• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.1
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• pp.37-43
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• 1995

This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as $4.56{\pm}1.38$ and $2.05{\pm}1.36$ points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%)and pallor (5 cases, 6.3%)were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27cases, 16.9%)and fear for needle insertion(6 cases, 3.8%). The most frequent problems with EMLA cream application were an inconvenience in use (11 cases, 6.9%)and tedious long pretreatment time(11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.

• Journal of Korean Academy of Nursing
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• v.23 no.3
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• pp.431-452
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• 1993

This study was done to determine the effect of music therapy on stress and quality of life in patients undergoing hemodialysis. The research design was a nonequivalent control group pre -post test design. The subjects consisted of 21 patients who received hemodialysis in two hospitals located in Kwang Ju. The fourteen receiving treatment in one hospital were assigned to the experimental group and the seven in the other hospital to the control group. Data were gathered from December 14, 1992 to January 16, 1993 through questionnaires and physiological measurement. Data were analyzed by the SAS package using frequency, t-test, paired t-test and Pearson Prod uct - Moment Correlation Coefficient. The results of this study are summarized as follows ; 1. There were no significant differences between the two groups on stress scores and quality of life scores before the treatment. 2. The mean score on the psychological stress scale for the patients undergoing hemodialysis was 2.48 out of a maximum mean score of four, the items with high stress scores were “feeling of weakness and annoyed by everything”, “limitation of food”, “limitation of fluid”, “change in skin color” in that order. The psychological category showed the highest stress score followed by developmental, scoioeconomic and physiological stress categories in that order. 3. In the experimental group, post - test diastolic blood pressure decerased significantly(t=3.24, p=0.0064), but in the control group pre and post - test diastolic blood pressure were not different. 4. There was no difference between the two groups on the pre and post -test psychological stress scores or the depression scores. 5. The mean score of quality of life for patients undergoing hemodialysis was 2.75 out of a maxi-mum mean score of five. The category of ‘emtional state’ showed the highest score followed by ‘self - esteem’, ‘physical state and function’, ‘economic life’, ‘relationship with neighbors’ and ‘family relationship’ categories in that order. There was no significant difference in the pre and post - test quality of life scores between the two groups. 6. Hypothesis 1 that patients undergoing hemodialysis who received music therapy would have less stress than patients undergoing hemodialysis who did not receive music therapy is divided into two sub - hypotheses. 1) The first sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less physiological stress than patients undergoing hemodialysis who did not receive music therapy was partly supported. Among three physiological stress indices (pulse, systolic blood pressure, diastolic blood pressure), only diastolic blood pressure decreased significantly after the treatment in the experimental group. 2) The second sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less psychological stress than patients undergoing hemodialysis who did not receive music therapy was not supported. Psychological stress score and depression score were not significantly different before and after the treatment. 7. Hypothesis 2 that patients undergoing hemodialysis who received music therapy would have a higher quality of life score than patients undergoing. hemodialysis who did not received music therapy was not supported. There were no significant changes in the quality of life scores before and after the treatment.

• Anxiety and mood
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• v.9 no.1
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• pp.38-44
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• 2013

Objective : The end-stage renal disease patients who shared fear of death, functional impairment due to hemodialysis are vulnerable to depression, anxiety and other mental problems. It is possible that their psychiatric characteristics and related autonomic nervous functions have some differences depending on their age. We purpose to find the differences of psychiatric characteristics and related autonomic nervous functions between adult and elderly hemodialysis patients. Methods : Our subjects are end-stage renal disease hemodialysis patients composed of 39 adults (<65 years) and 24 seniors (${\geq}65$ years). Outcome measures included the 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale and Mini-International Neuropsychiatric Interview by clinician. And subjects fulfilled self-report scale, The Positive thinking scale and The Snaith-Hamilton Pleasure Scale. The autonomic nervous functions are measured by heart rate variability. Results : There are no significant differences in demographic factors between two groups. The 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale, The Snaith-Hamilton Pleasure Scale and autonomic nervous functions are also not different. But only positive thinking scale is higher in adult hemodialysis group than the elderly (F=5.395, p=0.024). Conclusion : This study compared depression, anxiety and autonomic nervous functions between adult and senior hemodialysis patients. There are no significant differences in psychiatric characteristics and autonomic nervous functions between two groups except positive thinking traits. Senior patients endured their chronic disease similar to adult patients did in spite of their old age. This result suggests that elderly's higher positive thinking traits affect their endurances about the negative situations.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.12
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• pp.921-925
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• 2015

The number of people suffering from renal disease increases every year. One of the most common treatments (clinical care options) for renal diseases is hemodialysis. However it takes a long time and has a high cost. Therefore, the importance of artificial kidney research has risen. Filtering creatinine from blood is one of the prime renal functions. Thus, we designed a novel two channel microfluidic chip focused on that function. In order to bond the individual polydimethylsiloxane layers, we have developed a housing system using acrylic plastic frame. This method has significant advantages in changing filter membranes. We use anodic aluminum oxide for the filter membrane. We analyzed the difference in the absorbance values for various creatinine concentrations using the Jaffe reaction. For the purpose of acquiring a standard equation to quantify the creatinine concentration, we interpolated the measured data and confirmed the concentration of the filtered solution. Through this experiment, we determined how the filtration efficiency depended on the flow rate and creatinine concentration.

• Quality Improvement in Health Care
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• v.23 no.1
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• pp.55-67
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• 2017

Purpose:The purpose of this study was to apply the disinfection method using chlorhexidine in practice on disinfection of vascular access for hemodialysis. Methods: This study was designed as a randomized controlled trial for examining effectiveness on infection of the vascular access device for hemodialysis when using chlorhexidine and betadine/alcohol. One-hundred-thirty study participants were separated into two groups randomly. Infection signs of the vascular access device for hemodialysis were observed and recorded before disinfection on vascular access device. Result: Before the study, there was no difference between the experimental group (chlorhexidine group) and the control group (betadine/alcohol group) in general characteristics and hematological index. Incidence of infection rate of chlorhexidine group was 0 percent and the betadine/alcohol group was 1.5 percent. There was no significant difference between the two groups. Conclusion: This study examined the effectiveness of prevention of infection with the disinfection method using chlorhexidine and betadine/alcohol. The disinfection method using chlorhexidine is considered an effective and alternative method of betadine/alcohol.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.267-271
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• 2006

The present study was performed to clarity the effect of hemodialysis(HD) on acute renal failure induced by bilateral ligation of the ureter. HB was applied on 48 hours(1st HD) and 72 hours(2nd HD) after ligation of the ureter, respectively. Clinical signs including nausea, vomiting, diarrhea and depression were observed in all cases(6 heads), however, those symptoms were much improved after HD. Hematological values including WBC, PCV and PLT were increased after ligation of the ureter, however, those values were decreased by HD without significance, compared with those of before HD. In addition, serum BUN, creatinine, Ca and P levels were increased after ligation of the ureter, however, BUN(p<0.05), creatinine(p<0.05) and P(p<0.05) were significantly decreased by HD, compared with before HD, respectively. Considering above findings, it was thought that HD was effective for improvement of clinical symptoms of dogs with induced acute renal failure.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Nutrition and Health
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• v.34 no.8
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• pp.920-928
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• 2001

Malnutrition is a common problem in patients undergoing maintenance hemodialysis(HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in chronic HD patients. We investigated the nutritional parameters of 50 Korean HD patients(mean age: 46.9 $\pm$ 10.3y, men : 23, women : 27) by measuring anthropometric and biochemical blood indices and assessing food intake using 24-h recall method. Also we administered two questionnaires, one for assessing nutritional knowledge about renal disease and dietary therapy, the other for measuring dietary habits related to dietary therapy. According to the distribution of BMI, 21.3% of HD patients were underweight. The hematological values of HD patients, such as plasma hemoglobin, hematocrit, and total lymphocyte count were below the normal range. The serum cholesterol levels were 133.2 $\pm$ 30.5mg/dl. HD patients took energy and protein only 77.5% and 83.1%, respectively, of their RDA. There were significantly positive correlations between nutritional knowledge and intake of nutrients, such as energy, fat, cholesterol, iron, potassium, vitamin B$_1$, vitamin B$_2$, and niacin. Also, there was a significantly positive correlation between nutritional knowledge and dietary habits(r = 0.317, p < 0.05). In conclusion, Korean HD patients showed mild malnutrition and suboptimal nutrition intake. It can be postulated that the dietary intake can be increased by nutrition education improving nutritional knowledge and correcting the dietary habits of HD patients.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.749-758
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• 2003

Malnutrition is a common problem in patients undergoing maintenance hemodialysis (HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in these patients. This study was conducted to evaluate the effectiveness of nutrition education at improving nutritional status of 23 Korean HD patients (mean : 48.6 $\pm$ 10.4 years, men : 8, women : 15). Anthropometric indices, nutrient intakes, and biochemical blood indices were measured before and after a 6-month nutrition education intervention. Anthropometric indices such as percent ideal body weight [PIBW (%)], body fat, body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and calculated arm muscle area (CAMA) of subjects were within the normal range and not changed by nutrition education. Subjective global assessment (SGA) was significantly increased (p < 0.05) after nutrition education. Intake of total energy, carbohydrate, lipid, Ca, and vitamin B1 was increased significantly (p < 0.05) but intake of phosphorus, potassium, and sodium was decreased (p < 0.05). The serum concentrations of albumin, total protein, and Ca were significantly increased (p < 0.05), but levels of P and K were decreased (p < 0.05) after the intervention. These findings suggest that nutrition education for HD patients can be effective for positively changing nutrient intakes, leading to improvements in blood indices and nutritional status.

• Journal of Nutrition and Health
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• v.25 no.3
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• pp.256-263
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• 1992

As various metabolic alterations develope in uremic patients. their diets need to be restricted, Furthermore medical complications with accompanying anorexia result in further complications and decrease in body strength. To assess the nutritional status of hemodialyzed patients we performed evaluation for dietary intake and protein catabolic rate(PCR) For 24 clinically stable male patients undergoing maintenance hemodialysis dietary intake was estimated by 3-day food record method and PCR was calculated with blood urea nitrogen at pre and post hemodialysis. The results were as follows : 1) Average daily energy and protein intake were 26.7$\pm$5.1kcal/kg of body weight. 0.95$\pm$0.19 g/kg of body weight respectively. 2) Protein catabolic rate calculated from interdialysis blood urea nitrogen levels was 1.00$\pm$0.20g/kg of body weight. Protein catabolic rate was correlated with the amount of Protein intake(r=0.44 p<0.05) 3) Relative body weight(RBW) of the subjects was smaller than that of healthy man without hemodialysis. Calorie and protein intake and protein catabolic rate were significantly different (p<0.05) between patients with lower RBW(<90% of ideal body weight) and those with normal RBW(90~110% of ideal body weight) and those with normal RBW(90~110% of iedal body weight) 4) The duration of hemodialysis did not have a significant effect on the nutritional status of the subjects.