• Title/Summary/Keyword: peritoneal dialysis

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Development of a Quality of Life Scale For Children on Chronic Peritoneal Dialysis (만성 복막투석 아동용 삶의 질 척도 개발)

  • Shin, Min-Sup;Cho, Soo-Churl;Jang, Jae-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.202-212
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    • 2008
  • Purpose : The aim of this study was to develop a quality of life scale for children on chronic peritoneal dialysis(QOL-CPD). Methods : Thirty children on chronic PD at Seoul National University Children's Hospital participated. A healthy control group included 47 elementary school children. Other patients groups are 32 children from the department of pediatric orthopedics and 28 children from the department of child psychiatry. The age range of all children was 7 to 16 years. Preliminary items of the QOL-CPD were developed and administered along with the Korean version of the Children's Depression Inventory(CDI) to all children. Results : The final QOL-CPD was constructed by excluding those items with a factor loading of less than .20, and the principal axis factor analysis was performed again. The QOLCPD demonstrated a good internal consistency with a value of .87. The dialysis and childpsychiatric groups showed significantly lower QOL scores compared to the healthy control group. In addition, the dialysis and child-psychiatric groups showed greater difficulties on physical and academic functions. For the CDI, the PD group showed a mild level of depression. Conclusion : The results of this study demonstrate the clinical utility of a newly developed self-report QOL scale specific for children on chronic PD.

p-Cresyl sulfate and indoxyl sulfate in pediatric patients on chronic dialysis

  • Hyun, Hye Sun;Paik, Kyung Hoon;Cho, Hee Yeon
    • Clinical and Experimental Pediatrics
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    • v.56 no.4
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    • pp.159-164
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    • 2013
  • Purpose: Indoxyl sulfate and p-cresyl sulfate are important protein-bound uremic retention solutes whose levels can be partially reduced by renal replacement therapy. These solutes originate from intestinal bacterial protein fermentation and are associated with cardiovascular outcomes and chronic kidney disease progression. The aims of this study were to investigate the levels of indoxyl sulfate and p-cresyl sulfate as well as the effect of probiotics on reducing the levels of uremic toxins in pediatric patients on dialysis. Methods: We enrolled 20 pediatric patients undergoing chronic dialysis; 16 patients completed the study. The patients underwent a 12-week regimen of VSL#3, a high-concentration probiotic preparation, and the serum levels of indoxyl sulfate and p-cresyl sulfate were measured before treatment and at 4, 8, and 12 weeks after the regimen by using fluorescence liquid chromatography. To assess the normal range of indoxyl sulfate and p-cresyl sulfate we enrolled the 16 children with normal glomerular filtration rate who had visited an outpatient clinic for asymptomatic microscopic hematuria that had been detected by a school screening in August 2011. Results: The baseline serum levels of indoxyl sulfate and p-cresyl sulfate in the patients on chronic dialysis were significantly higher than those in the children with microscopic hematuria. The baseline serum levels of p-cresyl sulfate in the peritoneal dialysis group were significantly higher than those in the hemodialysis group. There were no significant changes in the levels of these uremic solutes after 12-week VSL#3 treatment in the patients on chronic dialysis. Conclusion: The levels of the uremic toxins p-cresyl sulfate and indoxyl sulfate are highly elevated in pediatric patients on dialysis, but there was no significant effect by probiotics on the reduction of uremic toxins in pediatric dialysis patients. Therefore, studies for other medical intervention to reduce uremic toxins are also necessary in pediatric patients on dialysis.

A Study on factors Affecting Quality of Life in Patients on Dialysis (투석환자의 삶의 질에 미치는 영향요인 분석)

  • Kim Nam-Cho;Song Hyo-Jeong;Oh Jung-Aha;Kim Tae-Yang;Kim Myung-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.163-170
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    • 2003
  • Purpose: This study was done to identify stress, fatigue, and self efficacy in patients on dialysis and identify their effect on quality of life. Method: The participants (n=149) who agreed to participate in the research were selected from among those who were on dialysis treatment at C University Medical Centers in Seoul and Inchon, and at C University Medical Center in Jeju. The data were collected from July, 2001 to March, 2002 using interviews. Data analysis was done with t-test, ANOVA, and multiple stepwise regression using the SAS program. Result: Quality of life was significantly different according to economic status, and type of dialysis. Quality of life for the group with higher economic status was better than for the group with lower economic status, and the group on peritoneal dialysis had higher quality of lift scores than the group on hemodialysis. As for self-efficacy, there were significant difference according to duration of disease, type of dialysis, and duration of dialysis. Stress was significantly different according to marital status. Quality of life was significantly predicted by stress (40.02%) and fatigue (3.85%). Conclusion: To improve quality of life for people on dialysis, their stress should be treated positively, also multi-dimensional nursing interventions to provide emotional support and nursing interventions to diminish fatigue are required.

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Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death

  • Chang, Hye Jin;Han, Kyoung Hee;Cho, Min Hyun;Park, Young Seo;Kang, Hee Gyung;Cheong, Hae Il;Ha, Il Soo
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.135-139
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    • 2014
  • Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

The Effect of Growth Hormone and the Factors Influencing Growth in Pediatric Chronic Peritoneal Dialysis Patients (만성 복막투석 환자에서 성장호르몬 치료의 효과와 성장에 영향을 주는 요인에 대한 연구)

  • Kim, Su-Jin;Park, Sung-Won;Sohn, Young-Bae;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.38-46
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    • 2008
  • Purpose: Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods: Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total $CO_2$, calcium, phosphate and iPTH during GH treatment were compared between the growth group (increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=l1) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results: The mean age at the start of dialysis was 7.7${\pm}$5.2 years and the mean age at the start of GH treatment was 8.5${\pm}$4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048) and residual renal Kt/Vurea was better (1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion: GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.

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웹기반 복막투석환자 간호 교육프로그램 개발 및 효과에 관한 연구

  • Yu, Ji-Su;Mun, Seong-Mi
    • Korean Medical Education Review
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    • v.3 no.2
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    • pp.35-43
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    • 2001
  • Development and Evaluation of the Effectiveness of a Web-Based Learning System Program for Nursing Education on Peritoneal Dialysis Ji-Soo Yoo(Professor, College of Nursing, Yonsei University, Seoul, Korea) Seong-Mi Moon(Doctoral Candidate, College of Nursing, Yonsei University, Seoul, Korea) The purpose of this study was to develop a nursing education program using a web-based learning system to teach peritoneal dialysis and to evaluate the effectiveness of the program. The program was developed in two steps. The first step was to develop the content using CVI, and the second was to program it using HTML. The program which was developed was evaluated with 50 nurses of whom 48 responded to the questionnaire. The results are as follows: Of the subjects, 85.4% responded that they were satisfied with this web-based learning system and 87.5% stated that they would recommend this system to nurses who are in other nursing education programs. Of the educational material charac- teristics, the item that the subjects evaluated as most valuable was "accuracy of the content". For system related charact- eristics, the item to which the subjects gave the most positive response was "clarity of the system tool marking" (81.3%). In conclusion, it was verified that a web-based learning system is an effective and satisfactory method for nursing education.

A Study on Influencing Factors in Health Promoting Lifestyles of Continuous Ambulatory Peritoneal Dialysis Patients (복막투석환자의 건강증진 생활양식과 관련요인 연구)

  • 김영순;정은순;김정순
    • Korean Journal of Health Education and Promotion
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    • v.18 no.1
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    • pp.17-33
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    • 2001
  • The purpose of this study was to identify the major factors affecting performance in health promoting lifestyles in continuous ambulatory peritoneal dialysis(CAPO) patients. The subjects for this study were 98 CAPO patients living in Pusan city. The data for this study were collected from October 15th, 1999 to January 15th, 2000 by structured questionaries. Statistical analysis was done using SPSS softwares. The results were as follows: 1. The average score of performance in the health promoting lifestyles was 2.34. The variable with the highest degree of performance was self-actualization and nutrition, whereas the one with the lowest degree was exercise. 2. In the subscale of the health promoting lifestyles, especially educational level, marital state and CAPO period, there was significant differences between demographic variables and performance in the health promoting lifestyles. 3. The activity-related affect, situational influences, self-efficacy, and perceived barriers in the behavior-specific cognitions and affect have a significant correlation with performance in the health promoting lifestyles. 4. The most important variable that affects the performance in the health promoting lifestyles was situational influences, and the self-efficacy, perceived barriers, every monthly treatment cost, duration of chronic renal failure followed in order, activity-related affect. Those six variables accounted for 38.3% among the variables in health promoting lifestyles.

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A Study on Self Care Compliance Related to Infection Management for Continuous Ambulatory Peritoneal Dialysis Patients (복막투석환자의 감염예방과 관련된 자가간호 이행에 관한 연구)

  • Lee Eun-Young;Kim Jung-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.313-323
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    • 1998
  • This study was a descriptive research on the level of self-care available to continous ambulatory peritoneal dialysis patients (hereinafter referred to as 'CAPD patient') related to the specific area of infection management. The method employed for the collection of data was a modified instrument of the self-care survey essentially based on Young Sook Choi's instrument. The relevant data was collected from september 1, 1996 to september 30, 1996. The subjects were provided with an open-ended question regarding the reasons behind why they did not seek self-care. The answers provided about self-care compliance were analyzed by SPSS for frequency, percentage, mean, t-test, ANOVA. Reasons for non-compliance were analyzed by content analysis. The results of the study were as follows : 1. The percentage of patients engaging in self-care were according to the following self performed tasks : preparation of dialysis : 30.58 points Dialysate exchange procedures : 49.40 points - Two bag type : 50.50 points - Spike type : 48.80 points - Neo type : 48.90 points Catheter exit site care : 25.13 points More specifically, in relation to the preparation of dialysis as referred to above, those patients engaging in self care was relatively high with respect to the cleaning of the dialysis before use and for the preservation of peritosol. However, in dialysate exchange procedures, data revealed that those patients engaging in self-care are relatively low with respect to putting on a mask during the performance of peritosol exchange. Similary in peritosol exchange procedure and catheter exit care, low levels of self-care performance were found in the area of putting on a mask during the peritosol exchange procedures and catheter line testing procedures, respectively. 2. In general characteristics, there appeared to be no distinction in self-care compliance among CAPD patients. 3. The main reasons for non-compliance were based in the following factor : intellectual, attitude, enviromental surrounding and physical. As a result of the foregoing finding, nurses should provide adequate assistance to promote self-care compliance by CAPD patients by checking the preparation of dialysis, dialysate exchange procedure, and catheter exit site care which recieved low point in this research.

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Comparison of Personal Characteristic Factors Relating to Quality of Life in Patients with End-Stage Renal Disease

  • Sittisongkram, Soontaree;Sarakwan, Jamras;Poysungnoen, Phakatip;Meepaen, Malee
    • Asian Journal for Public Opinion Research
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    • v.7 no.2
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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.