• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.642-652
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• 2016

Purpose: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. Methods: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing. Results: The Kt/V ($M{\pm}SD$) was $1.40{\pm}0.25$ at twice the blood flow rate, $1.41{\pm}0.23$ at 500 mL/min, and $1.46{\pm}0.24$ at 700 mL/min. The URR ($M{\pm}SD$) was $68.20{\pm}5.90$ at twice the blood flow rate, $68.67{\pm}5.22$ at 500 mL/min, and $70.11{\pm}5.13$ at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/ min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate. Conclusion: Increasing the dialy-sate flow rate to 700 mL/min is associated with a significant increase in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1069-1074
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• 2009

Peritoneal dialysis is a preferred modality of replacement therapy in children and adolescents with end-stage renal disease waiting for kidney transplantation. Recent development of pediatric swan-neck catheters with cuffs, novel dialysis solutions, and cyclers for automated peritoneal dialysis enabled more flexible prescriptions of dialysis with less complication, and improved patients' activities as well as the dialysis adequacy. Principles and practical issues of chronic peritoneal dialysis in children and adolescents are reviewed and utility of a web-based Korean Pediatric CRF Registry is explained.

• The Journal of the Convergence on Culture Technology
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• v.4 no.4
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• pp.11-20
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• 2018

The purpose of this study was to examine the effect of the application of cool dialysis on dialytic stability, feeling of fatigue, pruritus and dialysis adequacy in hemodialysis. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 50 patients who were hospitalized to hemodialysis. The experimental group cool dialysis(n=25) and the control group received only the usual treatment (n=25). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of dialytic stability (F=5.53, p=.023) and feeling of fatigue (F=4.01, p<.001) in the experimental group were significantly different from that of the control group. However, the level of pruritus(F=.74, p=.394) and dialysis adequacy(F=1.02, p=.327) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that cool dialysis as an effective intervention alleviating dialytic stability and feeling of fatigue.

• Korean Journal of Adult Nursing
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• v.13 no.3
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• pp.451-462
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• 2001

This study was conducted to examine and compare the characteristics in the cognitive functions of peritoneal dialysis, hemodialysis and normal kidney function groups as basic data for effectively educating dialysis patients. The data were collected from May 10 to October 30. 2000, collected from each of 20 patients with peritoneal dialysis, hemodialysis and normal Kidney function and who registered for the dialysis room at a general hospital affiliated to a university in Seoul and sampled by age and educational level through personal interviews with the researchers of this study. As a measuring tool, MMSE developed by Folstein et al.(1975) to measure cognitive function disorder was used, slightly revised for hemodialysis patients. Collected data were processed into frequency, percentage, mean, and standard deviation by the use of SAS. The results of this study are as follows : 1. With a maximum of 30 points for cognitive function, the mean of the peritoneal dialysis patients was $27.06{\pm}2.06$, while that of the hemodialysis patients was $27.25{\pm}2.76$; that of the normal Kidney function patients was $27.85{\pm}2.00$, indicating no significant difference among those three groups. 2. As for the subjects who scored 23 points, the turning point of confirming the cognitive disorder, the percentage was 5% in the case of the peritoneal dialysis, 10% in the case of the hemodialysis and 5% in the case of the normal Kidney function group. 3. Differences between the peritoneal dialysis and hemodialysis patients by gender, occupation, spouse, diabetes, hypertension, the period of dialysis, number of hospitalizations, and the use of erythropoietin were not significant in the scoring of cognitive function. 4. There was no significant correlation between the level of Hb, Hct, albumin, aluminium, PTH, BUN, Cr, dialysis adequacy and the cognitive function. Considering such results, it is clear that there is no significant difference in the cognitive functions of the sampled subjects. Therefore, the nurse in the dialysis room should continually carry out assessment and intervention against elements degrading the effect of patients' education to improve self- care.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.255-263
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• 2007

Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

• Biomedical Science Letters
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• v.25 no.1
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• pp.32-39
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• 2019

Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.436-439
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• 2015

Four cases of acute or acute-on-chronic kidney injury were referred for hemodialysis therapy. All cases had a history of uremic syndrome including refractory vomiting, anorexia, diarrhea and depression. They already had been treated with conventional therapies but the intractable clinical signs were remained without response of medications. Intermittent hemodialysis (IHD) sessions were executed in four cases. This study describes the clinical signs and biochemical features of four hemodialysis patients with dialysis adequacy indexed by Kt/V. This report introduced the estimation of hemodialysis adequacy method with clinical cases for establishment of standardization of hemodialysis therapy assess in dogs.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.333-341
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• 1999

Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.189-196
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• 2009

Purpose : The pathophysiologic mechanism of nephrotic syndrome is not yet known clearly. At least in some cases, certain 'circulating factors' are thought to increase the glomerular protein permeability. Considering the systemic effect of the circulating factor on peritoneal membrane, we evaluated the loss of protein through peritoneal membrane in patients on peritoneal dialysis due to the end stage renal disease (ESRD) caused by steroid resistant nephrotic syndrome (SRNS). Methods : We retrospectively reviewed the medical records of 26 pediatric patients on peritoneal dialysis ensued during the period from 2001 to 2007 at our clinic. Twelve patients had SRNS, while 14 patients had ESRD caused by the congenital anomalies of urinary system. Results : While the other parameters including nPNA indicating the adequacy of protein intake were similar between the two groups, serum albumin was lower in SRNS patients than the non-SRNS patients ($3.7{\pm}0.3$ g/dL vs. $4.0{\pm}0.4$ g/dL, P=0.021). Peritoneal protein loss was higher in SRNS patients than in non-SRNS patients ($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007). The protein permeability of the peritoneal membrane measured by the ratio of total protein concentration in dialysate to plasma was twice as high in SRNS patients as the non-SRNS ($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). After 1 year, peritoneal protein loss increased in both patient groups, but to a significantly greater degree in non-SRNS patient (P=0.023). Conclusion : The results of our study support the notion that in nephrotic syndrome there are some 'circulating factors' with the systemic effect. Since the greater protein loss through peritoneal membrane in SRNS was confirmed in this study, more meticulous nutritional support and close monitoring on the nutrition are required in these patients.

• Journal of Korean Biological Nursing Science
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• v.15 no.3
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• pp.122-132
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• 2013

Purpose: The purpose of this study was to evaluate the effect of periodic video education on knowledge about hemodialysis, patient role behavior and the physiologic index in patients with hemodialysis. Methods: One-group pretest-posttest design was applied. A total of 50 patients with hemodialysis at a university hospital hemodialysis unit in Daegu participated. Periodic video education about kidney function, diet, arteriovenous fistula management, medication, and exercise was administered to them for 12 weeks at intervals of 2 weeks. Before and after the education, the participants completed the self-administered questionnaires of knowledge about hemodialysis and patient role behavior and the measures of serum potassium and phosphorus concentration, weight gain between hemodialysis sessions, and adequacy of dialysis (Kt/V). Statistical analysis was performed using paired t-test. Results: Knowledge about hemodialysis and patient role behavior were significantly different between before and after education (p<.01). For the physiologic index, serum potassium concentration and weight gain between hemodialysis sessions were not significantly different but the serum phosphorus concentration and Kt/V were significantly different between before and after education (p<.05). Conclusion: The results suggest that the periodic video education for patients with hemodialysis contributed to the change and improvement in knowledge about hemodialysis, patient role behavior, and the physiologic index.