• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.127-135
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• 2021

Background: Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients. Methods: This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization. Results: The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend). Conclusion: Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.71-76
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• 2024

Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.66-69
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• 2022

Patients with vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder to the kidney, are known to experience renal scarring; this results in the worsening of renal function. Reflux nephropathy is a cause of chronic kidney disease, and VUR has also been observed in dialysis patients. VUR is a major underlying precursor condition of urinary tract infection (UTI) and is sometimes accompanied by hydronephrosis. However, there are no guidelines for the management of UTI due to VUR-associated hydronephrosis in patients with end-stage kidney disease. Herein, we report a case of UTI caused by VUR-associated hydronephrosis in a dialysis patient treated with percutaneous nephrostomy.

• 대한전해질대사연구회지
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• 제16권2호
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• pp.27-29
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• 2018

Peritoneal dialysis (PD)-related peritonitis is a major cause of injury and technique failure in patients undergoing PD. Aeromonas hydrophila is ubiquitous in the environment, and is a Gram-negative rod associated with infections in fish and amphibians in most cases; however, it can also cause opportunistic infections in immunocompromised patients. We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device. Although Set Plus is disposable, the patient reused the product by cleansing with tap water. He was successfully treated with intraperitoneally-administered ceftazidime and has been well without recurrence for more than 2 years.

• Journal of Korean Biological Nursing Science
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• 제9권2호
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• pp.105-117
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• 2007

Purpose: The purpose of this study was two folds: first, to identify the level of self care behavior of the hemodialysis patients and second, to find the correlation between the self care behavior and the physiologic indices. Method: The subjects were 52 hemodialysis patients, male and female, who have regularly received hemodialysis dialysis at the Dialysis Room in a leading teaching hospital, Seoul. The patients responded to the self care behavior questionnaires including their socio-demographic characteristics. The respondents have regularly recorded the self care log book. The physiologic indices, clinical characteristics related to the disease and hemodialysis were collected by the chart review. Result: The mean score of the self care behavior was 3.46. The mean score of the self care behavior on categories demonstrated as follows: medication 4.29, fistula management 4.13, management of physical problem 3.71, diet 3.28, exercise and rest 3.22, blood pressure and body weight management 2.97 and social adjustment 2.05 in order. Thirty patients managed discomfort of their fistula. Eleven patients took exercise for 0.5-1 hr/week. Thirty patients measured their body weight daily and thirty two measured their blood pressure daily. The score of self care behavior was significantly correlated with the mean weight gains between the dialysis sessions(r=-.312, p=.05). The mean weight gains between dialysis sessions was found to be high as the level of serum phosphorus and potassium increased(r=-.316, p=.05, r=-.465, p=.01). Conclusion: The result suggests that nursing intervention to the hemodialysis patients to improve self care behavior should be encouraged and further developed.

• 성인간호학회지
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• 제24권3호
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• pp.209-218
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• 2012

Purpose: This study is to identify how depression, hope and social support influence to suicidal ideation of renal dialysis patients and the relating factors according to their general characteristics. Methods: This descriptive correlative study was conducted through a organized and structured self-administrated questionnaire and 120 sampled renal dialysis patients. Collected data was analyzed by t-tests, ANOVA, Pearson's correlation coefficient and multiple regression analysis using SPSS/WIN 18.0. Results: Findings revealed that; 1) The degrees of suicidal ideation were significantly different among groups according to the marital status (F=3.37, p=.021), drinking (F=4.97, p=.008) and smoking history (F=4.77, p=.010), 2) Pearson's correlation coefficient revealed a significant association among the suicidal ideation, hope, depression and social support, 3) Multiple regression analysis showed depression (${\beta}$=.58, t=7.77, p<.001), social support (${\beta}$=-.21, t=-2.69, p=.008) and alcohol drinking (${\beta}$=.17, t=2.61, p=.010) were related to factors. They accounted 54% of the suicidal ideation of the subjects. Conclusion: Based on the findings of this study, health professionals should provide renal dialysis patients with proper management of suicidal ideation as well as its relating factors, hope, depression and social support. Especially, it needs to implement suicidal ideation management and self-help group program to renal dialysis patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권2호
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• 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.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.149-158
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• 2006

Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.