• Journal of Chest Surgery
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• v.32 no.9
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• pp.835-839
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• 1999

Since the first report of coronary artery bypass grafting (CABG) in patients with end-stage renal disease in 1974, numerous reports have documented the feasibility of CABG in patients with chronic renal diseases. Patients with chronic renal failure often have comorbid disorders such as hypertension, and diabetes mellitus, each with their own complications and associated impact on both short and long-term survivals. In addition, infection and sepsis have been identified as significant causes of morbidity and mortality in most series of patients with end-stage renal disease undergoing cardiac surgical procedure. As a result of these and other factors such as perioperative volume and electrolyte disturbances, patients with chronic renal failures are at an increased risk of complication and mortality after CABG. We report 3 cases of "Off-pump" CABG in the chronic renal failure patients. patients.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.122-129
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• 2018

Background: For hemodialysis patients with end-stage renal disease (ESRD), it is important to construct an efficient vascular access with a superior patency rate. This study investigated the factors influencing the efficiency of arteriovenous fistulas (AVFs) constructed using an autologous vessel and evaluated the necessity of ultrasonography as a preoperative tool for AVF construction. Methods: A retrospective analysis was performed of 250 patients in whom an AVF was constructed using an autologous vessel due to ESRD at our institution from January 2009 to April 2016. Results: The 1-, 3-, and 5-year patency rates for all subjects were 87.6%, 85.6%, and 84.4%, respectively. The patients who underwent a preoperative evaluation of their vessels via ultrasonography had better patency rates than those who did not. Superior patency rates were found in patients under 65 years of age or with an anastomotic vein diameter of 3 mm or more. The 1-year patency rate and the diameter of the anastomotic vein showed a positive relationship. Conclusion: Ultrasonography is strongly recommended for AVF construction, and efforts should be made to increase the patency rate in patients over 65. Superior clinical results can be expected when an AVF is made using an autologous vessel with an anastomotic vein diameter of at least 3 mm.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.164-174
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• 2013

Objective : The aim of this study was to determine 30-day mortality and 6-month functional recovery rates in spontaneous intracerebral hemorrhage (S-ICH) patients undergoing hemodialysis treatment for end-stage renal disease (ESRD), and to compare the outcomes of these patients and S-ICH patients without ESRD. Methods : The medical records of 1943 S-ICH patients from January 2000 to December 2011 were retrospectively analyzed with focus on demographic, radiological, and laboratory characteristics. Results : A total of 1558 supratentorial S-ICH patients were included in the present study and 102 (6.5%) were ESRD patients. The 30-day mortality of the S-ICH patients with ESRD was 53.9%, and 29.4% achieved good functional recovery at 6 months post-S-ICH. Multivariate analysis showed that age, Glasgow Coma Scale (GCS) score, pupillary abnormality, ventricular extension of hemorrhage, hemorrhagic volume, hematoma enlargement, anemia, and treatment modality were independently associated with 30-day mortality in S-ICH patients with ESRD (p<0.05), and that GCS score, volume of hemorrhage, conservative treatment, and shorter hemodialysis duration was independently associated with good functional recovery at 6 months post-S-ICH in patients with ESRD (p<0.05). Conclusion : This retrospective study showed worse outcome after S-ICH in patients with ESRD than those without ESRD; 30-day mortality was four times higher and the functional recovery rate was significantly lower in S-ICH patients with ESRD than in S-ICH patients without ESRD.

• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.493-504
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• 2015

Purpose: This study was a qualitative study to explore and understand the adaptation experiences of hemodialysis among women with End-Stage Renal Disease (ESRD) and to develop a substantive theory using the grounded theory method. Methods: Participants were 15 female patients who underwent hemodialysis for ESRD treatment from three general hospitals. The data were collected through in-depth individual interviews. Results: The adaptation experience of participants was emerged as a process of taking care and enduring. There were four adaptation stages as a negative, despair, receptive, and maintenance period in reference to hemodialysis. The causal conditions were a vague expectations of recovery and refusal to undergo hemodialysis. The core phenomenon was that of confinement to dialysis machine. The contextual conditions for this phenomenon were the loss of femininity. They used action/interaction strategies such as transition their life with a focus on hemodialysis, seeking information, and learning how to take care of their body. Through this process, they had a strong will to live or had sustained their life. Conclusion: These results indicate that there is a need for nurses to understand the different steps of adaptation experiences of the given patient population. It is necessary for nurses to support them to lead their life as much normal as possible and improve the adaptation experience of ESRD.

• Asian Journal for Public Opinion Research
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• v.7 no.2
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• pp.94-112
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• 2019

Objective: The objective of this study was to compare the quality of life (QOL) of patients with end-stage renal disease (ESRD) between patients receiving hemodialysis (HD) and patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to compare personal characteristic factors relating to the quality of life in patients with ESRD. Method: This study used a descriptive research design. The sample was recruited using purposive sampling that included 76 ESRD patients receiving either HD or CAPD at a dialysis clinic in Phraphutthabat Hospital, Saraburi Province, Thailand. Data was collected using the Quality of Life Questionnaire for Chronic Kidney Disease ($KDQOL-SF^{TM}$) version 1.3. Independent t-test and ANOVA procedures were used to analyze study data. Results: The results revealed that the HD patients had a moderate level of QOL. The highest scoring dimension of QOL was the encouragement of staff at the dialysis unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=89.29$, SD =16.88) and cognitive function (${\bar{X}}=88.57$, SD=11.82). On the other hand, the lowest scoring QOL dimension was physical problems (${\bar{X}}=50$, SD=51.89), and pain (${\bar{X}}=50$, SD=39.03), followed by work status (${\bar{X}}=53.57$, SD=45.84) and burden from kidney disease (${\bar{X}}=58.48$, SD=31.07). The CAPD patients also had a moderate QOL. The highest scoring QOL dimension was the encouragement of staff in the renal unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=95.61$, SD=14.20) and cognitive function (${\bar{X}}=88.83$, SD=13.52). The worst scoring QOL dimensions were work status (${\bar{X}}=44.44$, SD=42.72), general health (${\bar{X}}=53.61$, SD=39.05), and pain (${\bar{X}}=62.70$, SD=41.14). The difference overall and in each dimension of QOL in ESRD patients who were treated with HD and CAPD was not statistically significantly different. The QOL was not significantly different among patients with different personal characteristics except for income and duration of treatment; in those cases, the difference in QOL was statistically significant (p=.05). Conclusion: The overall QOL and life expectancy of patients with ESRD treated with HD and CAPD are not affected by gender, age, marital status, education, occupation, or type of health coverage. QOL was not significantly different, except for patients with different incomes and duration of renal replacement therapy, whose QOL was significantly different. The QOL of patients receiving dialysis should be studied to develop a QOL program for patients with chronic kidney disease who receive dialysis.

• Journal of Korean Physical Therapy Science
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• v.17 no.3_4
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• pp.1-9
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• 2010

Purpose: The objectives of this study were to investigate the current status of the pain in and the dysfunction related to the musculoskeletal system experienced by patients with end-stage renal failure receiving hemodialysis. Methods: A questionnaire survey was given to 107 patients undergoing hemodialysis in M Hospital. The survey was conducted by using a brief pain inventory(BPI) to investigate the body parts in pain, degree of pain, difficulty in daily life, correlation with hemodialysis and the degree of satisfaction with their own health. Results: The investigation of the patients undergoing hemodialysis showed that 89(83.2%) of the 107 patients experienced pain in their musculoskeletal system. Their pain's incidence was highest in the knees(46.1%) and 68.5% of the patients reported that the most severe pain they had experienced within the past 24 hours was at a level between "moderate" and "severe." The limitation of daily life by pain is high most as 47.7% in the accomplishment of works. Conclusion: Most hemodialysis patients experience musculoskeletal related pain that affects their daily life. Hemodialysis patient management programs should include an assessment and management of such pain.

• Childhood Kidney Diseases
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• v.28 no.1
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• pp.44-50
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• 2024

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

• 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.

• Journal of Genetic Medicine
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• v.10 no.1
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• pp.7-12
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• 2013

Familial Juvenile hyperuricemic nephropathy (FJHN) is a rare autosomal dominant disorder, characterized by early onset of hyperuricemia, gout and progressive kidney disease. Hyperuricemia prior to renal impairment and decreased fractional excretion of uric acid are hallmarks of FJHN. Renal dysfunction gradually appears early in life and results in end-stage renal disease usually between the ages of 20 and 70 years. FJHN is mostly caused by mutations in the uromodulin gene located at 16p12. The course of FJHN is highly variable. Treatment includes management for hyperuricemia, gout and progressive kidney disease. Individuals with gout have been usually treated with allopurinol. But controversy exists as to whether uric acid lowering therapy prevents the progression of chronic kidney disease.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.36-39
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• 2011

Bartter syndrome (BS) is a clinically and genetically heterogeneous inherited renal tubular disorder characterized by renal salt wasting, hypokalemic metabolic alkalosis and normotensive hyperreninemic hyperaldosteronism. There have been several case reports of BS complicated by focal segmental glomerulosclerosis (FSGS). Here, we have reported the case of a BS patient who developed FSGS and subsequent end-stage renal disease (ESRD) and provided a brief literature review. The patient presented with classic BS at 3 months of age and developed proteinuria at 7 years. Renal biopsy performed at 11 years of age revealed a FSGS perihilar variant. Hemodialysis was initiated at 11 years of age, and kidney transplantation was performed at 16 years of age. The post-transplantation course has been uneventful for more than 3 years with complete disappearance of BS without the recurrence of FSGS. Genetic study revealed a homozygous p.Trp(TGG)610Stop(TGA) mutation in the CLCNKB gene. In summary, BS may be complicated by secondary FSGS due to the adaptive response to chronic salt-losing nephropathy, and FSGS may progress to ESRD in some patients. Renal transplantation in patients with BS and ESRD results in complete remission of BS.