ABSTRACT
BACKGROUND: In chronic renal failure (CRF) patients, iron deficiency is a common problem and a primary cause of resistance to recombinant human erythropoietin (rHuEPO) therapy. Serum ferritin and transferrin saturation (TS) are most commonly used parameters of iron status in CRF patients but may be influenced by the presence of inflammation and malnutrition. Recently soluble transfer-rin receptor (sTfR) has been advocated as a useful parameter of iron deficiency. We evaluated sTfR as an iron deficient marker in CRF patients. METHODS: Included in this study were 73 CRF patients, 30 uncomplicated iron deficiency anemia (IDA) patients, and 55 normal control. Serum sTfR, serum ferritin, TS, and complete blood count were measured. The CRF patients were classified as absolute iron deficient, functional iron deficient, non-iron deficient, and iron overload groups according to National Kidney Foundation Kidney Disease and Dialysis Outcome Quality Initiative (NKF-K/DOQI) guideline. RESULTS: The sTfR concentrations were significantly higher in uncomplicated IDA patients (3.9 +/-1.5 mg/L) and significantly lower in CRF patients (1.1 +/-0.4 mg/L) than in normal controls (1.4 +/-0.4mg/L). In uncomplicated IDA patients, sTfR was inversely correlated with MCV, MCH, and MCHC. In CRF patients, sTfR had a weak inverse correlation with TS and MCHC, but not significantly different between the four groups. The sTfR was not significantly different between the CRF patients with the normal CRP and those with an increased CRP. CONCLUSIONS: The sTfR is useful for diagnosis of uncomplicated IDA, but not for the detection of iron deficiency in CRF patients. Further studies are needed for the evaluation of sTfR as an erythro-poietic marker with rHuEPO therapy.
Subject(s)
Humans , Anemia, Iron-Deficiency , Blood Cell Count , Diagnosis , Dialysis , Erythropoietin , Ferritins , Inflammation , Iron , Iron Overload , Kidney , Kidney Diseases , Kidney Failure, Chronic , Malnutrition , Receptors, Transferrin , TransferrinABSTRACT
PURPOSE: The purpose of study was to identify the relationship between body image and self-esteem in patients with chronic renal failure. METHOD: The subjects of study were 97 patients with chronic renal failure who were outpatients at K medical center, B hospital, H hospital in Busan. Data were collected from Nov. 15th to Dec. 17th, 1999. The instruments used for study were the Body Cathexis Scale and Rogenberg's Self-esteem Scale. Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, and Pearson's correlation coefficients. RESULT: 1. The mean score for body image was 137.46+/-22.21, the mean mark 2.92+/-0.47, and the mean score of self-esteem was 30.80+/-0.76, the mean mark 3.08+/-0.87. 2. There was a significant difference in the score for body image according to educational level (F=5.189, P=0.002) and type of residence (F=6.095, P=0.001). 3. There was a significant difference in the score for self-esteem according to age (F=3.615, P=0.009), educational level (F=4.772, P=0.004), marital status (F=3.498, P=0.019), and presence of children (F=2.511, P=0.014). 4. Body image in patients with chronic renal failure patients showed significant correlation with self-esteem (r=0.519, P=0.000). CONCLUSION: From this study, a relationship between body image and self-esteem in patients with chronic renal failure was identified. Therefore, nursing interventions are needed to promote body image and self esteem in patients with chronic renal patients.
Subject(s)
Child , Humans , Body Image , Cathexis , Kidney Failure, Chronic , Marital Status , Nursing , Outpatients , Self ConceptABSTRACT
The elimination of most anticholinesterases depends on the kidney, even if the main organ for their metabolism is the liver. Renal excretion of pyridostigmine, edrophonium and neostigmine accounts for 15%, 70% and 50%, respectively. In the absence of renal function, the serum half-life of neostigmine is prolonged, its plasma clearance is decreased However, the pharmacodynamics of neostigmine have not been determined in renal failure. This study was designed to compare the neostigmine dynamics in 18 patients with normal renal function to that in 18 patients with renal failure(Group I & II, respectively). Using the flexor carpi ulnaris EMG via ulnar nerve stimulation with Train-Of-Four(TOF) under the constant infusion of vecuronium to produce about 85%-twitch depression, the responses of neostigmine with three different doses were obtained. The results are follows; 1) The constant infusion rates of vecuronium to maintain sbout 15&-twitch height prior to the administration of neostigmine showed no significant difference between two groups. 2) Immediately prior to each dose of neostigmine, the mean values of twitch heights were 11.7 to 13.7%. 3) There was no significant difference in the onset time, maximum twitch responses and antagonism effects between two groups in respect to each same dose of nesotigmine. 4) The duration of neostigmine with the half of ED only in Group II was significantly longer than that in Group I, even if the durations with the other doses in Group II were not significantly longer than those in Group L These results suggest that the reversal effect of neostigmine to vecuronium-induced block- ade may be outlasted in patients with renal failure and the prolongation of neostigmine effeet may render some benefits to reverse the relaxants which have the limitation of its elimination in this patients.