• Kidney Research and Clinical Practice
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• v.36 no.2
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• pp.111-116
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• 2017

The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of 'the clinical practice guideline for hemodialysis facilities dealing with MERS patients' built upon our previous experience.

• Journal of Korean Clinical Nursing Research
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• v.25 no.1
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• pp.98-105
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• 2019

Purpose: The study was conducted to investigate correlation between professionalism, organizational communication the and patient safety culture of nurses in hemodialysis units and verify factors that affect patient safety culture. Methods: Data were collected from 109 nurses working in hemodialysis units located in Seoul and Gyeonggi-do. collected data were analyzed using descriptive statistics including t-test, one-way ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS 21.0 program. Results: The Professionalism of participants was significantly correlated with patient safety culture while the Organizational communication was also correlated with patient safety culture. Factors influencing participants' patient safety culture included professionalism, organizational communication, employment history in current hospital, and the number of patients per nurse. These factors explained 57.8% of patient safety culture. Conclusion: The research findings suggest that in order to increase the awareness of patient safety culture of nurses in hemodialysis units, strategic efforts are needed to enhance professionalism and organizational communication satisfaction of nurses in hemodialysis units.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.221-227
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• 2018

Purpose: This study aimed to evaluate the effect of illness perception on depression and quality of life in patients with hemodialysis. Methods: This is a cross-sectional study using structural equation modeling. Depression, quality of life and cognitive and emotional illness perceptions were measured by the Center for Epidemiologic Studies Depression-10 (CESD-10), Short Form-36 version 2 (SF-36v2), and Brief Illness Perception Questionnaire (BIPQ) in 272 hemodialysis patients. Results: Prevalence of depression was 76.1%, and higher in female patients on hemodialysis. Cognitive illness perception had effect on depression and quality of life, while emotional illness perception had effect only on depression. Quality of life was explained 69.6% through depression (${\beta}=-.74$, t= -8.17) and cognitive illness perceptions (${\beta}=.21$, t= 3.06), while depression was explained 40.5% through cognitive (${\beta}=-.34$, t= -5.99) and emotional (${\beta}=.59$, t= 9.37) illness perceptions. Conclusion: In the inevitable choice of dialysis, illness perception could decrease depression and improve quality of life in hemodialysis patients.

• Journal of muscle and joint health
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• v.27 no.3
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• pp.268-277
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• 2020

Purpose: This study aimed to examine the effects of hemodialysis patients' uncertainty and resilience and the communication styles of nurses on the self-care of the patients and to improve their quality of life. Methods: The study was conducted from June 13 to July 12, 2019, with patients receiving hemodialysis more than three times a week at five medical institutions located in G metropolitan city. Data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression using the SPSS/WIN 25.0 program. Results: The factors influencing self-care were resilience (β=.43, p<.001) and marital status (β=.27, p=.001), which explained 30.8% of the variance. Conclusion: The resilience of hemodialysis patients was confirmed to be the main variable influencing self-care. Therefore, to improve the self-care of hemodialysis patients, it is considered that the development of interventions and programs to improve resilience is necessary.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.548-554
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• 1995

Background: Cardiogenic pulmonary edema increases nonspecific airway responsiveness in humans and animals. Increased extravascular lung water from overt pulmonary edema to subclinical interstitial edema is a common finding in patients with chronic renal failure. Several studies carried out to assess pulmonary function disturbances in this condition have documented a reduction in forced expiratory volume that usually reverses after hemodialysis, suggesting airway edema as the underlying mechanism. This interstitial edema may also lead to nonspecific bronchial hyperresponsiveness. We hypothesized that patients with chronic renal failure may present nonspecific bronchial hyperresponsiveness due to subclinical interstitial pulmonary edema. Methods: We studied 18 chronic renal failure undergoing regular hemodialysis 3 times a week(New York Heart Association Class II) without concomittent disease. These patients were checked pulmonary function test and metacholine provocation test before hemodialysis and same procedure was repeated if responsive, after hemodialysis. Results: 1) 12 out of 18 patients before hemodialysis were reactive in metacholine provocation test(66.7%) before hemodialysis. This airway hyperresponsiveness were decreased after hemodialysis. 2) Pulmonary function was improved after hemodialysis and change in $FEV_1$ was correlated with change in weight(r=-0.62, p<0.01). 3) There was a close correlation between log $PD_{20}$ and $FEF_{25}$, which is one of the variables of the peripheral airways(r=0.58, p<0.05). Conclusion: We speculated interstitial pulmonary edema may play a significant role in bronchial hyperresponsiveness and lung function impaired in patients with chronic renal failure.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• 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.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.45-56
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• 2013

Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant's serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22) based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG) (n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also, ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %), pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4816-4827
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• 2015

The purpose of this study was to identify the experience symptoms and severity of hemodialysis patients and to determine the effects of each symptom on health related quality of life. This research involved 102 patients who were receiving hemodialysis at one university hospital and two Kidney Center in D city. Data collection were collected from April to May 2014. Data analysis was performed by SPSS/WIN 18.0 using ANOVA, t-test, Pearson correlation and stepwise multiple regression. Fatigue was the highest among symptoms on hemodialysis patients and dry skin, itching was in order. Factors affecting health related quality of life were income and symptoms level. These factors explain 42.2% of the variance in health related quality of life. Based on the results, it is necessary to develop various programs and apply for nursing interventions to alleviate the experience symptoms and severity and expand support in social service perspective in hemodialysis patients. Especially, we suggest that further research for developing nursing interventions for relieving fatigue, itching, and sleep disorders of hemodialysis 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.