Wyniki wyszukiwania - Biblioteka Nauki

1

Assessment and management of pain in hemodialysis patients: A pilot study

100%

Kafkia T. , Vehviläinen-Julkunen K. , Sapountzi-Krepia D.

Progress in Health Sciences

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2014

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tom 4

|

nr 1

53-60

XX

Purpose: To assess pain levels of hemodialysis (HD) patients and to report pain management techniques. Materials and methods: A quantitative descriptive study design with a summative approach to qualitative analysis was held, with a personal interview of the HD patients in a Southern European city hospital (n=70), using the Visual Analog Scales (VAS), the Wong-Baker Pain Scales (WBPS) and McGill Pain Questionnaire. People confused or in a coma, with hearing or reading problems and inability to communicate in the spoken language were excluded. Results: Renal patients under investigation were 69.72 ±12.45 years old, male (58.5%) and on HD for 35.5 ± 27.4 months. In the Wong Baker Scale, pain was rated as “hurts little more” 30.8%, (n=20) and in the VAS 30.8% (n=20) reported 6/10 the amount of pain experienced. Forty-six percent pinpointed internal pain in the legs. Pain experienced was characterized as sickening (70.8%), tiring (67.7%), burning (66.2%), rhythmic (86.2%), periodic (66.2%) and continuous (61.5%). The patients studied mainly manage pain either with warm towel/cloth (85.2% females and all male patients), with massage (84.2% and 88.9%, respectively) or painkillers (47.4% and 52.6%, respectively). In a correlation of gender and pain management techniques, statistical significance was found only with warm towel (p=0.038). Conclusions: As renal patients are an increasing group of healthcare service users, and pain is affecting their everyday life, it is essential to individualize pain evaluation and to provide further education to clinical nurses so that they can effectively manage pain.

2

Life’s quality of chronically dialyzed children in Poland

100%

Juzyszyn A. , Kunecka D. , Musiał B.

Progress in Health Sciences

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2016

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tom 6(2)

117-124

EN

Introduction: The paper presents the possibility of assessing the quality of life (QOL) of children on dialysis. Purpose: To evaluate the QOL depending on the health status of children on dialysis, to compare the subjective assessment of the QOL and to identify some of the factors independently affecting the QOL. Materials and methods: The study has been conducted on a group of 28 children on dialysis. Research tools: Poland abbreviated version of the survey assessing the quality of life of The World Health Organization Quality of Life (WHOQOL); survey constructed on the basis of the Polish version of Kidney Disease and Quality of LifeTM Short Form (KDQOL-SFTM) Version 1.2 and a questionnaire assessing QOL of children and adolescents with end-stage renal disease on dialysis and transplantation of kidneys by Rubik, Grenda, Jakubowska - Winecka and Dabrowska. Results: There were no significant differences in QOL between children treated with peritoneal dialysis and Hemodialisis (HD). While there is a strong correlation between the severity of depressive symptoms and the treatment's duration, financial status and parents' education. Conclusions: The phenomenon of reduced QOL must be counteracted. Medical pediatric staff of dialyze centers should especially pay attention to the problem of life’s quality, due to the intensity of disease’s impact on growing organism, should actively counteract the phenomena of its decrease by continuous therapeutic education of patient and his or her family.

3

Estimation of Predictive Factors Affecting Patency of Dialysis Arteriovenous Fistulae

88%

Mularczyk T. , Kostewicz W.

Polish Journal of Surgery

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2010

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tom 82

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nr 3

147-158

EN

Native arteriovenous fistula is considered the best type of access for dialysis. Its function is affected by multiple factors.The aim of the study was to identify risk factors of the loss of fistula patency.Material and methods. Between 1990-2004, 218 patients underwent 276 surgical procedures involving vascular access creation. In 245 (89%) of cases, a fistula was created using only patient's own blood vessels; in 31 (11%) of cases a vascular graft was implanted. 158 (64%) radio-cephalic fistulae were created, 15 (6%) radiobasilic fistulae, 33 (14%) brachiocephalic and 39 (16%) brachiobasilic fistulae. Duration of primary patency was identified for 217 native fistulae. Age, gender, diabetes mellitus, type, mode of creation and fistula location, vein translocation, type of anastomosis and time of initial cannulation were analyzed as potential factors affecting the fistula patency. Cox proportional hazards model was used in the analysis.Results. Probability of fistula patency loss in patients above 46 years of age was 2.12-fold higher than in younger patients and 1.62-fold higher for end-to-side anastomosis versus end-to-end anastomosis. Risk of loss of patency in fistulae cannulated for the first time within the first 14 days, 15-21 days and 22-35 days from their creation was 31-, 19- and 7-fold higher than when they were cannulated after the first 35 days.Conclusions. Type of vascular anastomosis, age above 46 years and time of the first cannulation are independent risk factors of the loss of patency of vascular access. First cannulation should not take place earlier than 7 weeks after its creation.

4

Ocena niskorosłości dzieci dializowanych w latach 2000–2016 – doświadczenie jednego ośrodka

75%

Zachwieja K. , Drożdż D. , Hubert J. , Dudek N. , Moczulska A. , Miklaszewska M. , Pietrzyk J. A.

Annales Academiae Medicae Silesiensis

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2017

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tom 71

122-128

EN

WSTĘP: Celem pracy była ocena wzrastania dzieci dializowanych w latach 2000–2016. MATERIAŁ I METODA: U 102 dzieci w wieku 10,2 roku ± 5,66 przeanalizowano rozpoznania, schorzenia dodatkowe, czas i rodzaj dializoterapii, losy pacjenta, zastosowanie hormonu wzrostu. Niedobór wzrastania (Z score) stwierdzono u 87 dzieci przy rozpoczęciu badania i u 94 przy zakończeniu leczenia. WYNIKI: U 60% dzieci pierwszą metodą dializoterapii była dializa otrzewnowa, u 38% hemodializoterapia, u 2% wyprzedzające przeszczepienie nerki. W chwili zakończenia obserwacji 70% pacjentów żyło z czynnym przeszczepem nerki, 15% było nadal dializowanych, 13% zmarło, u 2% doszło do poprawy funkcji nerek. Średni czas dializoterapii (94 dzieci) wynosił 34,6 mies. (1–136 mies.) i był dłuższy w latach 2000–2008 niż w okresie 2009–2016 (śr. 43,3 ± 32,7 mies. vs 18,3 ± 13,1; p = 0,00005). W grupie ze schorzeniami dodatkowymi (46% dzieci) stwierdzono większy niedobór wzrostu na początku (Z score 0: -2,3 ± 2,3 vs -1,08 ± 1,6; p = 0,003) i na końcu leczenia (Z score 1:-2,7 ± 2,6 vs -1,2 ± 1,5; p = 0,001) oraz dłuższy czas dializoterapii (42,7 ± 34,4 mies. vs 27,8 ± 23,8; p = 0,02). Z score 0 wyniósł dla wszystkich pacjentów -1,7 ± 2,0 (-9,3 do +2,0) przy rozpoczęciu leczenia i nie różnił się od Z score 1: -1,9 ± 2,2 (-8,3 do +2,4); p = 0,37 w chwili zakończenia. U 42,5% dzieci na początku i u 45% na końcu terapii Z score był < -2,0. W grupie 17% dzieci leczonych hormonem wzrostu stwierdzono wyrównanie się niedoboru wzrostu po zakończeniu dializoterapii w porównaniu z grupą nieleczoną (Z score 1: -2,4 ± 1,7 vs -1,9 ± 2,3; p = 0,37). WNIOSKI: Niskorosłość stanowi istotny problem dzieci dializowanych. Współchorobowość jest czynnikiem pogarszającym niedobór wzrostu. Zastosowanie hormonu wzrostu daje szansę na poprawę wzrastania.

PL

INTRODUCTION: The aim of the study was to assess the growth in children on RRT during the period 2000–2016. MATERIAL AND METHODS: The diagnosis, comorbidity, RRT data, patient outcome and growth hormone (GH) usage (in 102 patients) and height Z score for 87 patients at the start of RRT and for 94 patients at the end of RRT were analyzed. RESULTS: In 60% of patients, peritoneal dialysis was the first method, in 38% hemodialysis and in 2% a preemptive transplantation was performed. The average dialysis time was 34.6 months (1–136 months) and it was statistically longer in the years 2000–2008 than in 2009–2016 (av. 43.3 ± 32.7 months vs 18.3 ± 13.1; p = 0.00005). In the group with comorbidity (46% patients) Z score 0 (start) and Z score 1 (the end) were lower than in the group without comorbidity (average Z score 0: -2.3 ± 2.3 vs -1.08 ± 1.6; p = 0.003) and the dialysis time was also longer (p = 0.02). The Z score in all the patients at the start of RRT was -1.7 ± 2.0 (min: -9.3 to max: +2.0) and there was no statistical difference in comparison to the Z score at the end of RRT: Z score 1; p = 0.37. A Z score < -2.0 was found in 42.5% of children at the start and in 45% at the end of RRT. In 17% of the GH treated group, growth improvement was shown by no difference in Z score 1 in comparison to the group without GH therapy. CONCLUSION: Short stature is still a problem in children on dialysis. Comorbidity is important factor of growth retardation. GH therapy is effective in children on RRT.

5

Project of the Health Policy Program: Access to Vessels in Renal Replacement Therapy – Fistula First/Catheter Last

75%

Kubielas G.

Polish Journal of Surgery

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2020

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tom 92(3)

1-8

EN

Introduction: The number of patients with end-stage renal failure (ESRF) that require inclusion in the renal replacement therapy program (RRT) is steadily increasing. This fact caused an increase in vascular operations involving the production of vascular access. According to the current guidelines, the best and safest option for a patient with chronic kidney disease (CKD) is the early creation of arteriovenous fistula (AVF). An efficient vascular access to haemodialysis determines the procedure and directly affects the quality of life of a patient with CKD. Aim: The aim of this paper is to present the author’s project of the health policy program „Vascular access in renal replacement therapy – fistula first/catheter last”, the essence of which is to assess the practical effectiveness and develop an optimal model of CKD patient care organization qualified for the chronic RRT program. Material and methods: The target population of the program consists of all patients diagnosed with CKD, qualified for the RRT program. The basic measures of the program’s effectiveness include: (1) reduction in the number of re-hospitalizations related to vascular access, (2) reduction in the number of complications associated with haemofiltration surgery, (3) reduction in general mortality among patients undergoing dialysis in a 12-month perspective, (4) increasing knowledge in the field of self-care and self-care of arteriovenous anastomosis, and (5) creating a register of vascular access in Poland. Conclusions: To sum up, health policy programme “Vascular access in renal replacement therapy – fistula first/catheter last” covering health care services provided in the scope and on the conditions specified in the regulations issued on the basis of article 31d of the Act of 27 August 2004 on health care benefits financed from public funds, is to check whether planned changes in the organization and delivery of services will improve the situation of patients with CKD eligible for chronic RRT and whether it will be effective the point of view of the health care system.

6

Transplantacja nerki jako metoda leczenia nerkozastępczego pacjenta z przewlekłą chorobą nerek

63%

Woderska-Jasińska A. , Hermanowicz M. , Włodarczyk Z.

Innowacje w Pielęgniarstwie i Naukach o Zdrowiu

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2021

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tom 6

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nr 1

73-83

EN

Introduction. It is estimated that 500-600 million people are affected by chronic kidney disease. In Poland, 6500 among 4-5 million patients with chronic kidney disease require renal replacement therapy de novo every year. Renal transplant is a well-established treatment of end-stage chronic kidney disease, and the most effective one in comparison to alternatives – hemodialysis and peritoneal dialysis. Aim. Presenting the current condition of knowledge of issues is a purpose of the work to the subject chosen concerning transplanting kidneys as procedures in chronic nephropathy. Review. In this review the author presents the current state of knowledge about selected aspects of kidney transplantation in Poland from deceased and living donors, including transplantations from nonrelated living donors (Kidney Paired Donation program). Conclusions. Renal transplant allows to achieve both longer survival and better quality of life than dialysis and therefore is the treatment of choice in end-stage chronic kidney disease.

PL

Wstęp. Szacuje się, że przewlekła choroba nerek stanowi problem zdrowotny 500–600 milionów osób, z czego 4-5 milionów mieszkańców Polski, spośród których rocznie de novo 6500 wymaga leczenia nerkozastępczego. Transplantacja nerek jest uznaną metodą leczenia nerkozastępczego i najskuteczniejszą w porównaniu z alternatywnymi metodami leczenia przewlekłej choroby nerek - hemodializą i dializą otrzewnową. Cel. Celem pracy jest przedstawienie aktualnego stanu wiedzy na temat wybranych zagadnień dotyczących przeszczepiania nerek jako metody leczenia nerkozastępczego w przewlekłej chorobie nerek. Przegląd. W pracy przedstawiono aktualny stan wiedzy na temat wybranych zagadnień dotyczących transplantacji nerek w Polsce od dawców zmarłych i żywych, w tym przeszczepień od żywych dawców niespokrewnionych w ramach Programu Wymiany Par. Podsumowanie. Transplantacja nerek zapewnia chorym dłuższe przeżycie i lepszą jakość życia niż dializoterapia, dlatego jest metodą z wyboru w leczeniu schyłkowej niewydolności nerek.

7

Wybrane aspekty jakości życia pacjentów hemodializowanych

63%

Piernikowska A.

Innowacje w Pielęgniarstwie i Naukach o Zdrowiu

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2023

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tom 8

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nr 1

59-87

EN

Introduction. Renal replacement therapy performed as part of dialysis among patients allows replacing the work of their renal failure. However, due to the aggravating nature of this method of treatment, it significantly affects the modification of patients' quality of life. Aim. The purpose of research in this study was to verify selected aspects of the life of hemodialysis patients using a hemodialysis catheter and – venous arteriovenous fistula. Material and methods. The studies were conducted among 100 patients undergoing hemodialysis. They used the diagnostic survey method, estimation method, techniques: survey and estimation scale, and the WHOQOL - BREF questionnaire with the proprietary record. Results. Research results indicate a varied level of quality of life for hemodialysis patients in different domains of their functioning. Conclusions. Most hemodialysis patients present an average level of satisfaction with the quality of their lives. They perceive the individual, general perception of quality of life better than the individual general perception of their own health. The quality of life of patients undergoing hemodialysis does not depend significantly on their age, education and place of residence. Significantly higher assessment of the quality of life within the environmental domain was presented by persons in relationships, the lowest assessment within the social domain was made by widows / widowers. The quality of life of patients undergoing hemodialysis does not depend significantly on the cause, method and time of renal replacement therapy.

PL

Wstęp. Terapia nerkozastępcza realizowana w ramach dializoterapii wśród pacjentów umożliwia zastąpienie pracy ich niewydolnych nerek. Jednak z uwagi na obciążający charakter tej metody leczenia wpływa ona istotnie na modyfikację jakości życia pacjentów. Cel pracy. Celem badań pracy była weryfikacja wybranych aspektów życia pacjentów hemodializowanych przy użyciu cewnika do hemodializ oraz przetoki tętniczo – żylnej. Materiał i metody. Badania przeprowadzono wśród 100 pacjentów poddawanych hemodializie. Wykorzystano w nich metodę sondażu diagnostycznego, metodę szacowania, techniki: ankietowania i skali szacunkowej oraz kwestionariusz WHOQOL - BREF z autorską metryczką. Wyniki. Wyniki badań wskazują one na zróżnicowany poziom jakości życia pacjentów hemodializowanych w różnych domenach ich funkcjonowania. Wnioski. Pacjenci hemodializowani w większości prezentują przeciętny poziom zadowolenia z jakości swojego życia. Postrzegają oni indywidualną, ogólną percepcję jakości życia lepiej, aniżeli indywidualną ogólną percepcję własnego zdrowia. Jakość życia pacjentów poddawanych hemodializie nie zależy istotnie od ich wieku, wykształcenia i miejsca zamieszkania. Istotnie wyższą ocenę jakości życia w ramach domeny środowiskowej prezentowały osoby pozostające w związkach, najniższej oceny w ramach domeny socjalnej dokonywali wdowy/wdowcy. Jakość życia pacjentów poddawanych hemodializie nie zależy istotnie od przyczyny, metody i czasu prowadzenia leczenia nerkozastępczego.

8

Jakość życia pacjentów dializowanych

51%

Pszczółkowska P. , Turek J.

Problemy Jakości

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2018

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tom R. 50, nr 7

21--27

PL

Liczba pacjentów ze schyłkową niewydolnością nerek (SNN) rośnie dynamicznie w tempie 5–7% rocznie, co stanowi globalny problem dotyczący jakości świadczonej usługi medycznej przy ograniczonych, publicznych środkach finansowych. Istnieją sposoby polepszenia jakości usługi przy jednoczesnym zachowaniu równowagi między obsługą chorego dializowanego a płatnikiem NFZ. Artykuł ma charakter teoretyczno-empiryczny. W przeglądzie literatury przedstawiono analizę finansową i statystykę wykonywanych procedur medycznych, jak również zaprezentowano metaanalizę badań. W artykule przedstawiono wyniki badań własnych wykonanych w szpitalu, który wdrożył systemy zarządzania jakością, jak również uzyskał certyfikat akredytacyjny. Badania dotyczą innowacyjnej metody polepszającej jakość dostępu naczyniowego u pacjentów dializowanych. Celem artykułu jest ocena problemu jakości życia pacjentów dializowanych i zaprezentowanie rozwiązania podnoszącego jakość obsługi pacjenta dializowanego w kontekście utrzymania dobrego dostępu naczyniowego, stanowiącego kluczowe wyzwanie dla personelu medycznego i samego pacjenta.

EN

The number of patients suffering from end-stage renal disease (ESRD) is growing dynamically at the rate of 5–7% annually which makes it a global issue regarding the quality of medical services provided in the situation of limited public funds. There are methods to improve the service quality with concurrent maintenance of balance between the service provided to the dialysis patient and the National Health Fund payer. The article is of theoretical and empirical nature. The review of literature presents the financial analysis and statistics regarding the performed medical procedures as well as provides a meta-analysis of research. The article presents results of own investigation carried out at a hospital which has implemented quality management systems and was awarded the accreditation certificate. Investigation is the innovative method improving the quality of vascular access in hemodialysis patients. The purpose of the article is to assess the problem of the quality of life in hemodialysis patients and to present a solution that improves the quality of service provided to a hemodialysis patient in the content of maintenance of good vascular access, being the key challenge for the medical personnel as well as the patients themselves.

9

Dialysis therapies: Investigation of transport and regulatory processes using mathematical modelling

51%

Pstras L. , Stachowska-Pietka J. , Debowska M. , Pietribiasi M. , Poleszczuk J. , Waniewski J.

Biocybernetics and Biomedical Engineering

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2022

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tom Vol. 42, no. 1

60--78

EN

Haemodialysis (HD) and peritoneal dialysis (PD) are the main kidney replacement therapies for patients with end-stage renal disease. Both of these life-sustaining therapies replace the key functions of the failing kidneys, i.e. the removal of the excess body water and waste products of metabolism as well as the restoration of fluid-electrolyte and acid-base balance. The dialysis-induced multi-scale transport and regulatory processes are complex and difficult to analyse or predict without the use of mathematical and computational models. Here, following a brief introduction to renal replacement therapies, we present an overview of the most important aspects and challenges of HD and PD, indicating the types and examples of mathematical models that are used to study or optimize these therapies. We discuss various compartmental models used for the study of intra- and interdialytic fluid and solute kinetics as well as distributed models of water and solute transport taking place across the peritoneal tissue or in the dialyzer. We also discuss models related to blood volume changes and cardiovascular stability during HD, including models of the thermal balance, likely related to intradialytic hypotension. A short overview of models of acid-base equilibration during HD and mineral metabolism in dialysis patients is also provided, along with a brief outline of models related to blood flow in arteriovenous fistulas and cardiovascular adaptations following the fistula creation. Finally, we discuss the model-based methods of assessment of dialysis adequacy in both HD and PD.