성복막투석을 시행 받고 있는 소아 환자를 대상으로 후향적 단면연구를 시행하여 복막투석 방법에 따른 투석 결과의 차이가 있는지에 대하여 연구해 보고자 한다. 방 법 : 단일 기관에서 2004년과 2007년 사이에 복막투석을 시행 받았던 환자들 중 투석 후 3개월에서 15개월 사이에 복막투석 적절도에 대한 평가가 이루어졌던 35명의 환자를 대상으로 하였다. 연구 당시 시행하고 있던 복막투석 방법에 따라 CAPD 군, CCPD 군과 NIPD 군으로 환자들을 분류하였고 각각 17명, 13명, 5명의 환자들이 포함되었다. 각 군 사이에 항고혈압제를 복용하고 있는 환자 수, 체중, 신장 및 일반화학 검사와 혈색소 검사를 포함한 혈액 검사 결과의 차이가 있는지 비교 분석하였다. 투석 및 잔여 신기능을 통한 주간 $Kt/V_{urea}$, Ccr과 초여과양 및 소변량에 대한 비교 분석도 시행하였다. 표준 방법을 통한 복막평형검사를 시행하여 개인의 복막 투과성에 대해서도 알아보았다. 결 과 : 각 군 간에 항고혈압제를 복용하고 있는 환자의 비율, 체중과 신장 Z-score의 월간 변화 및 혈액검사 평균 수치의 차이는 유의하지 않았다. CAPD 군과 CCPD 군에서, 복막투석 및 잔여 신기능을 통한 주간 Kt/Vurea, Ccr 및 수분 배설 의 차이는 없었다. NIPD 군의 복막투석을 통한 주간 Ccr이 다른 두 군에서보다 유의하게 낮았지만, 잔여 신기능을 통한 보상으로 총 주간 Ccr에는 차이가 없었다. 복막 평형 검사 결과 저 투과성(low transporter) 및 저 평균 투과성(low average transporter)으로 분류되었던 환자들을 대상으로 비교하였을 때, CAPD를 통한 주간 Ccr이 CCPD를 통한 주간 Ccr 보다 유의하게 높았다. 결 론 : 본 연구의 결과를 토대로, 소아 만성복막투석 환자들에 있어서 투석 방법은 환자의 선호도에 의하여 자유롭게 선택될 수 있어야 할 것을 제안하는 바이다. 또한 초여과의 실패 및 부적절한 투석으로 투석 방법의 변경이 불가피한 상황에서, 복막 평형 검사는 투석 방법 변경이 적절이 이루어질 수 있도록 도와주는 귀중한 정보를 제공해 줄 것이다. 투석 방법 간의 명확한 비교를 위하여 향후 복막염의 빈도, 영양상태 및 장기간의 성장등 다양한 투석 성적을 비교하는 추가 연구가 필요할 것으로 생각된다.

• 대한의생명과학회지
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• 제23권3호
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• pp.185-193
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• 2017

Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.121-124
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• 2012

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

• 디지털융복합연구
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• 제10권9호
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• pp.429-434
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• 2012

본 연구는 노인 복막투석 환자의 의존성과 가족의 부담감을 파악하고 그 관계를 규명하여 노인 환자와 가족을 위한 간호중재를 개발하는데 기초 자료를 마련하고자 시도되었다. 연구 대상자는 서울지역에 소재한 3차 의료기관 신장내과에 등록되어 외래를 방문한 만 65세 이상의 노인 복막투석 환자 50명과 그 가족 50명이며, 자료수집기간은 2011년 4월 4일부터 15일까지였다. 수집된 자료는 SPSS WIN 12.0을 이용하여 분석하였다. 본 연구 결과 대상자의 의존성은 평균 139.6점이었고, 가족의 부담감은 평균 84.2점이었으며, 노인 복막투석 환자의 의존성은 가족의 부담감과 통계적으로 유의한 순상관관계(r=.61, p=.000)가 있는 것으로 나타났다. 이상의 연구 결과를 통해, 노인 복막투석 환자의 의존성은 높은 수준이며, 이들을 돌보는 가족의 부담감도 매우 높다는 것을 확인할 수 있었다. 따라서 노인 복막투석 환자의 의존성과 가족의 부담감을 감소시킬 수 있는 간호중재를 개발하고 그 효과성을 검증하는 연구가 지속되어야 할 것이다.

• Asian Journal for Public Opinion Research
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• 제7권2호
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• pp.94-112
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• 2019

Objective: The objective of this study was to compare the quality of life (QOL) of patients with end-stage renal disease (ESRD) between patients receiving hemodialysis (HD) and patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to compare personal characteristic factors relating to the quality of life in patients with ESRD. Method: This study used a descriptive research design. The sample was recruited using purposive sampling that included 76 ESRD patients receiving either HD or CAPD at a dialysis clinic in Phraphutthabat Hospital, Saraburi Province, Thailand. Data was collected using the Quality of Life Questionnaire for Chronic Kidney Disease ($KDQOL-SF^{TM}$) version 1.3. Independent t-test and ANOVA procedures were used to analyze study data. Results: The results revealed that the HD patients had a moderate level of QOL. The highest scoring dimension of QOL was the encouragement of staff at the dialysis unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=89.29$, SD =16.88) and cognitive function (${\bar{X}}=88.57$, SD=11.82). On the other hand, the lowest scoring QOL dimension was physical problems (${\bar{X}}=50$, SD=51.89), and pain (${\bar{X}}=50$, SD=39.03), followed by work status (${\bar{X}}=53.57$, SD=45.84) and burden from kidney disease (${\bar{X}}=58.48$, SD=31.07). The CAPD patients also had a moderate QOL. The highest scoring QOL dimension was the encouragement of staff in the renal unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=95.61$, SD=14.20) and cognitive function (${\bar{X}}=88.83$, SD=13.52). The worst scoring QOL dimensions were work status (${\bar{X}}=44.44$, SD=42.72), general health (${\bar{X}}=53.61$, SD=39.05), and pain (${\bar{X}}=62.70$, SD=41.14). The difference overall and in each dimension of QOL in ESRD patients who were treated with HD and CAPD was not statistically significantly different. The QOL was not significantly different among patients with different personal characteristics except for income and duration of treatment; in those cases, the difference in QOL was statistically significant (p=.05). Conclusion: The overall QOL and life expectancy of patients with ESRD treated with HD and CAPD are not affected by gender, age, marital status, education, occupation, or type of health coverage. QOL was not significantly different, except for patients with different incomes and duration of renal replacement therapy, whose QOL was significantly different. The QOL of patients receiving dialysis should be studied to develop a QOL program for patients with chronic kidney disease who receive dialysis.

• 대한간호학회지
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• 제34권3호
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• pp.440-448
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• 2004

Purpose: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. Method: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. Result: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period ($x^2$=20.84, p=.00), exercise frequency ($x^2$=9.03, p=.0l), exercise time ($x^2$=9.03, p=.0l) and exercise intensity ($x^2$=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. Conclusion: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.

• 기본간호학회지
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• 제15권2호
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• pp.206-212
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• 2008

Purpose: This study was done to identify the effects of self-care behavior, self-efficacy and family support on the occurrence of peritonitis in patients on CAPD (Continuous Ambulatory Peritoneal Dialysis). Methods: Data were collected from 81 patients on CAPD either as out-patients or in-patients between July and September 2004. Data were analyzed to identify relevant frequencies, percentages, averages, and standard deviations, and t-test and logistic regression were done using SPSS WIN 10.0 Results: a) Mean score for self-care behavior was 2.9 (of a possible 4.0), for general self-efficacy, 3.2 (of a possible 5.0), for specific self-efficacy 3.5 (of a possible 5), and for family support, 3.7 (of a possible 5). Family support generally showed the most positive results. b) Occurrence of peritonitis was not affected by general characteristics. c) There was a significant difference in the occurrence of peritonitis in terms of self-efficacy. Patients with peritonitis had lower self-efficacy than those who did not. 4) Of the four factors reviewed in relation to peritonitis, only self-efficacy was statistically significant: an increase in self- efficacy by 1 point increased the occurrence of peritonitis by 0.90. Conclusion: Among the four factors potentially affecting peritonitis in CAPD patients, general self-efficacy was found to be the main factor influencing the occurrence of peritonitis.

• 대한지역사회영양학회지
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• 제11권6호
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• pp.793-807
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• 2006

This study was performed to estimate the effect of alphacalcidol supplementation or nutrition education on the nutrient intakes, bone mineral density and bone markers in continuous ambulatory peritoneal dialysis (CAPD) patients. The 90 CAPD subjects were randomly assigned to 3 groups (alphacalcidol group: AG, nutrition education group: NG, and control group: CG). Alphacalcidol supplementation($0.5{\mu}g/day$) was carried out for 8 months. Nutrition counseling was performed according to the patient s individual question for the first 6 months and scheduled nutrition education with individual counseling was carried out for the last 2 months. In baseline data. there were no significant differences in age, sex, family number, education years and monthly income except the NG showed significantly less duration of CAPD (p< 0.05) compared to other two groups. After intervention all three groups showed tendency of lower intakes. NG revealed less decrease in protein, especially in animal protein calcium from Ca-P binder, dietary calcium, dietary iron and niacin. NG showed significantly more increase in dry weight (p<0.05) and AG in waist circumference (p<0.001) after intervention. The groups did not show significant differences in the changes of biochemical indices related to bone metabolism. NG revealed more increase in trochanter BMD(p < 0.05) compared to other two groups. It seems that nutrition education is more effective in preventing deterioration or improving the bone and general nutrition status.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.245-249
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• 2008

복막염은 지속성 외래 복막투석 환자에게 있어 중요한 합병증 중 하나이다. 이러한 복막염은 잦은 재발과 최근 내성균의 출현으로 치료에 어려움을 겪고 있다. vancomycin 내성 장구균(VRE, Vancomycin-resistant Enterococcus)에 의한 복막염은 1999년에 국내에서 처음 보고된 이래로 계속 증가하고 있으나 아직까지 치료에 대해 명확한 기준이 없는 실정이다. 저자들은 복막투석 소아에서 리네졸리드(linezolid)로 VRE에 의한 복막염을 성공적으로 치료한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.