bluuebunny/crossref_metadata_2025_split huggingface dataset:
The biographical approach in Renal Care
Authors: Howlett Cherryl 
Published: July 2012

SummaryThis paper explores the value of the biographical approach and indicates its relevance for health care intervention in relation to renal nursing. As care and technology in Renal Services has become more refined, effective and safe the service is now offered to many elderly people who would not have necessarily received treatment in the past. Nursing staff work in a highly technological environment following critical care pathways but with little emphasis on the specific needs of elderly patients. In the past much literature concerning elderly care has concentrated on the negative aspects of old age and authors advocating the biographical approach highlight this. A biographical approach is a broad idea encompassing different perspectives such as reminiscence and life review and the associated aspects of identity maintenance and “managing”.
Recent developments in pancreatic transplantation
Authors: Hesse U.J. 
Published: July 2012

SummaryAt this moment there are more than 10,000 pancreases transplanted into those with diabetes mellitus worldwide. The introduction of new immunosuppressants and refined technical procedures have resulted in a survival of 90% of the grafts and patients. In most cases a simultaneous kidney transplant is performed in patients requiring haemodialysis or peritoneal dialysis. This results in a normal daily life without insulin injections or dialysis treatment. A successful pancreas transplantation in combination with a kidney transplantation can protect the transplanted kidney from diabetic changes. The day in, day out, quality of life of these patients is dramatically increased. The longest pancreas transplant known to be still working is now more than 20 years old. The results from the DCCT study (1) are demonstrating that tight blood sugar control, in those with type I diabetes reduces the complications of diabetes. This is best accomplished by transplanting pancreas grafts into diabetic patients.
The other “Midnight Express”
Authors: de Clerck Eddy 
Published: July 2012

The “Renal Disaster Relief Task Force” was founded around 8 years ago, after the earthquake in Armenia, under the direction of Professor Lameire from the UZ Gent (Ghent University Hospital). This task force was set up in the bosom of the “International Society of Nephrologists” (ISN). The objective was to offer nephrological help in case of disasters, in the region encompassing Europe and the Western part of Asia. In Belgium, this organisation works together with ORPADT (the association of dialysis personnel).Together with a medical company (Baxter) 2 tonnes of aid material is kept in readiness at all times, in Brucargo in Zaventem. Personnel are sent in cooperation with Médecins sans Frontières (MSF). They take care of the logistic support and the organisation.Three of us enrolled right from the start (Gina De Brouwer, Stefaan Demeulenaere and myself) to stand in, in the case of a disaster occurring.The years went by and the Task Force was only ever sporadically mentioned. At the start of this year an update of available volunteers was made. Again, the three of us enrolled.Then the 17th August came along…
Rehabilitating the frail and elderly on renal replacement therapy
Authors: Williams M. 
Published: July 2012

The World Federation of Occupational Therapists defines Occupational Therapy as “ … the treatment of physical and psychiatric conditions through specific activities in order to help people reach their maximum level of function and independence in all aspects of daily life.”Occupational Therapy has long been associated with the frail and elderly, both in hospital and the community. In the United Kingdom however, it appears formal input to the renal multidisciplinary team is a relatively new development. Certainly across Europe, none of us needs reminding of the increasing incidence of older patients with renal failure. United Kingdom figures released in the Second Annual Report of the UK Renal Registry in December 1999 state that, “At the start of treatment 46% of patients were aged 65 or more” (1).
Improvement in care: A collaborative approach to rehabilitation
Authors: Wilde C. , Macefield J. 
Published: July 2012

SummaryExamination of the patient experience within our unit, from pre dialysis through to establishment of dialysis in the community identified that the care was fragmented. To improve patient care, a change process was initiated. Four home care teams comprising three qualified nurses and one renal care assistant were established with each team responsible for a caseload of patients within a specified geographical location. To measure the impact on the patient, 100 questionnaires were circulated after twelve months. Results from 60 patients showed 76% of pre dialysis patients and 80% of dialysis patients were very satisfied with the change process. The main advantage of this change for the patient is that they are in a continuous supportive cycle for all their non‐inpatient care throughout their replacement therapy. We conclude that patient focused care is essential and should be a transition catalyst in a change resistant environment.
Hepatitis C virus: Overview of clinical and technical perspectives
Authors: Jayasekera H. 
Published: July 2012

SummaryThe increasing incidence/prevalence of hepatitis C virus (HCV) infection in dialysis patients is a cause for concern. In particular, the problem of possible transmission of HCV within a dialysis unit needs to be investigated from both a clinical and technical perspective and substantial evidence generated to support future management.Nosocomial transmission has been repeatedly recognised as a major factor in the spread of HCV. Professional negligence and patient naivety can result in the rapid development of nosocomial infection and research has identified that the incidence of transmission, in environments where parental routes are accessible, is higher.There have been a limited number of investigations into transmission through dialysis equipment and to date this evidence seems to indicate that HCV RNA (cells) do not pass through the dialysis membranes. With so little evidence, there is a need for further clarity.Currently it appears that there is no general agreement about preventative measures. Despite a limited amount of evidence, there appears to be a wide variation in policies concerning the isolation of patients.This article will provide an overview of current clinical and technical research that addresses the management of this virus within the haemodialysis environment. It is also the intention of the author that the article acts as a catalyst to promote interest in an international collaborative research project (CRP), which will be launched by the EDTNA/ERCA Research Board.
Improving the nurse‐patient relationship: a multi‐faceted approach
Authors: Bennett Lesley , Woodford Jill , Söderberg Lena , Corl Samuel , Clyne Naomi 
Published: July 2012

SummaryAim: A Corporate Education Session was held to provide concrete strategies for overcoming several specific barriers in the daily nurse‐patient relationship that negatively affect the patient, nurse, or both, and to provide the latest information about best practice as it affects nurses in renal care.Methodology: The session was led by a moderator who presented three video case studies to the audience. Communication strategies for recognising and overcoming nurse‐patient communication barriers were presented. The audience expressed their views about each case study using voting pads, and a panel of experts addressed the comments of the audience and discussed guidelines for best practice in renal care. The panel comprised three experienced renal nurses, a senior nephrologist, and an expert in social interaction.Conclusions: Optimal treatment of patients with renal disease should include early treatment of anaemia, adequate levels of dialysis, and a multidisciplinary approach, responding to both the medical and the social needs of the patient.
Treatment of patients with acute renal failure during Marmara earthquake
Authors: Yürügen Birsen , Emir Gönül , Ersoy Alpaslan 
Published: July 2012

summaryCrush syndrome or traumatic rhabdomyolysis is a serious and epidemic clinical case that develops among casualties of earthquakes or other catastrophic events. Hypocalcaemia is one of the main symptoms that accompanies crush syndrome. It is essential that immediate IV volume replacement treatment be initiated for such patients, which is known to positively affect prognosis and help prevent the development of acute renal failure.Following the earthquake of 17th August 1999 in the north‐west of Turkey, 333 casualties were hospitalised in the Medical Faculty of Uludag University. 60 (18%) of these patients [34 males (56.6%) and 26 females (43.4%)] received haemodialysis treatment. The average number of HD sessions received by the patients was 48. Intermittent HD applied to 44 patients (73.3%) was the preferred method of treatment. Fluid overload and azotemia were the leading indications (76.6%) for dialysis. The lower extremities were mainly injured in these patients [33 (55%)]. Therefore, subclavian catheterisation was preferred in those patients with trauma at this site. 594 (67.1%) HD sessions were applied with limited heparin due to the risk of bleeding.Hypotension in 94 patients (61%) and thrombosis in 60 (45.7%) were the main complications. Of the complications not due to HD, infection in 23 patients (38.3%) was the most significant. 21 patients (35%) were lost during the treatment.It was thanks to the sacrifices and co‐operation among national and international medical teams that the mortality rate was low.
Nutritional screening tools for CAPD patients: Are computers the way forward?
Authors: Gower T. 
Published: July 2012

SummaryThe aim of this study was to develop a computer programme (CP) to identify CAPD patients at risk of malnutrition as well as screen monthly biochemical results of transplant (tx), haemodialysis (HD), CAPD and nephrology (Ne) patients for abnormal levels such as hyperkalaemia.Methods: The CP was designed using the programme Proton. Proton can automatically download biochemical results from pathology making it possible to generate a list of patients with results outside a desired biochemical range in accordance with national renal standards for adult patients. Biochemical measures of nutritional status were used to define malnutrition as 2 or more results outside of these parameters (see Table 1): 10% weight loss, Kt/V < 1.9, normalised protein catabolic rate (nPCR) < 1.2: predialysis urea < 15 mmol/L, phosphate (PO4) < 0.75 mmol/L, potassium (K), < 3.3 mmol/L. The CP was compared with standardised dietetic assessments (SDA) for validity. An SDA includes a review of medical, social history, biochemistry (blood and urine), dialysis prescriptions, treatment plans, medications, weight changes, BMI, dietary intake compared to therapeutic guidelines with documented aims. The therapeutic guidelines used to complete dietary assessment include: protein 1.2‐1.5 g/kg Ideal Body Weight (IBW), energy: aim for BMI of 20–25 kg/m2, sodium: 100–120 mmol/L, K: 1 mmol/kg IBW, fluid: urine output + medical advice, PO4: 175–200 mg of PO4/10 g of protein.3005 patients from Richard Bright Renal Unit in Bristol, England, including 4 Satellite HD units, had blood results screened for abnormal levels using CP (see Table 1). In the clinic setting, the length of time taken to review biochemical results was measured before and after implementation.Results: The CP identified 88% of CAPD patients at risk of malnutrition compared with 67% by SDA. The time taken to look up biochemical results of patients attending the outpatient clinics was reduced by approximately 30 minutes leaving only the diet history computer screen to review for each patient.Discussion: The CP should be compared with subjective global assessment (SGA) for validity in the identification of malnutrition. Serum cholesterol, prealbumin, protein equivalent of total nitrogen appearance (nPNA), C reactive protein (CRP) and bicarbonate should be incorporated into the CP in order to improve its specificity.Conclusion: Using the present parameters, the CP over diagnosed the number of CAPD patients at risk of malnutrition. However, the CP improves time management and rationalisation of dietetic activity by screening abnormal biochemistry.
Enhancing patency, safety and cost effectiveness of catheters
Authors: Polaschegg HD. , Sodemann K. , Feldmer B. 
Published: July 2012

SummaryCatheters are generally known to be the last resort for blood access in dialysis. Because of the many problems related to catheter use, catheters are banned from vascular access courses organized by professional societies and the development of catheters and catheter related equipment relies on a few interested medical doctors with limited knowledge of hydraulics and material science. Rather than accepting the need for catheters and the need for improving catheters and catheter related procedures, vascular access meetings typically begin and end with statements saying that the use of fistulas must be increased and catheters must be banned. Several small companies have developed new catheters and catheter related equipment, which potentially overcome many of the problems related to the use of catheters. The authors had the privilege of participating in one of these developments and report about basic features and clinical experience of the DIALOCK® blood access port and an antimicrobial catheter locking solution (CLS) which is used with conventional catheters as well as with the DIALOCK®.
Improving the nurse‐patient relationship: a multi‐faceted approach
Authors: Jenkins Karen , Bennett Lesley , O'Donoghue Donal , Lancaster Larry , Carillo Frank 
Published: July 2012

SummaryAim: The aim of the symposium was to provide strategies to help overcome different types of nurse—patient communication problems, with particular reference to the renal disease setting. In this context, the importance of effective patient education to increase patient compliance played a vital role. The case studies presented and the subsequent discussions helped increase the awareness of important medical aspects, such as the increased risk of anaemia‐related complications in diabetic patients and the importance of early referral and anaemia treatment in patients with renal disease. Strategies proposed were supported by best practice guidelines and the latest scientific data.Methodology: A moderator led an interactive session that included two video case studies, scientific presentations and panel discussions. The audience played an active role by expressing their opinions via keypads. The case studies and the views of the audience were discussed by a panel of experts, who related their experiences and advice.Conclusions: A good nurse‐patient relationship is essential to meet the clinical, psychological and social needs of the patient in order to optimise treatment. Effective patient education is an important tool to meet patient's needs and increase treatment compliance. Moreover, optimal treatment of patients requires a multidisciplinary approach to allow early identification and treatment of associated co‐morbidities. Anaemia‐related co‐morbidities are particularly important in diabetic patients with renal disease, since this patient group develops anaemia at an early stage and has a significantly increased risk of cardiovascular complications. In renal disease, there are well‐defined guidelines and treatment options for anaemia‐related co‐morbidities, which can easily be adapted to a patient's needs in order to offer flexible, individualised treatment with the aim of improving treatment outcomes.
Patient education in renal transplantation
Authors: Akyolcu N. 
Published: July 2012

SummaryRenal transplantation is the surgical implantation of a human kidney from a compatible donor into a recipient. Renal transplantation is a means of restoring renal function to normal in most patients, thus allowing a return to a healthy lifestyle. Patients and their families often ask nurses for health information. Professional nurses must ensure that patients and families understand the transplantation and therapeutic regimen and provide health education. It should be remembered that certain physiological, psychosocial and pathological conditions might inhibit the education process. Before renal transplantation the patient's understanding of the procedure and follow‐ up regimen and also the patient's ability to cope with a complex medication regimen are assessed. The nurse and the patient and family should work together to set realistic, achievable goals, the aims of which are mutually agreed. The agreed goals of health education should be documented in a care plan, which will also provide reinforcement for both the nurse and patient.
Iron management in renal failure patients — How do we achieve the best results?
Authors: Kosch M. , Schaefer RM. 
Published: July 2012

SummaryThe majority of patients with renal insufficiency suffer from a normochromic, normocytic anaemia (1). This renal anaemia affects the quality of life of these patients and reduces their chance of survival (2). Despite the availability of recombinant human erythropoetin for the treatment of renal anaemia, many patients do not achieve the target haemoglobin concentration of more than 11 g/dl. A major factor contributing to suboptimal correction of renal anaemia and reduced responsiveness to epoetin is a lack of iron availability to the stimulated erythropoesis. Thus, for the majority of patients with renal insufficiency intravenous iron therapy will be the treatment of choice to replete and maintain adequate iron stores (3).
Acute Renal Failure in childhood
Authors: Proesmans Willem 
Published: July 2012

SummaryThe definition of acute renal failure is a sudden reduction in renal function of at least 50 percent and is characterised by rising serum levels of waste products such as urea and creatinine, by disturbed water and electrolyte metabolism and changes in the amount or composition of the urine. The clinical manifestations are extremely variable, there are very many causes and the outcome depends mainly on the underlying condition, which is either in the kidneys or in the body as a whole. This paper will discuss the pathophysiology of acute renal failure and the aetiology including prerenal, renal and postrenal causes. Clinical findings, diagnosis and treatment will be discussed and complications of this life‐threatening condition highlighted. The final part of the paper deals with the prognosis of acute renal failure.
PALLIATIVE CARE PROVISION IN END‐STAGE RENAL FAILURE
Authors: Casey J. , Hodson S. 
Published: July 2012

SUMMARYThe increasingly aging dialysis population, recent advances in renal medicine and changes in family structure all contribute to a greater demand for palliative care. Renal nursing leadership is paramount to ensure the needs of the dying renal patient are met, within the limited resources available. At the heart of these competing needs lies the concept of a good death with renal nurses having a vital role to play in shaping the delivery of care both locally and nationally.As a chronic disease with no cure other than organ transplantation, dialysis becomes the maintenance of life and is described as a ‘complex therapeutic procedure used to correct a life‐threatening body dysfunction’ (1). The lack of curative ability can induce the description of ESRF as a terminal illness. The role of palliative care in ESRF patients should encompass physical, spiritual and psychological needs and should include a ‘holistic approach to the care of patients whose disease is incurable’ (2). Recommendations made by the Council of Europe have urged governments and the medical professions to give a higher priority to the provision of appropriate palliative care (3).
MANAGEMENT OF VASCULAR ACCESS IN EUROPE: PART 2 ‐ A MULTI CENTRE STUDY OF RELATED COMPLICATIONS
Authors: Elseviers Monique M. , Van Waeleghem Jean‐Pierre , Lindley Elizabeth 
Published: July 2012

SUMMARYIntroduction | The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. This paper reports on the second part of the project, investigating VA related complications reported during an observational prospective study.Methods | A cohort of 1380 adult patients, randomly selected in 47 centres out of 16 European countries were followed during one year using a computerised data collection system. Data were collected at baseline, after six and 12 months and each time a VA complication occurred.Results | At the start of the observation period, 77% had a native AV fistula, 10% had an AV graft and 13% a catheter. A total of 489 complications were noted. Most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Hospitalisation (mean duration=6.2 days) was required in 39% of complications and 29% of complications resulted in a definitive loss of VA. Complications were more frequently observed in catheters (27%) and AV grafts (37%) compared to AV fistulae (15%). When compared with AV fistulae, the risk for thrombosis was more than four times higher and for bleeding more than six times higher if an AV graft was used. Catheters showed an eightfold increased risk to develop infections and flow problems.Conclusion | This study revealed the high complication rate in VA and strengthened the actions to promote AV fistulae as first choice VA.
ENCOURAGING SELF‐ADMINISTRATION OF ERYTHROPOIETIN
Authors: Balshaw‐Greer A. , Casey J. 
Published: July 2012

SUMMARYEuropean Best Practice Guidelines of 1999 for managing anaemia in patients with kidney failure state that patients using the subcutaneous route should be encouraged to self‐administer epoetin whenever possible. This article argues for and substantiates the need to develop an education programme, which should consist of group and one‐to‐one teaching sessions with discussion, role‐play, visual aids and demonstration. Information booklets will be provided covering blood pressure monitoring, ordering and storage of medication and safe disposal of syringes. Methods to evaluate the education programme include direct observation, laboratory reports, patient care plans and feedback. The theoretical benefits of such a programme should include; improved cardiovascular function with a more compliant patient enjoying an improved quality of life. The organisation should benefit through lower costs and a structured method of audit.
AWARENESS OF ANAEMIA IN DIABETES PATIENTS
Authors: Jenkins K. , Van Waeleghem J‐P 
Published: July 2012

SUMMARYAlthough the link between diabetes and anaemia has been firmly established in the renal world, patients with diabetes and healthcare workers in this field are clearly failing to recognise many of the common symptoms of anaemia, a key indicator for renal disease. By forging links and instigating an exchange of information, renal health care workers can work with their colleagues in diabetes to raise awareness of the important benefits arising from the early diagnosis and treatment of the anaemia related to kidney disease.