bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraperitoneal hydrostatic pressure and volume in peritoneal dialysis patients
Authors: Di Lauro V. , Luccio F. , Colaluca M. , De Francesco F. , Pintauro A. 
Published: July 2012

SummaryDialysate Intraperitoneal Volume (IPV) represents one of the major determinants of Peritoneal Dialysis (PD) efficiency, but most adult patients are currently treated with the same standard IPV, regardless of body size. In order to evaluate the tolerability of different IPV, we adapted the current connection in use at our Institution to produce a simple method to directly measure Intraperitoneal Hydrostatic Pressure (IPP). We studied the relationship between IPV and IPP in 30 adult (age 19–77 years) patients (19 males) of various body sizes, on PD between 17±17 months. Mean end‐inspiratory and end‐expiratory IPP with different IPV were measured in each patient in the IPV range of clinical interest. A total of 210 individual measurements showed a statistically significant positive relationship between BSA‐normalised IPV and IPP (r=0.355, p<0.001). Interpatient variability was high, thus suggesting that individualisation of IPV according to body size is not accurate, IPP being often higher in larger body size. Direct IPP measurement with different IPV in the single patient is a simple, safe and reproducible procedure, allowing an individually tailored IPV prescription which should optimise PD efficiency while monitoring for IPP related complications.
Pre‐dialysis education. A change in clinical practice. How effective is it?
Authors: O'Donnell A. , Tucker L. 
Published: July 2012

SummaryThe last decade has seen a great expansion in the provision of pre‐dialysis education within the UK, with our programme in operation since 1996. In order to evaluate its impact on patient care, two methodologies were employed: the first used a satisfaction survey with which to examine patient perception of the programme; the second approach examined resource utilisation, in particular length of stay, as an outcome measure. Difficulties have arisen in discerning the impact of the programme amongst the other education interventions to which the patient is exposed. Comparative length of stay data was used as an alternative means of assessment. The results of the audit led us to question the effectiveness of the methodology that we employed and has led us to propose the development of a standard. It is hoped that the adoption of a more structured approach will not only aid the effectiveness of the programme itself but also facilitate the evaluation process.
EDTNA/ERCA Technicians' SIG Journal Club 1/99 Summary of paper discussion
Authors: Stragier André 
Published: July 2012

SummaryThe selected paper focused on 29 cases of bloodstream infections that occurred in 2 haemodialysis centres. Culture studies revealed that the same pathogens were present in the Waste Handling Option (WHO) of the machines used. The WHO is a device of Centry Cobe machines, for disposal of spent saline. The pathogens could enter directly or indirectly into the blood line tubing from this WHO. These incidents were halted by measures directed at the WHO attachment.
The dark side of the moon: how clients face dialysis
Authors: Bruno E. 
Published: July 2012

SummaryPatients requiring haemodialysis experience various problems, some of which are caused by the medical treatment. We explored various aspects of a haemodialysis patients life, to focus on the effects that their treatment had on their daily life. The aim of this study was “to know the life of the respondent, in order to improve the quality of the assistance.” This pilot study allowed the staff to plan arrangements in order that the patient could pursue a “normal life”.
The psychosocial implications of live‐related kidney donation
Authors: Eggeling C. 
Published: July 2012

SummaryThe aim of the study was to explore the donor's experience of the live related transplantation process whilst seeking to identify the external and internal resources and ethical considerations which were reflected in the decision‐making process. The outcome would indicate that altruism and a sense of moral obligation were the prime motivational influences with the spontaneity of decision‐making casting doubt on the ability to give informed consent. These findings are also discussed in relation to implications for professional practice and would suggest that potential donors benefit from having access to a counsellor during the donor‐search and throughout the transplant work up programme.
Increasing the safety of volumetric ultrafiltration control
Authors: Peter H. 
Published: July 2012

SummaryDeviations in ultrafiltration volume can cause various problems for patients undergoing a haemodialysis treatment. With the introduction of high flux dialysers, closed systems with volumetric fluid balancing became the systems of choice, because control of transmembrane pressure used previously is too inaccurate and unsafe to be used with such filters. In this article, a reliable and cost effective test method is described to increase the safety of a closed system. The test is carried out by simply analysing the dialysate pressure while the dialyser is isolated from the system for typically 7.2 seconds. No additional sensors and components other then a valve combination used to isolate the dialyser are required.
Haemodialysis in acute renal failure
Authors: Taratufolo A. , Manzi M. , Pedulla F. , De Bernardini F. , Carofei O. , Alaimo M.R. , Ugolini N. , Galeotti P. 
Published: July 2012

SummaryHaemodialysis in acute renal failure differs from chronic uraemia. We describe our clinical experience comparing tolerance to dialysis and dialysis efficacy of bicarbonate haemodialysis in comparison to haemofiltration. Both provide adequate treatment for ARF, Kt/v 0.6±0.1, URR 56% in bicarbonate haemodialysis compared to Kt/v 0.4±0.06, URR 60% in haemofiltration. Clinical outcome was the same in both groups, in particular the overall survival was satisfactory at about 70%. These results are likely to reflect close control of these patients by nursing staff committed to haemodialysis in acute renal failure.
Total quality improvement assessment of the EPO co‐ordinator role
Authors: Morrison E.A. 
Published: July 2012

SummaryTotal quality management or total quality improvement has developed and grown from the process of quality assurance. Its main features are, quality is a management led approach, top management participation is essential, it is a concept for preventing mistakes, not finding fault and correcting it. A client centred approach and teamwork are seen as key components. This paper explores the role of the Epo co‐ordinator and identified what changes were required to improve the quality of the service.
Preparing for the challenges of the millennium
Authors: Polpitiye M. , Fairchild V. 
Published: July 2012

SummaryThis paper describes a retrospective view of the challenges the two authors were faced with as Nurse managers when the haemodialysis unit was expanded from ten dialysis stations to thirty‐one within a period of three years. This expansion involved changes to the environment and management strategies. There were four issues identified that helped to face these challenges and they are described in depth. The authors claim the skill of communication within the team and the proactive approach to change was the key to their success.
Exit‐site infection prevention and treatment protocol
Authors: Rivetti M. , Galliano F. , Cotto M. , Benotto S. , Bosio A. 
Published: July 2012

SummaryInfections are universally known as one of the main causes of drop‐out in peritoneal dialysis. Exit‐site infections are often a problem, as they are difficult to treat, tend to become chronic and may lead to the development of continuity peritonitis, resulting in the need for removal of the peritoneal catheter. The purpose of this paper is to describe the application of an exit‐site infection prevention and treatment protocol.
The patient with diabetic nephropathy in the hospital
Authors: Thanasa G. , Afthentopoulos I. E. 
Published: July 2012

SummaryDiabetic nephropathy leads to chronic renal failure in 30–40% of diabetic patients. By offering primary health care and teaching patients with diabetic nephropathy about factors which influence their renal function, we can delay the renal deterioration and therefore the start of the renal replacement therapy. By learning to control their blood pressure, blood glucose and diet they will be fully aware of their health problem, avoid possible complications and last but not least they will possibly achieve more time. The nephrology nurse is capable of making a difference by offering advanced nursing care and being the patient's teacher and supporter.
Treatment decisions in paediatric dialysis: children's versus parental rights
Authors: Gabbai N. , Rauch‐Elnekave H. , Spitz M. , Weissman I. 
Published: July 2012

SummaryTreatment decisions in Paediatric Dialysis are often fraught with ethical questions about how to serve the best interests of children on dialysis, especially when parents refuse recommended treatments and opt for non‐optimal interventions. This paper reviews the issues of children's rights, as guaranteed in the United Nations Covenant on Children's Rights and the Israel's Patients' Rights Law, and presents several case vignettes where conflict between children's rights for optimal treatment and parental desires arose. The paper concludes with policy recommendations to assure that children's expressed desires and medical needs are met, including the establishment of multidisciplinary committees to address the needs of children on dialysis and their families.
An educational programme for persistent life‐style changes in patients with chronic renal disease
Authors: Bergström K. , Bárány P. , Holm I. 
Published: July 2012

SummaryThe aim of this study was to produce positive life‐style changes in patients with chronic renal disease through a residential education programme about the medical aspects of chronic renal failure and the various treatment options in order to increase their physical capacity, emotional stability and general well‐being. The programme was available to all categories of patients with chronic renal disease irrespective of treatment modality. Comparison of data pre and post course demonstrated improvements in physical activity, mental well‐being and nutritional awareness.
Review of arteriovenous fistula care
Authors: Yang R. , Humphrey S. 
Published: July 2012

SummaryThe patient with End Stage Renal Failure is largely dependent upon haemodialysis for survival. Vascular access is the vital lifeline. This paper provides a review of the literature and aims to advocate the advantages of arteriovenous fistulae compared with other vascular access. It will discuss the main causes of thrombosis in arteriovenous fistula failure, measurements of early detection of venous stenosis and the care of an arteriovenous fistula to ensure its patency. The responsibility of the dialysis nurse is also considered.
Influence of post haemodialysis sampling on Kt/V result
Authors: Gago C. , Marco B. , Fernández J. , Piña M.D. , Gálvez C. , González A. , Martínez S. , Hernando P. , Gruss E. 
Published: July 2012

SummaryThe recommended Kt/V is 1.2. Unfortunately there is no written policy for nurses on the procedure for taking blood urea nitrogen samples post haemodialysis. The aim of this study was to establish the Kt/V variability of haemodialysis patients depending on the method of collection of post‐haemodialysis blood urea nitrogen. Twenty‐two patients were analysed. A Kt/V was performed every 15 days during a period of 2 months. It was taken five times on each patient: 30 minutes before the end of a haemodialysis session (Kt/V30), at the end of haemodialysis (Kt/V1), after slowing flows (50 ml/min) for 2 minutes (Kt/V2) and after the blood circuit had been returned to the patient at 5 and 15 minutes respectively. (Kt/V5, Kt/V15). The Kt/V results were: Kt/V1 1.23+/‐0.2 Vs Kt/V2 1.14+/‐0.19 (p< 0.003); Kt/V5‐ 1.05+/‐0.19 (p<0.002 Vs Kt/V2); Kt/V15 1+/‐0.16 (p<0.05 Vs Kt/V5); Kt/V30 1.12+/‐0.21 (pNS Vs Kt/V2). In conclusion, there was a large variability in the Kt/V depending on the method of collection of the blood urea nitrogen sample post‐haemodialysis.
Nutritional education of CAPD patients and media influence
Authors: Bordin G. , Zuccherato N. , Toniato E. 
Published: July 2012

SummaryThe aim of our paper was to investigate the short period of training offered to peritoneal dialysis patients. We focused our attention on the nutritional knowledge of patients who often gather information, and advice from external factors such as their family and the media. We organized group meetings on nutrition for 22 patients and 17 relatives. Questionnaires were completed before and after the education programme. The group meetings improved knowledge on nutrition and highlighted the influence of the media. The important role of the nurse at these meetings has also been recognised.
Complications of complicated grief in renal failure
Authors: Harvey B. 
Published: July 2012

SummaryThis paper sets out to bring together recurrent themes in the understanding and care of patients with Chronic/End Stage Renal Failure centring on the key issue of loss. A multi‐disciplinary conceptual framework is proposed based on three perspectives ‐ Systemic, Existential and Narrative. The integrated framework for understanding the complexity of grief issues for dialysis and pre‐dialysis patients focuses on the perception of self and the inter‐relationship with others directly involved in their care.
Quality of life and exercise in renal disease
Authors: Moltó C. Iborra , Vicent L. Picó , Castillo A. Montiel , Ramón F. Clemente 
Published: July 2012

SummaryMany publications describe the advantages of physical exercise in improving quality of life. The aim of this study was to highlight the need for physical activity when patients commence haemodialysis. A correlation was found between muscular deterioration and the years on haemodialysis and it was accentuated in men. From our study we recommend adequate physical activity at the beginning of, and during the lifetime of haemodialysis to enhance the physical and psychological well being of patients.
Factors Leading to Increased Mortality in ESRF
Authors: Khan I.H. 
Published: July 2012

SummaryEnd‐stage renal disease is a condition, which can only be treated with renal replacement therapy, in the form of dialysis and transplantation. Despite great technological advances in the field of renal replacement therapy, mortality among patients remains very high. A variety of factors are responsible for the increased mortality in end‐stage renal disease despite treatment. These have been classified in this review into those that are patient related and those, which can be modified by treatment. Age, comorbidity, malnutrition and pattern of referral of patients with end‐stage renal disease are the major associations of adverse survival in renal replacement therapy.
Management of temporary haemodialysis catheters in paediatrics
Authors: Muñoz E. Tornay , Moreno C. Xérès 
Published: July 2012

SummaryChildren with haemodialysis catheters can suffer serious complications related to activity, cognitive level, and hospitalisation. The objective of this study was to improve our patients' quality of life by studying catheter fixation and preservation of skin integrity. In this descriptive‐prospective study we used a hydrocolloid dressing to fix the catheter and an elastic tubular mesh to complete the immobilisation. We studied 21 catheters in 6 children, aged 3 to 11 years, from December 95 to April 98. Of the 21 catheters, 13 were changed and 6 were removed. The incidence of local infection was 38% and general infection 28%. The mean duration was 42 days.
Disinfectant rebound release from adequately rinsed, reused dialysers: Is the potting resin the main source?
Authors: Stragier A. , Wenderickx D. , Maes T. , Struyven J. 
Published: July 2012

SummaryDisinfectant Rebound Release (DRR) from adequately rinsed, reused dialysers is usually considered to originate from the potting resin and thus unavoidable. We measured DRR of 3 disinfecting agents from 8 dialysers groups, with (capillaries) and without (plates) potting resin. Our results demonstrate that in current dialysers the main determinants of DRR are the type of disinfecting agent and dialysis membrane. DRR is similar for plate and capillary dialysers, proving thus that the presence of potting resin is currently not responsible for DRR from chemically disinfected reused dialysers.
Assessing Quality of Life in routine clinical practice: A pilot study
Authors: Keogh A.M. , Carfray A. , Andrews S. , Jenkins J. , Longmate R. , Nichols N. , Farina C. , Wilde D. 
Published: July 2012

SummaryTo assess the feasibility and usefulness of administering a quality of life (QoL) questionnaire in routine clinical practice, we performed a 5‐centre UK study with nurses administering a disease‐specific questionnaire, the Renal Quality of Life Profile (RQLP), to 140 patients. The completed questionnaires were reviewed by the nurse who felt that there were issues requiring discussion in 46% of patients. These issues were either discussed with the nurse immediately in person (65%), or the patient was contacted by telephone (28%) or post (7%) and appropriate referrals and interventions were actioned. We conclude that measurement of QoL is feasible and useful in routine clinical nursing practice.
Is it surprising they omit their tablets?
Authors: Valentine A. 
Published: July 2012

SummaryNon‐compliance is a significant contributory factor to graft loss. In these days of organ shortage and ever growing transplant waiting lists it is important that we maximize graft survival by addressing this issue. A study was conducted of eighty‐three patients consecutively attending the annual health review clinic. A series of structured questions were asked to ascertain, the patients' knowledge about medications, feelings about taking them, level of compliance and reasons for non‐compliance. Results showed that 90% of the patients fully understood what all their tablets were for, 74% said they never missed taking any of their tablets, whilst 22% forgot occasionally. Three patients admitted to stopping one or all of their immunosuppressive medications completely and one patient was enjoying a ‘holiday’ from his medications. Reasons given for non‐compliance included; adverse effects of the drugs, the number of tablets to be taken, life crises and forgetfulness.
Improving Nutritional Intake in Dialysis Patients
Authors: Russell Lesley 
Published: July 2012

SummaryThe developments in the field of renal replacement therapy have created a challenge for all those who are involved in the nutritional elements of patient care. We can expect to look after our patients for longer, see all ages and a full range of Coexisting morbidity. To support this there have been some advances in nutritional care, which can be offered, but for the vast majority of patients it is normal food, which provides the means to meeting these needs.
Technical basis for immunoadsorption
Authors: di Nicuolo A. , Braun N. , Risler T. 
Published: July 2012

SummaryImmunoadsorption is a new extracorporeal treatment for immunologicaly‐mediated diseases. This review deals with the primary plasma separation for immunoadsorption, the various immunoadsorbers and the technique of immunoadsorption itself. Primary plasma separation can be performed either by plasma membrane filtration or by centrifugation depending on the quantity of processed plasma. Currently, there are non‐selective, semi‐selective and highly selective adsorbers commercially available. Adsorbers can be subdivided into single‐use and reusable devices. The choice of the adsorber is dependent on the clinical situation of the patient. An adapted anticoagulant regimen must be used to avoid complications in the patient and to obtain optimal adsorber performance. Thus, immunoadsorption is an effective and safe extracorporal treatment in severely ill patients suffering from autoimmune diseases.
Perceptions of renal nursing
Authors: Keogh A.M. , Pope J. , Anthony I. , Arnell‐Cullen V. , Hamilton M. 
Published: July 2012

SummaryRecruitment and retention of nursing staff in general, but renal nurses in particular has become an increasing problem in Britain in recent years. This study set out to measure nurses' attitudes to and understanding of renal nursing and explore the image of renal nursing. The methodology used included focus group discussion and telephone interviews with both renal and non‐renal nurses. Strategies and factors, which may influence recruitment and retention of staff, are recommended.
The care of the elderly renal patient
Authors: Ashwanden C. 
Published: July 2012

SummaryDo we who deliver renal care understand how old age alters mental and physical perspectives and are we able to meet the changing needs of our increasing elderly dialysis population? This paper examines the need for a review of the care of our ageing renal population and how the physiological and the psycho‐social needs of the elderly change and asks how far do we understand these changes. How can we as nurses support our elderly patients through the changes that affect them, as they grow older? The findings of this paper show that the Renal Health Care team is not fully conversant with the physiological or mental changes that old age makes to the body. The conclusion is that because the renal population is growing older, the Renal Team needs to be more aware of the changes which occur as people grow older and to deliver care acknowledging these changes.
Competency based standards for advanced practice in nephrology nursing
Authors: Stewart G. , Bonner A. 
Published: July 2012

SummaryThe purpose of this paper is to present the outcomes of a nationwide nursing research project in Australia. Utilising the Delphi technique, ninety‐four clinically based nephrology nurses reviewed a series of competency based standards documents. The purpose of this research was to reveal the ways in which nephrology nurses practice at an advanced level. The results will facilitate the way in which advanced practice nephrology nursing is understood and inform nursing curricula development.
Preventing hypoxaemia during haemodialysis: Oxygen therapy and bicarbonate profiling
Authors: Leggate P. 
Published: July 2012

summaryThis study was undertaken, because in the Haemodialysis Unit, where this author practices, patients with a history of cardiovascular disease and who undergo routine maintenance haemodialysis were exhibiting signs and symptoms of hypoxaemia, such as agitation, restlessness, yawning and eventual collapse. The experience itself is described by the patients involved as terrifying and therefore should be a priority in their Nursing Care Plan. It should be remembered however that the bicarbonate profile used in the programme should reflect the results of predialysis blood samples and altered accordingly. Haemodialysis induced hypoxaemia has been reported many times and several investigations have confirmed the occurrence of this phenomenon. In this study, the concern is how to prevent patients from experiencing this event.
A nursing view of future haemodialysis anticoagulation treatments
Authors: de Vos J‐Y. 
Published: July 2012

summaryThe purpose of prescribing anticoagulation therapy in haemodialysis treatments ‐ extracorporeal treatments in general ‐ is to avoid coagulation of blood within the extracorporeal circuit. I.e. catheter/needle(s), bloodlines, artificial kidney/haemofilter. In this paper we differentiate between chronic treatments and acute treatments. The methods of anticoagulation are quite similar in both groups, except for specific preferences and adapted dose.