bluuebunny/crossref_metadata_2025_split huggingface dataset:
LATE SOMATIC AND PSYCHO‐SOCIAL CONSEQUENCES OF RENAL INSUFFICIENCY IN CHILDREN
Authors: Groothoff J.W. 
Published: July 2012

ABSTRACTThe aim of the project was to establish the somatic and psycho‐social consequences in adulthood of paediatric end‐stage renal disease (ESRD). A long term follow up study of all Dutch patients who started renal replacement therapy at age 0–15 years between 1972 and 1992 and who were born before 1979 was undertaken. The study was performed between 1998 and 2000. About 25% of patients had died at time of investigation. Cardiovascular abnormalities were prominent in both transplanted and dialysis patients and cardiovascular disease was also found to be the most prominent cause of death. Skeletal disorders as a result of metabolic bone disease accounted for most frequent occurring disabilities. The risk for malignancies was 10‐fold that of the normal population. Mean IQ and educational attainment were low as compared to the normal population. The overall quality of life was good, despite the co‐morbidity and disabilities. Adverse outcomes were in nearly all cases related to a prolonged period of dialysis in the past and to (current) hypertension, not to the state of dialysis at time of investigation.
IMPLEMENTING NURSE PRESCRIBING WITHIN THE HAEMODIALYSIS UNIT
Authors: Gerrish M. 
Published: July 2012

SUMMARYPatients within satellite haemodialysis units do not always have access to a medical practitioner. This may cause problems when prescriptions are required. Amendments to UK law to allow the introduction of supplementary prescribing came into force in 2003 allowing nurses with the appropriate experience, training and qualification to prescribe for their patients.Within a 14‐station satellite unit a prescribing partnership has been successfully established. Clinical Management Plans have been implemented for haemodialysis patients. These include areas such as dialysis adequacy, access management, anti‐coagulation, anaemia management, MRSA treatment and prophylaxis, antihypertensive therapy, calcium and phosphate control and exit site or line infection.100% of patients within the unit have consented to the nurse prescribing for them under the Clinical Management Plan.Supplementary prescribing enhances nursing practice by empowering those who are best placed to make decisions regarding care and treatment for their patients. Patients appear confident in the ability of the nurse within the haemodialysis unit to prescribe competently.Nurse prescribing is of benefit to patient care, meeting the demands of an expanding patient population. It is recognition of the skill and experience required of haemodialysis nurses.
COMPLIANCE IN HYPERTENSION
Authors: Burnier M. 
Published: July 2012

SUMMARYDespite improvements in the management of hypertension in the past several years, nearly 70% of patients with hypertension are not adequately controlled. Today's physician treating hypertension is armed with numerous efficacious antihypertensive agents. Thus, one of the major contributors to the large number of uncontrolled hypertensive patients appears to be non‐compliance with prescribed regimens. Non‐compliance is a universal characteristic and can affect all patients. However, the major problem of non‐compliance is that it remains largely unrecognised in clinical practice. Several types of non‐compliance exist with the ‘drug holiday’ being the most common. Good communication with the patient and the entire health care team is critical in increasing patient compliance. Long‐acting medications that provide good blood pressure control beyond the 24‐hour dosing period should be considered drugs of choice in non‐compliant hypertensive patients. This article will discuss different types of compliance, methods to measure compliance, and clinical consequences of non‐compliance in hypertension.
MANAGEMENT OF VASCULAR ACCESS: MONITORING AND SURVEILLANCE
Authors: Lopot F. , Švára F. , Polakovic V. 
Published: July 2012

AbstractThis article reviews vascular access (VA) assessment methods and procedures. It gives an overview of the existing methods for bed‐side VA assessment by means of pressures, recirculation and access flow measurement. Pros and cons of the methods are discussed and additional benefits of a combined recirculation and access flow measurement are explained. Present vascular access care guidelines are discussed, namely the K/DOQI and EVAS documents. Practical setup of a vascular access monitoring and surveillance system is illustrated with data from the authors' own unit where such a system has been in use since 1999. The issue of adequate target setting is analysed in view of published works on clinical impact of access surveillance system introduction (timely detection of access stenosis and access patency). Critical re‐evaluation is needed especially in current QVA threshold and intervention timing.
IS POTENTIAL EQUALISATION IN HD TREATMENTS NECESSARY?
Authors: Wictor P.‐O. , Svensson R. 
Published: July 2012

AbstractIn some cases in haemodialysis blood access is established with a special type of central venous catheter (CVC), sometimes called a central dialysis catheter (CDC), instead of an AV fistula or graft. This central venous catheter tip is placed very close to the heart, increasing the probability of a leakage of electrical current passing through the heart. This may cause arrhythmia or ventricular fibrillation. This current is generally referred to as patient leakage current and has to be kept very low for patient safety. All staff involved in CVC treatments, nursing staff as well as technicians, should be aware of this particular risk to the patient.The purpose of this article is to discuss the background of the above‐mentioned safety issue and suggest precautionary measures for minimising this risk. Precautions discussed include potential equalisation, use of separating transformers, periodic maintenance (normally performed by a service technician) and physical placement of the equipment used in the vicinity of the patient (normally the responsibility of the nursing staff).
QUALITY OF LIFE IN CHRONIC KIDNEY DISEASE
Authors: Pugh‐Clarke K. , Naish P.F. , Mercer T.M. 
Published: July 2012

AbstractBackground — Quality of life (QOL) is suboptimal in end‐stage renal disease. However, studies indicate that QOL is already impaired prior to the initiation of renal replacement therapy, implying that the initial decline originates in the chronic kidney disease (CKD) phase of the renal disease trajectory. Given the significance of QOL as a clinical outcome, there is a paucity of QOL research in CKD.Aims — To measure QOL at three distinct phases (based on creatinine clearance — Ccr) of the disease trajectory in CKD: normal renal function (NRF) with underlying renal disease, moderate CKD, and advanced CKD (Ccr ≥75, 40–60, and ≤30 ml/minute, respectively), and to establish if QOL is different between these groups.Methods — Data was collected from 25 patients from each of the Ccr bands (N=75). We measured self‐reported QOL (Schedule for the Evaluation of Individual Quality of Life — SEIQOL), uraemic symptoms (Leicester Uraemic Symptom Scale — LUSS), and laboratory variables.Results — SEIQOL was significantly lower (p<0.001), and symptom number, frequency, and intrusiveness significantly higher (all p<0.001) in the advanced CKD group when compared to the NRF group. Although SEIQOL and symptom intrusiveness did not differ between the advanced and moderate CKD groups, SEIQOL was significantly lower (p<0.05) and symptom intrusiveness significantly higher (p<0.05) in the moderate CKD group when compared to the NRF group.Conclusion — QOL is already impaired in moderate CKD. The significant difference in QOL and symptom intrusiveness between the moderate CKD and NRF groups may denote a causal relationship between symptom intrusiveness and QOL early in CKD.
ENHANCING LIFESTYLE THROUGH HOME HAEMODIALYSIS
Authors: Blogg A. , Hyde C. 
Published: July 2012

SUMMARYThe Sydney Dialysis Centre (SDC) supports 150 patients who dialyze in the home environment. Since its inception SDC has been assisting patients to modify their dialysis regime according to individual needs. In 2003–2004 a postal survey was sent to SDC patients who had changed their dialysis regime to ascertain the effect of this change on lifestyle. This article will present the results of the survey with regard to patients who dialyze nocturnally (LND) and for longer hours (LH). The patients experience will be presented in relation to their reason for modifying treatment, resultant changes in diet and medication prescription and their subjective experience of wellbeing. Findings indicate that patients who dialyse nocturnally and for longer hours experience improved sense of wellbeing, diet control and increased energy levels. While nocturnal dialysis does not suit all patients, the respondents in this survey reported benefits such as: increased opportunity for employment; less restrictions on free time; improved blood results and better lifestyle.
CARING FOR PEOPLE WHO ARE DYING ON RENAL WARDS: A RETROSPECTIVE STUDY
Authors: Noble H. , Rees K. 
Published: July 2012

SUMMARYUnfortunately, there is still a high mortality rate among patients with end‐stage renal disease (ESRD). If the decision is made to activate non‐dialytic management of the patient with ESRD, it should be made jointly by the patient and responsible consultant nephrologist after consultation with relatives, the family doctor and other relevant members of the caring team. This paper discusses the establishment of a new renal supportive care service for patients opting not to have dialysis and focuses on the results of a ‘death audit’ carried out on this patient population. Recommendations for practice resulting from analysis of the audit results include, the use of advance directives, identification and prompt treatment of symptoms, increased staff education, timely referral to the palliative care team and expansion and further integration of the renal supportive care team.
EARTHQUAKE IN PAKISTAN — THE RENAL DISASTER RELIEF TASK FORCE IN ACTION
Authors: Van Dam R. 
Published: July 2012

SUMMARYFollowing an earthquake, an International stream of help is launched. Teams of nephrologists, renal nurses and technicians from many European countries are ready as volunteers to come into action when needed. Basic help is necessary but what is the benefit of nephrologists and renal nurses, as the Renal Disaster Relief Task Force comes into action? The scouting team assesses the situation in the disaster area. Treatment of acute renal failure, hyperkalemia and Crush Syndrome can be life saving. The ability to accommodate dialysis treatment is investigated, in collaboration with local nephrologists.Belgian, French, Irish and Turkish colleagues who made up two teams, with Médecins sans Frontières (MsF) left for Pakistan following the devastating earthquake in October 2005. This is a report from one of the volunteers from the first team explaining the individual contribution that his mission made to the disaster.
Merits and limitations of continuous blood volume monitoring during haemodialysis: Summary of the EDTNA|ERCA Journal Club discussion: winter 2005
Authors: Lindley Elizabeth J , Ward Richard , Pearson Chris , Harrington Maurice , O'Kane Frankie , Belot Bertrand , Shaldon Stanley , De Vos Jean‐Yves , Lopot Franta , Nikman Anahita , Curtis Jim , Schneditz Danny , Gerrish Martin , Roy Thomas , Tattersall James , Dasselaar Judith 
Published: July 2012

SUMMARYThe discussion explored and expanded on the issues raised by Dasselaar et al in their review of the measurement of relative blood volume (RBV) changes during dialysis (NDT 2005). Dialysis machines incorporating blood volume monitoring and control are widely available in Europe. The use of continuous blood volume monitoring (CBVM) to help establish dry weight; problems with CBVM due to connection and use of single needle dialysis; the physiological processes that cause RBV changes during eating, exercise and posture changes; and the application of blood volume based biofeedback control were discussed by participants from ten countries. The ‘take‐home’ messages from the discussion were that CBVM can assist in setting target weight, but must be used together with traditional measures and experience. Biofeedback control may help to achieve symptom‐free dialysis, but staff should be prepared to monitor patients systematically for several weeks to obtain individualised settings. Users of CBVM should be aware of factors that can alter the central haematocrit leading to apparent changes in RBV. Practical guidelines should be developed to help staff interpret CBVM data effectively.
AN EXPLORATORY STUDY OF PATIENT'S FEELINGS ABOUT ASKING HEALTHCARE PROFESSIONALS TO WASH THEIR HANDS
Authors: Duncan C. 
Published: July 2012

ABSTRACTThe purpose of this study was to explore patient opinion about asking healthcare professionals to wash their hands prior to a clinical procedure and to explore if MRSA status and access to patient information about infection control would influence anxiety about asking.A descriptive survey was undertaken using a semi‐structured questionnaire. The questionnaire was distributed to a randomised convenience sample of 185 in‐patients across all departments of an acute NHS Trust hospital (response rate 59.4%).Spearman's rank order and Kendall Tau‐b tests were used to analyse specific correlations.Respondents were more confident than anxious to be involved in a campaign that asked patients to ask staff to wash their hands. Patients were more anxious to ask if previous admission episodes were fewer, if their knowledge of MRSA was high and if there was less information about infection control available. Less anxiety was associated with patients who had MRSA in the past and the suggestion that staff wore badges saying ‘It's OK to ask’.
RELATIVE BLOOD VOLUME BASED BIOFEEDBACK DURING HAEMODIALYSIS
Authors: Dasselaar J.J. 
Published: July 2012

ABSTRACTIntra‐dialytic hypotension is the most frequently occurring complication during haemodialysis and can lead to serious complications. Devices that continuously and non‐invasively monitor relative blood volume (RBV) changes during HD are being advocated as a tool to maintain an adequate volume of the intravascular compartment in order to avoid dialysis hypotension. Nowadays, most manufacturers have incorporated a RBV monitor in their dialysis apparatus and two manufacturers have designed biofeedback devices that control intra‐dialytic RBV changes. The goal of RBV based biofeedback systems is to prevent a severe or abrupt decrease in blood volume in order to prevent the development of dialysis hypotension. Biofeedback technologies can diminish the severity and/or frequency of dialysis hypotension. At present, however, a completely symptom‐free HD is not a reality. The major reasons for this are patient characteristics such as cardiovascular co‐morbidity and high UF rates and a lack of understanding of the relation between RBV changes and blood pressure/ cardiovascular stability.
SELECTION OF DONOR AND ORGAN VIABILITY CRITERIA: EXPANDING DONATION CRITERIA
Authors: Gutiérrez E. , Andrés A. 
Published: July 2012

SUMMARYDonation criteria have been becoming more flexible over the years. Currently, the only absolute exclusion criteria are human immunodeficiency virus infection (HIV), uncontrolled tumor disease and bacterial or viral infections. Clinical conditions dictate organ viability criteria: biochemical, morphological and functional, that must be fulfilled by the donors and their organs in order to focus the decision on which donor organs can be used. These criteria attempt to assure that the transplanted organs function after the extraction, transformation, implantation and reperfusion process without transmitting any infectious or tumour disease. In recent years, the gross and microscopic appearance has become one of the fundamental criteria for selection of potentially viable organs. At present, there is no age limit for hepatic and renal donation; the principal contra‐indication is chronic organ damage. The use of each organ must be decided individually after a profound analysis of all the viability criteria, weighing the advantages and disadvantages of the implant of a certain organ for the recipient.
SHOULD WE PROVIDE ULTRAPURE DIALYSIS FLUID? Summary of the EDTNA|ERCA Journal Club discussion Winter 2006
Authors: Murcutt Gareth , Shaldon Stanley , De Vos Jean‐Yves , Lindley Elizabeth , Greening Robert , Hansen Susan K , Stragier André , James Ray , Hoenich Nic , Brooke Simon , Mahalko John , Ledebo Ingrid ,   An EDTNA/ERCA Journal Club (Winter 2006) discussion based on “Ultrapure dialysis fluid — how pure is it and do we need it” by Dr Ingrid Ledebo PhD of Gambro Corporate Research, Sweden.
Published: July 2012

ABSTRACTThe paper discussed during winter 2006 was an editorial in Nephrology, Dialysis and Transplantation (NDT) entitled “Ultrapure dialysis fluid — how pure is it and do we need it” by Dr Ingrid Ledebo PhD of Gambro Corporate Research, Sweden. Thirteen people from seven different countries contributed to the wide‐ranging discussion whose topics ranged from the most cost effective way of producing ultrapure dialysis fluid (UPDF) to the environmental impact of heat sanitisation and the industrial‐scale bleeding of the Limulus horseshoe crab. Different methods of disinfection such as heat and UV light were discussed as well as the requirement and funding for microbial detection assays and their various sensitivities.Participants concluded that the available evidence supported the use of UPDF as standard, but identified financial pressures, via differing reimbursement systems, as the main barrier to its universal introduction.
RENAL ANAEMIA: RECENT DEVELOPMENTS AND FUTURE DIRECTIONS FOR IMPROVED MANAGEMENT
Authors: Mahon A. , Bennett L. 
Published: July 2012

SUMMARYThe global burden of chronic kidney disease (CKD) and associated anaemia is substantial. With the increasing numbers of patients that are likely to be affected in the future, approaches are required to improve anaemia management without increasing the workload of renal units. Advocating early treatment may improve patient outcomes and nurses are in an ideal position to identify and manage anaemia at an early stage in patients with CKD. In addition, adopting a multidisciplinary approach, alongside nephrologists, diabetologists, cardiologists, social workers, nutritionists and pharmacists, may allow nurses to detect and treat anaemia earlier in patients with CKD. Maintaining awareness of factors associated with decreased erythropoiesis‐stimulating agents (ESAs) efficacy (e.g. iron deficiency or poor nutritional status) is also important. To reduce the burden on healthcare providers, anaemia management could be simplified by extending the administration interval of ESAs.Recent studies have explored the clinical efficacy of administration of currently available agents at intervals of up to once monthly in highly selected, stable patients. The use of an ESA that can control anaemia while maintaining haemoglobin levels within guideline ranges with extended administration intervals in all patients without the need for additional screening or stepwise dose adjustments with attendant monitoring may help improve patient care while reducing the workload of healthcare providers.
HYPERKALAEMIA AND HAEMODIALYSIS PATIENTS: ELECTROCARDIOGRAPHIC CHANGES
Authors: Sánchez José Luis Cobo , Camarero Ana Rosa Alconero , Pérez María Casaus , Sota Maza Ma Ángeles , Llamazares Camino Villa , Roldán Carmen Higuera , Viadero Raquel Menezo , Nates Rosa Alonso 
Published: July 2012

SUMMARYBackground — Patients with end‐stage renal disease (ESRD) present hydro‐electrolytic alterations due to the lack of adequate regulation of the internal medium. Of these alterations hyperkalaemia is frequent and produce neuromuscular symptoms, electrocardiographic changes and arrhythmias. Literature affirms that patients with ESRD present less prominent hyperkalaemia‐related electrocardiographic changes than those patients with normal renal function.Objectives — To evaluate electrocardiographic alterations related with potassium in our ESRD patients and to compare the obtained results with those previously reported.Methods — Descriptive, cross‐sectional and prospective study in hospital haemodialysis (HD) patients. Pre‐ and post‐HD serum potassium and other electrolyte concentrations were measured, and simultaneous 12‐lead electrocardiogram (ECG) obtained at the first session of the week. An expert evaluated all ECG's.Results − 39 patients were included in the study, 58.9% were women and 41.1% men, with a mean age 67.35 years (24–89). Serum potassium pre‐HD range was 2.8 to 7.4 mEq/l (mean 5.07 mEq/L), 29.4% of the sample presented levels ≥5.5 mEq/l and the most frequent alteration in the ECG was high and peaked T waves in leads V2 to V4. In the hyperkalaemia cases, the mean elevation of T wave was 7mm. In 2 hyperkalaemia patients there was no elevation of T wave: one T wave was negative (K+ = 6 mEq/L) and another one stayed normal (K+ =5.6 mEq/L).Conclusions — The ECG continues to be a good tool of early hyperkalaemia detection, contributing to estimating severity. Patients with ESRD present electrocardiographic alterations similar to the healthy population.
EDUCATIONAL NEEDS FOR BLOOD PRESSURE CONTROL IN CHRONIC KIDNEY DISEASE
Authors: Mason Jo , Stone Margaret , Khunti Kamlesh , Farooqi Azhar , Carr Sue 
Published: July 2012

ABSTRACTStrict blood pressure control reduces the risk of adverse outcomes in chronic kidney disease but is difficult to achieve. To inform the design of an educational intervention for patients with chronic kidney disease and hypertension, we used focus groups to identify key patient issues, from both patient and healthcare professional perspectives. Framework methodology was used to analyse data and patient confusion emerged as the core concept. This was both an effect and, in some cases, a cause of the six key themes identified: lack of basic knowledge; conflicting advice; nature of diagnosis; changes in evidence‐based practice; views on patient empowerment and views on the patient‐health professional relationship. Educational needs identified involved addressing confusion by increasing both knowledge and motivation. In people with chronic kidney disease, confusion can lead to a lack of motivation and negative views that need to be addressed through appropriate education and support.
CAN INCREASED DIETARY FIBRE REDUCE LAXATIVE REQUIREMENT IN PERITONEAL DIALYSIS PATIENTS?
Authors: Sutton Debbie , Dumbleton Susan , Allaway Claire 
Published: July 2012

SUMMARYConstipation is an important cause of technique failure and poor dialysis efficiency in Peritoneal Dialysis (PD) patients. A review of patient notes on our unit revealed 43% reported difficulties associated with constipation. A stool and laxative recording diary was sent to 126 PD patients. 46 patients reported using laxatives. All respondents using laxatives were invited to use a soluble dietary fibre supplement for 4 weeks, followed by dietary advice to see if they could achieve the same effect using high fibre foods.23 patients entered the intervention stage of the study. 17 succeeded in replacing prescribed laxatives with the fibre supplement. 16 tried to increase their intake of high fibre foods, with 8 of these succeeding in improving their dietary intake of fibre; however only 2 were able to reduce their intake of fibre supplement. The results of the study suggest that a fibre supplement can be as effective as current laxative treatment in preventing constipation, as well as being the preferred choice of patients as many felt it improved bowel habits while not having the side effects of stimulant laxatives.