Depression and Anxiety among Patients undergoing Dialysis: An Observational Study

Introduction: Depression and anxiety are the most prevalentpsychological disorders among end-stage renal diseasepatients and are associated with various conditions that resultin poorer health outcomes, e.g. reduced quality of life andsurvival. Along with the psychological problems of patientsundergoing hemodialysis, sleep quality also plays a negativerole in patient health status. Frequent reports have documentedthat patients having complicated health and mental status maylead to poor health quality and may lead to mortality. Weaimed to investigate the prevalence of depression and anxietyamong patients undergoing renal dialysis therapy.Material and methods: A total of 95 patient’s data werecollected by using DASS questionnaire. DASS questionnairescores were evaluated, result was tabulated and interpreted.Scoring of questionnaire test is based on the a 0 – 3 scale whichindicates various range of depression, anxiety and stress scale.Results: Our study indicate that among 95 patients, manyof the patient having mild psychological problems includesdepression, anxiety and stress. Maximum range of 13.68%of patients have found out with anxiety and stress and nodepression state. But there were patients with no sign ofanxiety, stress and depression. Previous studies state thatpsychological variables include depression, stress, and,anxiety took part to get more health complications along withsleep disorders. But by providing right time health care andmental support, it is possible to get back patient health tonormal state. Our result concluded that none of the patient hasfound with complicated mental and health issues.Conclusion: Current study contributed that, among 95patient’s data analysis we have found out few number ofpatient with mild psychological abnormalities. But theseproblems did not reach to highly complicated state. So ourresearch study aimed to suggest nephrologists to aware ofthe quality of life in their patients and should consider thescreening of patients for various symptoms to improve thequality of life.

Quantitative Determination of Cinacalcet in Dialysis Patients' Plasma by a High Performance Liquid Chromatography Mass Spectrometry Method / 中国药学杂志

OBJECTIVE: To establish a high performance liquid chromatography mass spectrometry (HPLC-MS/MS) method to determine the cinacalcet concentration in plasma of dialysis patients. METHODS: Fendiline hydrochloride was selected as the internal standard (IS), in the meantime, plasma samples were extracted through the solid phase extraction (SPE), and the internal standard method was used to determine the concentration of cinacalcet. The analyte was separated by Inertsil SIL-150A (2.1 mm×50 mm, 5 μm) matched with guard column Inertsil SIL-150A (3.0 mm×50 mm,5 μm). The cinacalcet was eluted with acetonitrile, water and formic acid (90:10:1=V:V:V) at a rate of 0.35 mL•min-1. On MS, electrospray ionization (ESI) source with positive ion mode and multiply reaction monitoring (MRM) was used. The MRM transitions of cinacalcet and the IS were 358.1→155.1 and 316.0→212.1, respectively. The concentration in dialysis patients after 25 mg dose (one piece of tablet) within 24 h was determined by using the established HPLC-MS/MS method in this paper. RESULTS: A good linearity was obtained in the range of 0.1-50 ng•mL-1 of cinacalcet, and the validated accuracy and precision all were within ±15%. Long-term, freeze-thaw and autoinjector stability of cinacalcet QC samples were all in the range of 1.4%-3.9%. The matrix of cinacalcet is (104.5±3.1)%, (105.6±4.3)% and (104.0±3.1)% respectively and the matrix of IS is (106.4±3.0)%. This validated method can meet the guidance for bioanalytical method validation. CONCLUSION: The HPLC-MS/MS method is sensitive and specific enough to meet the quantitative requirements for determining cinacalcet in human plasma. It is rapid, accurate and in line with the guidance for bioanalytical method validation.

Adesão ao tratamento hemodialítico: percepção dos pacientes renais crônicos / Adherence to hemodialysis treatment: the perception of chronic renal patients / Adhesión al tratamiento hemodialítico: percepción de los pacientes renales crónicos

Estudo descritivo, exploratório, de abordagem qualitativa que objetivou identificar fatores que interferem na adesão ao tratamento hemodialítico na percepção dos pacientes renais crônicos. Participaram 35 pacientes assistidos por um serviço público de hemodiálise em uma capital do Nordeste do Brasil, com coleta das informações entre maio e agosto de 2014. As informações foram coletadas por meio de questionário semiestruturado e analisadas pelo software ALCESTE. Os principais fatores que influenciaram na adesão foram: dificuldade de transporte, déficit de conhecimento sobre a doença, limitações do tratamento, transtornos vivenciados nas sessões de hemodiálise, controle das taxas pelos exames laboratoriais, fé, máquina de hemodiálise e suporte social. Considera-se, portanto, que os fatores que interferem na adesão são complexos, tornando-se necessária atuação multidisciplinar para a compreensão desse fenômeno e o desenvolvimento de estratégias educativas com vistas à conscientização dos indivíduos sobre a importância da adesão ao tratamento e possível melhoria da qualidade de vida (AU).

This descriptive exploratory study, with a qualitative approach, aimed to identify factors which influence adherence to hemodialysis treatment in the perception of chronic renal patients. A total of 35 patients participated, who were assisted by a public hemodialysis service in a state capital in the Northeast of Brazil, with data collection taking place between May and August 2014. The information was collected through a semistructured questionnaire and was analyzed using the ALCESTE software. The main factors that influence adherence were: transport difficulties, deficit of knowledge regarding the illness, limitations of the treatment, problems experienced in the hemodialysis sessions, control of the rates through laboratory examinations, religious faith, the hemodialysis machine, and social support. It is considered, therefore, that the factors influencing adherence are complex, making it necessary to undertake multi-professional activity in order to understand this phenomenon, and to develop educational strategies with a view to raising individuals' awareness regarding the importance of adherence to the treatment and possible improvement in quality of life (AU).

Estudio descriptivo, exploratorio, de abordaje cualitativo cuyo objetivo fue identificar factores que influyen en la adhesión al tratamiento hemodialítico en la percepción de los pacientes renales crónicos. Participaron 35 pacientes asistidos por un servicio público de hemodiálisis en una capital de Nordeste de Brasil. La obtención de las informaciones ocurrió entre mayo y agosto de 2014. Las informaciones fueron recogidas por medio de cuestionario emiestructurado y analizadas por el software ALCESTE. Los principales factores que influenciaron en la adhesión fueron: dificultad de transporte, déficit de conocimiento sobre la enfermedad, limitaciones del tratamiento, trastornos en las sesiones de hemodiálisis, control de las tajas por los exámenes de laboratorio, fe, máquina de hemodiálisis y apoyo social. Se considera, por lo tanto, que los factores que influyen en la adhesión son complejos, siendo necesaria actuación multidisciplinar para la comprensión de ese fenómeno y el desarrollo de estrategias educativas para concienciar los individuos acerca de la importancia de la adhesión al tratamiento y posible mejoría de la cualidad de vida (AU).

A adesão de indivíduos em terapia hemodialítica / Adhesión de individuos a terapia hemodialítica / Accession of individuals to hemodialysis therapy

Objetivo: analisar os indicadores de adesão relacionados com o perfil sociodemográfico de indivíduos submetidos ao tratamento hemodialítico. Método: pesquisa quantitativa realizada com 56 indivíduos em hemodiálise numa clínica renal no interior do Rio Grande do Sul. Os dados foram coletados por meio de questionário e consulta ao prontuário, nos meses de agosto e setembro de 2008. Resultados: os indivíduos casados com idade acima de 60 anos, analfabetos, ou ensino fundamental incompleto, com tempo de tratamento entre um a cinco anos adotaram maior quantidade de indicadores de adesão; indivíduos com renda superior a cinco salários mínimos aderiram a menos indicadores. Conclusão: Existem vários fatores envolvidos na adesão ao tratamento hemodialítico agindo de forma inter-relacionada. Cada indivíduo segue o tratamento de forma única e singular, influenciado por inúmeros fatores adquiridos ao longo da vida. Essas particularidades condicionam a resposta ao tratamento e devem ser entendidas pelos profissionais de saúde.

Objetivo: analizar los indicadores de adhesión relacionados al perfil sociodemográfico de individuos sometidos al tratamiento hemodialítico. Método: investigación cuantitativa realizada con 56 individuos en hemodiálisis en una clínica renal del interior de Río Grande del Sur. Los resultados fueron recolectados por medio de cuestionario y consulta a los expedientes clínicos, en agosto y septiembre de 2008. Resultados: los individuos casados, mayores de 60 años, analfabetos o con enseñanza primaria inconclusa, con tiempo de tratamiento entre uno y cinco años adoptaron mayor cantidad de indicadores de adhesión; individuos con renta superior a cinco salarios mínimos adhirieron a menos indicadores. Conclusión: existen varios factores involucrados en la adhesión al tratamiento hemodialítico actuando de forma interrelacionada. Cada individuo sigue el tratamiento de forma única y singular, influido por inúmeros factores adquiridos a lo largo de la vida. Esas particularidades acondicionan la respuesta al tratamiento y deben ser entendidas por los profesionales de salud.

Objective: to analyze the indicators of accession related with sociodemographic profile of individuals subjected to hemodialysis. Method: quantitative search with 56 individuals in hemodialysis in a renal clinic within Rio Grande do Sul. The data was collected through a questionnaire and research in medical records between August and September 2008. Results: married individuals aged 60 years, illiterate or incomplete primary education, treatment time between one and five years presented more indicators of accession; individuals with income above five minimum salary accepted less indicators. Conclusion: There are many involved factors in accession to hemodialysis and they are interrelated. Each individual follows the treatment in a unique and singular way with influence of many factors during their life. These particularities affect the answer to treatment and should be comprehended by professionals of health.

The Mortality Following Coronary Artery Bypass Grafting in Patients with Dialysis-Dependent Renal Failure and the Risk Factor for the Prognosis / 日本心臓血管外科学会雑誌

There were 3,129 consecutive patients who underwent CABG by only one operator at Kishiwada Tokushukai Hospital between January 1991 and December 2010. These patients included 236 patients requiring chronic renal hemodialysis at the time of operation. They consisted of 181 men and 55 women, with an average age of 64.1±9.7 years. The mean duration of hemodialysis was 10.1±20.4 years. Diabetic nephropathy (133 cases, 56.4%) was the most common disease leading to required for hemodialysis. The operative mortality and the hospital mortality were 3.4% and 6.4% respectively. The 1-year survival rate, the 3-year survival rate, the 5 year survival rate and the 10-year survival rate were 72.4%, 48.3%, 32.4% and 14.3%. Multivariate logistic analysis revealed that only peripheral artery disease (PAD) was a significant risk factor for mortality (<i>p</i><0.05). The infectious diseases were the most common cause of long term death (24.1%). The mortality rates of CABG in patients with dialysis-dependent renal failure are still higher than those for non-hemodialysis patients. Our data suggest that PAD is a great risk factor for mortality following CABG in hemodialysis patients.

Hospital-acquired Infections in Chronic Kidney Disease Non-dialysis Patients / 中华医院感染学杂志

OBJECTIVE To elucidate the hospital-acquired infections of chronic kidney disease non-dialysis patients and associated factors.METHODS Clinical data of 996 non-dialysis patients between Jun 1,2003 and Jun 1,2006 were enrolled in this retrospective study of hospitalized cases,there were 112 cases of hospital-acquired infections.The infection site,pathogens,renal function,serum albumin and hemoglobin were analyzed.RESULTS During above period 124 hospital-acquired infection episodes occurred.The infection rate was 11.2%,It was significantly higher than rate of hospital-acquired infection of our hospital at the same time(P