• Title/Summary/Keyword: Chronic Renal failure

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The Lived Experience of Caregivers of Chronic Renal Failure Patient (만성신부전환자의 주보호자로 살기)

  • Kim, Kyoung-Mi;Kong, Byung-Hye
    • Korean Journal of Adult Nursing
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    • v.17 no.5
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    • pp.709-718
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    • 2005
  • Purpose: The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. Method: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. "sole responsibility for the patient enduring everything", "creating their own field", "heavy and painful life without hope of their private life", "wishing not to be inherited and consoling each other". Conclusion: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.

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Event-related Potentials of Pre- and Post-Hemodialysis in Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 전후의 P300 인지유발전위검사)

  • Bae, Jae-Chun;Lee, Sang-Moo
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.136-142
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    • 2001
  • Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.

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Two cases of Familial Juvenile Hyperuricemic Nephropathy (Familial Juvenile Hyperuricemic Nephropathy 2례)

  • Park Jin-Ho;Choi Bo-Hwa;Lee So-Young;Yoo Eun-Sil;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.183-188
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    • 1997
  • Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

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A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome (전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예)

  • Baek, Seon Ha;Shin, Nara;Kim, Hyo Jin;Han, Mi Yeun;Choi, Dong-Ju;Bang, Soo-Mee;Kim, Sejoong;Paik, Jin Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.145-149
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    • 2012
  • Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyper-permeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

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Two-Case Report on Chronic Renal Failure Treated with Herbal Enteroclysis (한약 관장법으로 호전된 신부전 환자 2례)

  • Cho, Min-Jung;Oh, Jae-Joon;Joo, Ye-Jin;Jung, Hye-Mi;Yoon, Cheol-Ho
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.1115-1122
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    • 2008
  • Chronic renal failure (CRF) is defined as a permanent reduction in glomerular filtration rate (GFR) sufficient to produce detectable alterations in well-being and organ function. This usually occurs at GFR below 25 ml/min. In this report, is a 75-year-old woman who had back pain and diarrhea as chief complaints. She was diagnosed with CRF on March. 2008. is a 62-year-old man who had whole body weakness, anorexia and dyspepsia as chief complaints. He was diagnosed with CRF on 2008. We used herbal enteroclysis solution. which consists of Radix et Rhizoma Rhei. Concha Ostreae and Radix Glycyrrhizae or Radix Salviae Miltiorrhizae. Herbal enteroclysis was done for 15 min once a day. Enteroclysis solution was controlled at 37-39 $^{\circ}C$ and inserted 15-20cm depth for intubation. We found the patient's BUN, creatinine and GFR were improved through enteroclysis. In both and , the patient's BUN and creatinine decreased, and GFR increased favorably. This result suggests that herbal enteroclysis used for CRF is effective in clinical therapy.

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Specification and Testing Method of WHW ex. for Chronic Renal Failure (만성신부전 치료제 개발을 위한 WHW 엑스의 기준 및 시험방법 설정)

  • So, Jae-Woo;Kang, Hee-Chul;Seo, Chang-Gyo;Lim, Ji-Ho;Park, Yong-Ki;Lee, Young-Jae;Kim, Young-Ho;Kang, Jong-Seung;Cho, Cheong-Weon
    • Journal of Pharmaceutical Investigation
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    • v.39 no.3
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    • pp.161-166
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    • 2009
  • This study is to specify the criteria and testing methods of WHW extract which has a potency as a therapeutic agent for chronic renal failure. The determination of specifications of WHW extract is mostly important because of the quality assurance. Three batches of WHW extract were obtained by the extraction at $98^{\circ}$C for 3 hr using water from mixture of 15 herbal medicines including Codonopsis Pilosulae Radix, Salviae Radix, Pinelliae Rhizoma, Coptidis Rhizoma, Evodiae Fructus, Epimedii Herba, Rhei Rhizoma, Perillae Herba, Glycyrrhizae Radix, Artemixiae capillaris Herba, Alimatis Rhizoma, Hoelen, Atractylodies Rhizoma alba, Polyporus and Cinnamomi Ramulus, subsequently, vaccum-dried for 15 hr. The yield of WHW extracts was 24.53% on the average. The identification of each herbal medicine of WHW extract was performed by modification of Korean Pharmacopeia IX (KP IX). The assay of WHW extract was performed using standard such as berberine, icariin, glycyrrhizin, and cinnamic acid of indicative herbal medicines by modification of KP IX, too. As well as, paticle size classification test was carried out to indicate the boundary of particle size of WHW extract and the particle size of WHW extract more than 50% showed the 140 ${\mu}$m. Taken together, WHW extract could be prepared reproducibly and assurable if follows the presented extraction and drying steps and its specifications were satisfied with the indicated criteria.

Central Vein Occlusion Secondary to Hemodialysis Catheterization in Chronic Renal Failure Patient -One Case Report- (만성 신부전 환자에서 혈액투석 도관에 의한 중심정맥 폐쇄증의 수술치험 -1례 보고-)

  • Lee, Seock-Yeol;Lee, Jun-Bock;Lee, Man-Bok;Youm, Wook;Lee, Kihl-Rho
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.619-623
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    • 1998
  • A 51-year-old male with chronic renal failure had marked swelling and tenderness of the right arm. Venography revealed central vein occlusion involving stenosis of right proximal subclavian vein, right internal jugular vein, and left distal innominate vein, and obstruction of right brachiocephalic vein. Multiple obstruction of these veins was thought to have resulted from repeated subclavian catheterization. Right subclavian-superior vena cava was bypassed with 10 mm Gore-tex vascular graft and then left subclavian vein with 8 mm Gore-tex vascular graft was bypassed to the 10 mm Gore-tex vascular graft. The results were excellent.

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Comparison of Skin Stimulation Method and Topical Anesthetic Cream on Pain and Heart Rate Variability during Arteriovenous Fistula Puncture in Hemodialysis Patients (혈액투석 환자의 동정맥루 천자 시 피부자극법과 국소마취크림 도포에 따른 통증과 심박변이도 비교)

  • Kang, Hyo Young;Chae, Young Ran
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.207-216
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    • 2019
  • Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

A case report of diagnosis and treatment of metastatic calcinosis circumscripta secondary to chronic renal failure (만성 신부전에서 속발한 metastatic calcinosis circumscripta의 진단과 치료 1례)

  • Park, Seong-Jun;Park, Hye-Yeon;Jeon, So-Bun;Choi, Ho-Jung;Jeong, Seong-Mok;Song, Kun-Ho;Cho, Jong-Ki;Lee, Young-Won;Shin, Sang-Tae;Kim, Myung-Cheol;Kim, Duck-Hwan
    • Korean Journal of Veterinary Research
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    • v.45 no.3
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    • pp.445-450
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    • 2005
  • A 1.35 kg, three-year-old, female, Yorkshire terrier was referred to the veterinary medical teaching hospital of Chungnam National University with an alopecia, scale, polydipsia and polyuria. During hospitalization, the patient revealed swelling and pain of all four foot pads. The hematology indicated nonregenerative anemia. Blood serum chemistry revealed elevation of BUN, serum creatinine and phosphorus contents. Radiographs of feet revealed increased radiodensity in the soft tissue of the foot pad. In ultrasonographs of abdomen, kidneys showed diffusely echodense renal cortex with loss of the normal corticomedullary boundary. Fine needle aspiration of the swollen pad cysts contained a amorphous basophillic chalky, white and pasty material. The culture result was negative for bacteria. In conclusion, it was diagnosed as metastatic calcinosis circumscripta secondary to chronic renal failure. An oral charcoal absorbent and aluminum hydroxide were used to treat this condition. After six weeks treatment, hyperphosphatemia was corrected and metastatic calcinosis circumscriptawas not presented any more.

Results of Protocol-based Perioperative Management in Off-Pump Coronary Artery Bypass Grafting for Patients with Non-dialysis-dependent Chronic Kidney Disease

  • Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.427-434
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    • 2016
  • Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.