• Title/Summary/Keyword: 복막 투석

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Clinical Characteristics of Inguinal Hernia in Children on Peritoneal Dialysis (복막투석 중인 소아에서 발생한 서혜부 탈장의 임상상)

  • Park, Hee-Kyung;Jung, Kyu-Whan;Moon, Suk-Bae;Jung, Sung-Eun;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.141-148
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    • 2009
  • Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3 %, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69 %) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3 %) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5 %). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.

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The Acute Intermittent Peritoneal Dialysis in Acute Renal Failure of Newborn and Young Infants (신생아와 유아의 급성신부전증에 실시한 급성복막투석)

  • Park, Yong-Hoon;Moon, Han-Ku
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.375-382
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    • 1986
  • We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomittent illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC(disseminated intravascular coagulopathy), paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialvsate, Imperinol $solution^R$, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotol swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdiminal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomittant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.

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Complications of Continuous Ambulatory Peritoneal Dialysis in Children (소아에서의 지속적 외래 복막 투석의 합병증)

  • Park, Sung-Chan;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.9 no.2
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    • pp.77-80
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    • 2003
  • Continuous Ambulatory Peritoneal Dialysis (CAPD) has now become an established form of renal replacement therapy in children. Despite of technical improvements, there are various complications in CAPD. We reviewed medical records of children who received CAPD at Seoul National University Children's Hospital in the period between May 1991 and June 2002. Ninety-three procedures of CAPD catheter insertion in 70 patients were included in this study. Complication rate was 64.5%, and CAPD catheter related peritonitis was most common. In conclusion, CAPD catheter related peritonitis develops in considerable number of pediatric patients. Although the peritonitis could be treated with empirical antibiotics therapy, further investigation to prevent complication is required.

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An Analysis of Burnout Factors and Coping Methods on Continuous Peritoneal Dialysis Patients (복막투석환자의 소진요인과 대응양상에 관한 분석)

  • Jeong, Yeong-Sun;Choe, Gwi-Sun
    • The Korean Nurse
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    • v.34 no.2
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    • pp.66-76
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    • 1995
  • This study was done to identify burnout factors and coping methods surveyed upon 59 out-patients who have continuous peritoneal dialysis. Raw data was collected after being filled the questionnaire by subjects or directly interviewing at the peritoneal dialysis room of the K hospital. Taegu. Then. data was classified and analyzed according to categories of questions and revealed facts. The following results are obtained: The average age of subjects is 43.8 years old and the average duration of continuous peritoneal dialysis is 16.9 months. The reasons of choosing continuous peritoneal dialysis are 61. 0% by recommendation of doctor and nurse ranked as the first, 32. 2% by patient own decision ranked as the second. The 57.6% of subjects were experienced complications related to continuous peritoneal dialysis. The major psychosocial burnout factors because of the dialysis are confinement, wasting time, change in responsibility and role as a member of family, worriment for infection, interference in job: and the major physiological burnout factors are fatigue and weakness. Among the main coping methods, the problem-oriented coping methods are "accept the given situation itself, "actively try to change the situation", "try to maintain some controls over the situation", and the affective-oriented coping method are "give up and accept as fate", "pray", "ask comfort or help from family and friends", "sleep", "cry". Conclusively, it can be said that effective nursing intervention is needed to prevent continuous peritoneal dialysis burnout.

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Hypertensive Cardiomyopathy in a Pomeranian Dog Complicated with Chronic Kidney Disease (포메라니언 개에서 발생한 만성 신장질환과 합병된 고혈압성 심근증)

  • Lee, Joon-Seok;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.170-175
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    • 2009
  • A 7-year-old, intact male Pomeranian(weighing 2.2 kg), was presented with clinical signs of prolonged anorexia, polydypsia/polyuria, severe azotemia, proteinuria and heart murmur. Diagnostic studies found chronic kidney disease, severe hypertension and hypertrophic cardiomyopathy. The dog was treated with 2-day peritoneal dialysis, blood transfusion, anti-hypertensive therapy with amlodipine and conservative therapies direct to chronic renal failure. This is a rare case of hypertensive cardiomyopathy complicated with chronic kidney disease in dogs.

웹기반 복막투석환자 간호 교육프로그램 개발 및 효과에 관한 연구

  • Yu, Ji-Su;Mun, Seong-Mi
    • Korean Medical Education Review
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    • v.3 no.2
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    • pp.35-43
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    • 2001
  • Development and Evaluation of the Effectiveness of a Web-Based Learning System Program for Nursing Education on Peritoneal Dialysis Ji-Soo Yoo(Professor, College of Nursing, Yonsei University, Seoul, Korea) Seong-Mi Moon(Doctoral Candidate, College of Nursing, Yonsei University, Seoul, Korea) The purpose of this study was to develop a nursing education program using a web-based learning system to teach peritoneal dialysis and to evaluate the effectiveness of the program. The program was developed in two steps. The first step was to develop the content using CVI, and the second was to program it using HTML. The program which was developed was evaluated with 50 nurses of whom 48 responded to the questionnaire. The results are as follows: Of the subjects, 85.4% responded that they were satisfied with this web-based learning system and 87.5% stated that they would recommend this system to nurses who are in other nursing education programs. Of the educational material charac- teristics, the item that the subjects evaluated as most valuable was "accuracy of the content". For system related charact- eristics, the item to which the subjects gave the most positive response was "clarity of the system tool marking" (81.3%). In conclusion, it was verified that a web-based learning system is an effective and satisfactory method for nursing education.

A Study on Influencing Factors in Health Promoting Lifestyles of Continuous Ambulatory Peritoneal Dialysis Patients (복막투석환자의 건강증진 생활양식과 관련요인 연구)

  • 김영순;정은순;김정순
    • Korean Journal of Health Education and Promotion
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    • v.18 no.1
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    • pp.17-33
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    • 2001
  • The purpose of this study was to identify the major factors affecting performance in health promoting lifestyles in continuous ambulatory peritoneal dialysis(CAPO) patients. The subjects for this study were 98 CAPO patients living in Pusan city. The data for this study were collected from October 15th, 1999 to January 15th, 2000 by structured questionaries. Statistical analysis was done using SPSS softwares. The results were as follows: 1. The average score of performance in the health promoting lifestyles was 2.34. The variable with the highest degree of performance was self-actualization and nutrition, whereas the one with the lowest degree was exercise. 2. In the subscale of the health promoting lifestyles, especially educational level, marital state and CAPO period, there was significant differences between demographic variables and performance in the health promoting lifestyles. 3. The activity-related affect, situational influences, self-efficacy, and perceived barriers in the behavior-specific cognitions and affect have a significant correlation with performance in the health promoting lifestyles. 4. The most important variable that affects the performance in the health promoting lifestyles was situational influences, and the self-efficacy, perceived barriers, every monthly treatment cost, duration of chronic renal failure followed in order, activity-related affect. Those six variables accounted for 38.3% among the variables in health promoting lifestyles.

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A Study on Nutritional Status during Dialysis in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (지속성 외래 복막투석 환자의 투석기간에 따른 영양상태)

  • Seo, Ji-Yeon;Kim, Nam-Ho;Heo, Young-Ran
    • Journal of Nutrition and Health
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    • v.45 no.1
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    • pp.30-43
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    • 2012
  • Patients undergoing peritoneal dialysis are at risk for protein-energy malnutrition because of nutrient losses during dialysis. This study determined the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Forty-four patients receiving CAPD were divided into two groups according to dialysis period. We investigated the nutritional status of the patients by measuring anthropometric and biochemical parameters, as well as food intake, self-appetite, dietary habits, a subjective global assessment, and a total nutritional status assessment. Group I subjects (7 males, 13 females) had received dialysis for < 2 years, whereas the group II subjects (18 males, 6 females) received dialysis for ${\geq}$ 2 years. Energy intake with added dextrose in the dialysate per kg of body weight was $30.3{\pm}5.8$ kcal in group I and $29.0{\pm}8.1$ kcal in group II. The average protein intake per kg of weight was $1.0{\pm}0.3$ g in group I and $1.0{\pm}0.4$ g in group II, which were less than the recommended protein intake for patients undergoing CAPD (1.2-1.5 g/kg). Mean serum albumin level was significantly lower in group II than that in group I (p < 0.05). A recent self-appetite score was significantly higher in group II than that in group I (p < 0.01). The dietary habits score was significantly lower in group II than that in group I (p < 0.05). The subjective global assessment was significantly higher in group I (85.0%) than that in group II (54.2%) under normal nutrition status (p < 0.05). The dialysis period was significantly and negatively correlated with the subjective global assessment (r = -0.502, p < 0.01) and the total nutritional status assessment (r = -0.575, p < 0.01). These results demonstrated that patients undergoing CAPD for ${\geq}$ 2 years had worse nutritional status than those who had been undergoing dialysis for < 2 years. Good nutritional status can predict the long-term survival of patients undergoing peritoneal dialysis. Additionally, the exact evaluation of nutritional status before 2 years will be important to maintain long-term dialysis therapy in patients undergoing CAPD.

Risk Factors for Development of Acute Renal Failure in Patient undergoing Open Heart Surgery (개심술 환자의 수술 후 급성 신부전 발생 위험요인)

  • Jeon, Hyun Rye;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1728-1736
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    • 2013
  • The purpose of this study is to identify prognostic predictors of postoperative acute renal failure(ARF) for the patient undergoing cardiac surgery. Retrospectively review the electronic hospital database at a A hospital from Jan 2008 to Dec. 2011. 483 patients were included in this study. They were divided into a occurrence of ARF group(n=59) and a non occurrence of ARF group(n=424). ARF occurred in 59 cases (12.2%). Multi-variable logistic regression analysis identified that preoperative risk factors include creatinine(OR 3.92, p=<.001), advanced age(OR 2.142, p=.015), female(OR 2.165, p=.015), hypertension(OR 2.513, p=.005), NYHA(New York Heart Association) class II(OR 3.081, p=.003), and III(OR 6.759, p=.004), and intraoperative risk factor includes blood transfusion(OR 3.753, p=<.001), and postoperative factors include bilirubin(OR 4.541, p=.028), creatine(OR 8.554, p=.003), and cardiac output(OR 0.214, p=.033) as a prognostic predictors. The development of postoperative ARF could be a reason for increase in rate of complication and mortality after cardiac surgery. therefore the prevention of ARF is of paramount importance and treatment strategies are urgently needed.

Clinical Study on Hemolytic Uremic Syndrome in Children: Review of 23 Cases (소아 용혈성 요독 증후군 23예에 대한 임상적 고찰)

  • Oh Seungjin;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.136-143
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    • 2000
  • Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.

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