• 성인간호학회지
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• 제12권4호
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• pp.706-716
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• 2000

The purpose of this study was to provide fundamental data for nursing intervention by assessing self-esteem and quality of life(QL) in patients on hemodialysis and peritoneal dialysis. The subjects of this study were 60 patients on hemodialysis at H university medical center in Seoul and 56 patients on peritoneal dialysis at B company. The analysis was done by using t-test, ANOVA, Scheffe and Stepwise multiple regression. The results were as follows: 1. The average self-esteem score was significantly higher in patients on hemodialysis (27.98) than in patients on peritoneal dialysis (25.64). And there were no statistically significant differences between patients on hemodialysis(128.45) and patients on peritoneal dialysis(122.83) in the scores on QL. Among four factors of QL, hemodiaysis patients showed higher score than peritoneal dialysis patients in all factors. But, only family had statiscally significant differences. Also family showed the highest score in both groups, but psychomental showed the lowest score. 2. In patients on hemodialysis, self-esteem was significantly different by occupation(t=3.122, p=.003) and in patients on peritoneal dialysis by age(F=4.450, p=.007), education level(F=7.458, p=.001) and occupation (t=2.491, p=.017). Also in patients on hemodialysis, QL was significantly different by occupation(t=2.223, p=.033) and in patients on peritoneal dialysis by education level(F=4.007, p=.024), and occupation (t=2.806, p=.007). 3. Self-esteem accounted for 36.3% of variance in QL and monthly income accounted for an additional 6.1% of QL in hemodialysis patients by means of stepwise multiple regression analysis. In peritoneal patients, self-esteem accounted for 65.1% and monthly income accounted for an additional 2.7% in QL.

• 성인간호학회지
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• 제13권3호
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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.

• Clinical and Experimental Pediatrics
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• 제52권10호
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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.

• 한국임상약학회지
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• 제22권3호
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• pp.202-210
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• 2012

Methoxy polyethylene glycol-epoetin beta (MPG-EPO), a continuous erythropoietin receptor activator, is a new erythropoiesis-stimulating agent with a long half-life. The purpose of this prospective study is to assess the effects of once-monthly subcutaneous MPG-EPO on hematological responses and nutritional status in peritoneal dialysis patients. Forty four patients undergoing stable peritoneal dialysis were enrolled into the study. Darbepoetin alfa therapy, in peritoneal dialysis patients, was converted to the monthly administration of subcutaneous MPG-EPO for 6 months. The starting dose of MPG-EPO was based on the previous weekly dose of darbepoetin alfa. The dose adjustments were performed to maintain the hemoglobin (Hb) levels in a target range of 10.5-11.0 g/dL. If the Hb levels exceeded 11.0 g/dL, MPG-EPO was temporarily interrupted for 1 month. The mean Hb levels were stable with the values of $9.5{\pm}1.1$ g/dL at baseline, and $10.4{\pm}0.9$ g/dL at the 6th month after conversion. The mean differences in the changes of Hb levels between the baseline and the 6th month were $0.9{\pm}1.4$ g/dL, which was statistically significant. However, the mean differences of iron, transferrin saturation and ferritin concentrations were not significant. It did not show significant differences in the changes of the nutritional parameters. These results suggest that the once-monthly subcutaneous administration of MPG-EPO for 6 months effectively maintains the Hb levels and nutritional status in peritoneal dialysis patients. Taken together, the once-monthly subcutaneous administration of MPG-EPO was practical and might improve the clinical compliance for the management of renal anemia in peritoneal dialysis patients.

• 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.

• 한국산학기술학회논문지
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• 제21권11호
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• pp.364-374
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• 2020

본 연구의 목적은 말기신부전증으로 복막투석을 받는 환자의 식이적응 경험의 의미와 구조를 규명하고 기술하는 것이다. 연구 방법으로 Colaizzi의 현상학적 연구방법을 적용한 질적 연구로서, 자료는 G광역시 일개 대학병원을 다니고 있는 복막투석 6개월 이상 된 9명의 환자를 대상으로 심층면담을 통해 수집되었다. 자료 분석을 위해 모든 면담은 녹취되고 필사되었고, Colaizzi의 현상학적 방법을 이용하여 분석하였다. 본 연구결과, 복막투석환자의 식이적응 경험은 네개의 주제모음과 15개의 주제로 구조화되었다. 네 개의 주제모음은 '복막투석과 식이적응의 이중적 고통', '막막하고 답답한 식이조절', '체험하면서 느끼게 된 식이조절의 고됨', '투석과 식이조절 병행의 중요성을 깨닫고 삶의 목표 재설정'이었다. 결론적으로 본 연구를 통해 복막투석환자들이 겪는 현실적인 식이적응과정은 복막투석과 식이요법적응의 이중적 고통으로 삶이 고되었지만, 순응하고 더 나은 삶을 위해 나아가는 과정이었다. 이를 바탕으로 복막투석환자 식이적응의 어려움에 대해 깊이 있게 이해하고, 식이관련 맞춤형 중재연구 개발에 필요한 기초자료로 활용하고자 한다.

• Childhood Kidney Diseases
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• 제25권2호
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• pp.117-121
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• 2021

Chronic kidney disease (CKD)-mineral and bone disorder (CKD-MBD) is a common complication of CKD, often accompanied by extra-skeletal calcification in adult patients. As increased vascular calcification is predicted to increase cardiovascular mortality and morbidity, the revised Kidney Disease: Improving Global Outcomes guidelines recommend avoiding calcium-containing phosphate chelators. However, extra-skeletal calcification is less commonly noticed in pediatric patients. Here, we report our experience of such a complication in pediatric patients receiving maintenance peritoneal dialysis. Extra-skeletal calcification was noticed at the corneas, pelvic cavity, and soft tissues of the lower leg in 4 out of 32 patients on maintenance peritoneal dialysis. These patients experienced the aggravation of extra-skeletal calcifications during peritoneal dialysis, and 2 of them underwent excisional operations. It is required to monitor extra-skeletal calcifications in children on kidney replacement therapy.

• 대한전해질대사연구회지
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• 제16권2호
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• pp.27-29
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• 2018

Peritoneal dialysis (PD)-related peritonitis is a major cause of injury and technique failure in patients undergoing PD. Aeromonas hydrophila is ubiquitous in the environment, and is a Gram-negative rod associated with infections in fish and amphibians in most cases; however, it can also cause opportunistic infections in immunocompromised patients. We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device. Although Set Plus is disposable, the patient reused the product by cleansing with tap water. He was successfully treated with intraperitoneally-administered ceftazidime and has been well without recurrence for more than 2 years.

• Journal of Nutrition and Health
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• 제45권1호
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• pp.30-43
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• 2012

Patients undergoing peritoneal dialysis are at risk for protein-energy malnutrition because of nutrient losses during dialysis. This study determined the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Forty-four patients receiving CAPD were divided into two groups according to dialysis period. We investigated the nutritional status of the patients by measuring anthropometric and biochemical parameters, as well as food intake, self-appetite, dietary habits, a subjective global assessment, and a total nutritional status assessment. Group I subjects (7 males, 13 females) had received dialysis for < 2 years, whereas the group II subjects (18 males, 6 females) received dialysis for ${\geq}$ 2 years. Energy intake with added dextrose in the dialysate per kg of body weight was $30.3{\pm}5.8$ kcal in group I and $29.0{\pm}8.1$ kcal in group II. The average protein intake per kg of weight was $1.0{\pm}0.3$ g in group I and $1.0{\pm}0.4$ g in group II, which were less than the recommended protein intake for patients undergoing CAPD (1.2-1.5 g/kg). Mean serum albumin level was significantly lower in group II than that in group I (p < 0.05). A recent self-appetite score was significantly higher in group II than that in group I (p < 0.01). The dietary habits score was significantly lower in group II than that in group I (p < 0.05). The subjective global assessment was significantly higher in group I (85.0%) than that in group II (54.2%) under normal nutrition status (p < 0.05). The dialysis period was significantly and negatively correlated with the subjective global assessment (r = -0.502, p < 0.01) and the total nutritional status assessment (r = -0.575, p < 0.01). These results demonstrated that patients undergoing CAPD for ${\geq}$ 2 years had worse nutritional status than those who had been undergoing dialysis for < 2 years. Good nutritional status can predict the long-term survival of patients undergoing peritoneal dialysis. Additionally, the exact evaluation of nutritional status before 2 years will be important to maintain long-term dialysis therapy in patients undergoing CAPD.

• 기본간호학회지
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• 제25권3호
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• pp.220-230
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• 2018

Purpose: This study was a cross-sectional study comparing differences in self-management knowledge, self-management, physiologic indexes, and symptoms experience for two methods of dialysis. Methods: Participants were 90 patients on hemodialysis and 91 on peritoneal dialysis at A hospital. Results: There was no significant difference between the two groups for knowledge of self-management. A comparison of the categories in the evaluation of self-management showed that patients in the peritoneal dialysis group took better care of their dialysis access route (F=17.61, p<.001) and dialysis schedule (F=4.30, p=.040). The physiologic indexes between the two dialysis groups showed that hemoglobin levels were higher in the hemodialysis group (F=5.28, p=.023). The product of serum calcium and phosphate was higher in the peritoneal dialysis group (F=11.42, p=.001). Serum sodium level was also higher in the peritoneal dialysis group (t=5.36, p<.001) while serum albumin level (t=-3.36, p=.001) and mean arterial blood pressure (t=-2.50, p=.013) were higher in hemodialysis patients. There were no significant differences in the proportion of uncomfortable experiences between the two groups. Conclusion: Medical personnel should consider differences in self-management knowledge/self-management, physiologic indexes, and symptoms experience for hemodialysis and peritoneal dialysis populations, and should provide adequate education accordingly and promote behavioral change to improve physiologic indexes and reduce symptoms.