• Title/Summary/Keyword: Undergoing the Hemodialysis Therapy

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Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm (의인성 가성낭종 파열에 의한 출혈성 쇽의 비수술적 치료)

  • Kim, Soon Young;Kim, Tae Jun;Na, Seong Kyun;Park, Seung Ah;Jung, Dong Min;Kim, Yong Kyun;Jo, Sang-Ho
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.17-20
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    • 2014
  • Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

Estimating willingness-to-pay for Kremezin in delaying the initiation of dialysis treatments among patients with chronic renal failure (크레메진의 만성신부전증 환자 투석도입 지연효과에 대한 최대지불의사액(willingness-to-pay) 추청)

  • Lee Sun-Mi;Mun Youn-Ok;Cho Woo-Hyun;Lee Hoo-Yeon;Kang Hye-Young
    • Health Policy and Management
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    • v.16 no.2
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    • pp.96-116
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    • 2006
  • To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.

Effect of self awareness of halitosis on the quality of life related to oral health in patients with chronic renal failure (만성신부전증 환자의 자가 구취인식이 구강건강관련 삶의 질에 미치는 영향)

  • Cho, Eun-Suk
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.607-614
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    • 2013
  • This study has been conducted to investigate the effect of self awareness of halitosis on the quality of life related to oral health in patients with chronic renal failure undergoing hemodialysis and use basic data related to oral health of patients with chronic renal failure which is very rare in Korea. In terms of oral symptoms based on awareness of halitosis, there were significant differences in symptoms of teeth pain in the past one month, bleeding gums, symptoms of tongue or cheek pain, dry mouth, In terms of status of oral functions, there were significant differences in discomfort upon chewing foods, difficulty of pronunciation and presence of lost teeth. As the results of analysis of effect of self awareness of halitosis on the quality of life related to oral health in patients with chronic renal failure, it was shown that there were significant effects in psychological discomfort(B=-2.028, p<.01), poor social skills(B=2.596, p<.01) and social disadvantage(B=-2.173, p<.01). Thus, because self awareness of halitosis gives psychologically and socially negative effects, it could be an important factor to patients with renal failure whose number is rapidly increasing.

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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    • v.56 no.4
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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.