An investigation of factors associated with fluid adherence among hemodialysis patients: a self-efficacy theory based approach.

This research tested the hypothesis that fluid adherence (i.e. mean weekend interdialysis fluid weight gain) among adult chronic hemodialysis patients would have significant associations with fluid adherence efficacy expectation, fluid adherence outcome expectation, and fluid adherence motivation. The association of these variables with patients' medical characteristics was also examined. Results provide partial support for the hypothesis. Fluid adherence efficacy expectation was found to be a significant predictor of mean weekend interdialysis fluid weight gain (fluid adherence). Patients with higher fluid adherence efficacy expectations had lower mean weekend interdialysis fluid weight gains. However, fluid adherence outcome expectation and fluid adherence motivation were not found to be significant predictors of fluid adherence. Results also revealed that certain of the investigated medical characteristics were significantly associated with mean weekend interdialysis fluid weight gain and fluid adherence efficacy expectation. Implications for studying and modifying fluid adherence among hemodialysis patients are discussed.

Papillary necrosis in kidney transplant patients.

Of 158 renal transplant recipients, 75 underwent excretory urography at some point during a six-year period, 24 hours to 7 years after transplantation. In 11 patients, renal papillary necrosis (RPN) was found. RPN was associated in 9 patients with one or more disease entities known to be the etiologic factor to RPN in nontransplanted kidneys. In 2 patients, previous rejection episodes were the probable case for RPN. Renal papillary necrosis, a rather late complication with renal allograft, was demonstrated in this population on an average of 28.1 months after transplantation.