• 제목/요약/키워드: Dialysis

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

  • 정영순;최귀순
    • 대한간호
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    • 제34권2호
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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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透析法에 依한 이온量 및 分子量의 決定에 關한 硏究 (第4報). 比表面積 및 透析膜孔이 透析에 미치는 影響 (A Study on the Determination of Ionic and Molecular Weight of Dissolved Substance by Dialysis Method (Ⅳ). Effects of Specific Surface Area and Pore Size of Dialysis Membrane on Dialysis)

  • 신윤경;이전;김태천
    • 대한화학회지
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    • 제21권1호
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    • pp.44-52
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    • 1977
  • 透析係數가 常數로서 나타날 수 있는 條件究明의 一環으로서 透析液 單位體積當의 透析膜面積인 比表面積과 透析膜孔의 크기가 透析에 미치는 영향을 究明하였다. 1回의 透析實驗에서 任意時間區間마다 任意부피의 透析液試料를 잇따라 菜取하는 方法(間歇試料菜取法이라 呼稱하기로 함)은 透析係數를 求하는 方法으로서 採擇할 수 있음과, 또한 透析膜孔이 상당히 크더라도 膜을 通한 擴散係數는 自由擴散係數에 미치지 못함을 밝히었다.

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p-Cresyl sulfate and indoxyl sulfate in pediatric patients on chronic dialysis

  • Hyun, Hye Sun;Paik, Kyung Hoon;Cho, Hee Yeon
    • Clinical and Experimental Pediatrics
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    • 제56권4호
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    • pp.159-164
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    • 2013
  • Purpose: Indoxyl sulfate and p-cresyl sulfate are important protein-bound uremic retention solutes whose levels can be partially reduced by renal replacement therapy. These solutes originate from intestinal bacterial protein fermentation and are associated with cardiovascular outcomes and chronic kidney disease progression. The aims of this study were to investigate the levels of indoxyl sulfate and p-cresyl sulfate as well as the effect of probiotics on reducing the levels of uremic toxins in pediatric patients on dialysis. Methods: We enrolled 20 pediatric patients undergoing chronic dialysis; 16 patients completed the study. The patients underwent a 12-week regimen of VSL#3, a high-concentration probiotic preparation, and the serum levels of indoxyl sulfate and p-cresyl sulfate were measured before treatment and at 4, 8, and 12 weeks after the regimen by using fluorescence liquid chromatography. To assess the normal range of indoxyl sulfate and p-cresyl sulfate we enrolled the 16 children with normal glomerular filtration rate who had visited an outpatient clinic for asymptomatic microscopic hematuria that had been detected by a school screening in August 2011. Results: The baseline serum levels of indoxyl sulfate and p-cresyl sulfate in the patients on chronic dialysis were significantly higher than those in the children with microscopic hematuria. The baseline serum levels of p-cresyl sulfate in the peritoneal dialysis group were significantly higher than those in the hemodialysis group. There were no significant changes in the levels of these uremic solutes after 12-week VSL#3 treatment in the patients on chronic dialysis. Conclusion: The levels of the uremic toxins p-cresyl sulfate and indoxyl sulfate are highly elevated in pediatric patients on dialysis, but there was no significant effect by probiotics on the reduction of uremic toxins in pediatric dialysis patients. Therefore, studies for other medical intervention to reduce uremic toxins are also necessary in pediatric patients on dialysis.

노인 투석환자의 영양상태 평가 (Assessment of Nutritional Status in Elderly Dialysis Patients)

  • 노유자;하혜정;고혜영;박옥순
    • 대한간호학회지
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    • 제26권2호
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    • pp.304-319
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    • 1996
  • It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calorie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis. which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon-rank sums test, Scheffe test, Kruskal-Wallis test and Pearson correlation coefficients. The results are following : 1. There was no significant difference in the calorie and protein intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea nitrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine increased significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However. each of biochemical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status measured with protein and calorie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

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신 부전증 환자의 요소 및 비타민 B12 의 체내농도 추정 (Estimation of Urea and Vitamin B12 Concentrations in the Body using Two Compartment Model)

  • 장호남;박한철
    • 대한의용생체공학회:의공학회지
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    • 제3권1호
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    • pp.9-16
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    • 1982
  • Removal of urea and vitamin B12 was simulated using two pool models with closed loop dialysis, open loop dialysis, and hemodiafiltrations with predilution and postdilulion. It was found that urea removal was limited by dialyzer clearance, however B12 removal was limited both by the resistance between ECF and ICF and by dialyzer clearance. Open loop dialysis was better than closed loop dialysis in terms of dialysate requirement and removal efficiency. Residual renal function plays an important role in removing vitamin B12. Dialysis frequency more than twice/wide does not have great effect on removal efficiency, but has the effect of reducing the difference between maximum and minimum cancentrations during dialysis period.

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透析法에 依한 이온量 및 分子量의 決定에 關한 硏究 (第二報). 攪拌이 透析에 미치는 影響 (A Study on the Determination of Ionic and Molecular Weight of Dissolved Substance by Dialysis Method (II). Effect of the Agitation on Dialysis)

  • 신윤경;이전
    • 대한화학회지
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    • 제17권3호
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    • pp.213-223
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    • 1973
  • 透析液 및 溶媒液의 攪拌이 透膜面에 미치는 流體力學的인 壓力分布狀態를 究明하였고, 攪拌으로 招來되는 透膜面兩面의 壓力不均衡을 除去할 目的으로 攪拌裝置의 開發을 試圖하였다. 다음 攪拌速度가 透析係數에 미치는 影響을 究明하여 가장 正確한 透析係數를 求할 수 있는 攪拌速度를 確定시켰다.

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透析法에 依한 이온量 및 分子量의 決定에 關한 硏究 (第三報). 外部液量 및 透析溫度가 透析에 미치는 影響 (A Study on the Determination of Ionic and Molecular Weight of Dissolved Substance by Dialysis Method (Ⅲ). Effects of the Outer Solution Volume and the Dialyzing Temperature on Dialysis)

  • 신윤경;이전
    • 대한화학회지
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    • 제18권2호
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    • pp.138-142
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    • 1974
  • 透析係數가 常數로 나타날 수 있는 條件究明으로서 透析質의 種類에 따르는 外部內의 畜積限界量을 究明하였고, 한편 透析係數와 透析溫度사이의 相關關係를 아울러 究明하였다.

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투석환자의 삶의 질에 미치는 영향요인 분석 (A Study on factors Affecting Quality of Life in Patients on Dialysis)

  • 김남초;송효정;오정아;김태양;김명자
    • 기본간호학회지
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    • 제10권2호
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    • pp.163-170
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    • 2003
  • Purpose: This study was done to identify stress, fatigue, and self efficacy in patients on dialysis and identify their effect on quality of life. Method: The participants (n=149) who agreed to participate in the research were selected from among those who were on dialysis treatment at C University Medical Centers in Seoul and Inchon, and at C University Medical Center in Jeju. The data were collected from July, 2001 to March, 2002 using interviews. Data analysis was done with t-test, ANOVA, and multiple stepwise regression using the SAS program. Result: Quality of life was significantly different according to economic status, and type of dialysis. Quality of life for the group with higher economic status was better than for the group with lower economic status, and the group on peritoneal dialysis had higher quality of lift scores than the group on hemodialysis. As for self-efficacy, there were significant difference according to duration of disease, type of dialysis, and duration of dialysis. Stress was significantly different according to marital status. Quality of life was significantly predicted by stress (40.02%) and fatigue (3.85%). Conclusion: To improve quality of life for people on dialysis, their stress should be treated positively, also multi-dimensional nursing interventions to provide emotional support and nursing interventions to diminish fatigue are required.

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Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death

  • Chang, Hye Jin;Han, Kyoung Hee;Cho, Min Hyun;Park, Young Seo;Kang, Hee Gyung;Cheong, Hae Il;Ha, Il Soo
    • Clinical and Experimental Pediatrics
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    • 제57권3호
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    • pp.135-139
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    • 2014
  • Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

투석환자의 학습된 무기력과 자가간호역량에 관한 관계 연구 (A Study on the Relationship Between Learned Helplessness and Self-care Agency in Dialysis Patients)

  • 김은만;서문자
    • 재활간호학회지
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    • 제2권1호
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    • pp.7-21
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    • 1999
  • The purpose of this study was to identify the degree of learned helplessness and self-care agency in dialysis patients and the relationship between learned helplessness and self-care agency. The subjects were 168 dialysis patients who were undergoing hemodialysis and peritoneal dialysis from 1 university hospital, 1 hospital, 1 hemodialysis center in Seoul, 1 hospital in Incheon, Korea. The data were collected with two interview questionnaires which were Learned Helplessness Scale (LHS) and Self-as-Carer Inventory (SCI). The collected data were analyzed by descriptive statistics and t-test, One-way ANOVA and Pearson Correlation with SPSSWIN program. Results were obtained as follows : 1) The mean scores of learned were 45.93(range 20-80). The mean learned helplessness scores of peritoneal dialysis patient and hemodialysis (HD) patient were not different significantly. However by the aging process, the mean scores of learned helplessness has a tendency to get higher and who had a job were likely to low score of learned helplessness. 2) The mean scores of self-care agency were 142.48 (range 33-198). The mean self-care agency scores of peritoneal dialysis (PD) patient much higher than the score of it with hemodialysis. The score of self-care agency were significantly different between peritoneal dialysis patient and hemodialysis patient. The patients who have job were likely to be higher score of self-care agency than other groups. 3) There was significant relationship between the score of learned helplessness and self-care agency. In conclusion, there was an inverse relationship between learned helplessness and self-care agency in dialysis patients. Considering this, the high level of learned helplessness of dialysis patients should be intervened by nurse with a well developed edicational program or cognitive behavioral therapy.

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