Supervivencia a largo plazo en pacientes con enfermedad renal crónica estadio 5 tratada por hemodiálisis en Lima, Perú / Long-term survival in patients with stage 5 chronic kidney disease undergoing hemodialysis in Lima, Peru

Objetivo: Evaluar la supervivencia a largo plazo de pacientes con enfermedad renal crónica estadio 5 (ERC-5) que ingresaron a un programa de hemodiálisis en Lima, Perú y se determinó las variables de pronóstico que afectaron la supervivencia. Materiales y métodos: Se evaluó una cohorte prospectiva de 604 pacientes que ingresaron a un programa de hemodiálisis (1982-2009) y fueron seguidos hasta diciembre del 2015. La supervivencia fue estudiada mediante las curvas de Kaplan Meier; se estableció comparaciones, utilizando la prueba Log-rank según: edad, etiología, trasplante renal y período de ingreso a hemodiálisis. Mediante el análisis de regresión de Cox, se determinó variables pronósticas de supervivencia. Resultados: La edad promedio fue de 51,95 ± 16,17 años. El 43,1% era = 60 años; el 43,4% fueron mujeres. Las etiologías más frecuentes fueron las glomerulopatías primarias (21%), diabetes mellitus (20%), hipertensión arterial (12%) y las nefropatías intersticiales y/o uropatías obstructivas (11%). El porcentaje de supervivencia (IC95%) en los años 1, 5, 10, 15 y 20 fue 80% (intervalo de confianza al 95% (IC 95%): 77% - 83%), 47% (IC 95%: 43% - 51%), 25% (IC 95%: 21% a 29%); 17% (IC 95%: 13% - 21%) y 11% (IC 955: 8% - 14%), respectivamente. La regresión de Cox identificó al adulto mayor y al diabético como variables desfavorables en la supervivencia y al trasplantado renal como variable favorable. Conclusión: La supervivencia a largo plazo es comparable a otros estudios internacionales. La menor supervivencia de nuestros pacientes se relacionó con la condición de ser adulto mayor, diabético y no tener posibilidad de trasplante renal. Los cambios tecnológicos durante el período de seguimiento no modificaron significativamente las curvas de supervivencia

Objective: To assess the long-term survival of patients with stage V chronic kidney disease that entered a hemodialysis program in Lima, Peru and prognostic variables that affected survival were determined. Materials and methods: We assessed a prospective cohort of 604 patients enrolled in a hemodialysis program (1982-2009) and who were followed-up until December 2015. Survival was studied using the Kaplan Meier curves and comparisons were established using the Log-rank test; according to age, etiology, renal transplantation and period of admission to hemodialysis. Through the Cox regression analysis, prognostic variables of survival were delimited. Results: The mean age ± SD age of the population was 51.95 ± 16.17 years; 43.1% were > 60 years old, and 43.4% were women. The most frequent etiologies were primary glomerulopathy (21%), diabetes mellitus (20%), high blood pressure (12%), and interstitial nephropathy and/or urinary tract obstruction (11%). Survival percentages (95% confidence interval) in years 1, 5, 10, 15, and 20 were 80% (77%-83%); 47% (43%-51%); 25% (21%-29%); 17% (13%-21%), and 11% (8%-14%), respectively. Cox regression analysis identified being elderly and diabetic as unfavorable variables for survival, and having undergone renal transplantation as a favorable variable. Conclusions: Long-term survival is comparable to that found in other studies performed abroad. The lower survival of our patients is related to the following conditions: advanced age, diabetes, and not having the possibility of undergoing renal transplantation. Technological changes during the follow-up period did not significantly modify the survival curves

Analysis of related risk factors for retinal artery occlusion / 眼科新进展

Retinal artery occlusion (RAO) is one of ophthalmic emergencies,often resulting in painless vision decline and different levels of visual impairment,thereby leading to poor prognosis.It influences the life quality of patients.It has complicated pathogenesis and many clinical risk factors,such as cardiovascular diseases,cerebrovascular diseases,end-stage renal disease,periocular injections.This paper will summarize the related risk factors for this disease.

Phenomenology on the Hemodialysis Experience of Patients with End-Stage Renal Disease / 재활간호학회지

PURPOSE: This study aimed to explain what are the experiences of patients with renal disease who are just begun hemodialysis in the end-stage. METHODS: The data were collected from February to December in 2017 through individual in-depth interviews using open-ended questions. For data analysis, a phenomenological method suggested by Colaizzi was applied. A total of 8 hemodialysis patients with end-stage renal disease (ESRD) participated in this study. RESULTS: According to the analysis, five theme clusters emerged: ‘I go into darkness’, ‘Being disappearing from others’, ‘Baby bird living with love’, ‘Dawn in darkness’ and ‘A life longing for the absolute’. CONCLUSION: Patients undergoing hemodialysis experienced fear and anxiety at the beginning of hemodialysis. Therefore, counseling and social supports were needed for patients with ESRD in their early stage of hemodialysis. In addition, a multidisciplinary education program should be implemented in the future research. It may help to overcome for the patients who are experiencing complicated health problems in their early stage of hemodialysis treatment.

Analysis on the medical expenditure and influencing factors of the tumor and end-stage renal diseases of the poor patients in Hubei province / 中华医院管理杂志

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.