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Dialysis adherence

Matthieu Parmier, Bénédicte Gourieux, Thierry Krummel, Dorothée Bazin-Kara, Anne Dory, Thierry Hannedouche
The treatment of end-stage renal disease requires a significant number of drug treatments. At patient level, daily management is somewhat difficult: Number of prescribed pills, medication side effects, treatment of asymptomatic diseases… The objective of the study was to investigate the effect of guidance tailored to each patient receiving hemodialysis, performed by the pharmacist (educational interventions). Adult haemodialysis patients with hyperphosphatemia despite phosphate binders were eligible for study entry...
October 21, 2016: Néphrologie & Thérapeutique
Michael Copland, Paul Komenda, Eric D Weinhandl, Peter A McCullough, Jose A Morfin
Mineral and bone disorder is a common complication of end-stage renal disease. Notably, hyperphosphatemia likely promotes calcification of the myocardium, valves, and arteries. Hyperphosphatemia is associated with higher risk for cardiovascular mortality and morbidity along a gradient beginning at 5.0mg/dL. Among contemporary hemodialysis (HD) patients, mean serum phosphorus level is 5.2mg/dL, although 25% of patients have serum phosphorus levels of 5.5 to 6.9mg/dL; and 13%, >7.0mg/dL. Treatment of hyperphosphatemia is burdensome...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Verónica Poveda, Leonilde Amado, Madalena Filgueiras, Laetitia Teixeira, Vasco Miranda, Alice Santos-Silva, Constança Paúl, Elísio Costa
Non-adherence to medical plans is recognized as an important problem in dialysis patients, since it has been associated with increased morbidity and mortality, resulting in disproportionately high costs of care. The success of renal replacement therapy depends on the adherence of patients to the different aspects of the therapeutic strategy, which includes a complex drug regimen involving a wide variety of drugs and doses, several prescribed dialysis sessions with different durations, dietetic recommendations and restriction of fluid intake...
October 20, 2016: Renal Failure
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
A Illés, B Nemes, L Zsom, S Kovács, A Bugán
OBJECTIVE: The aim of this work was the exploration of chronic renal insufficiency patients' attitudes toward treatment, various motifs underlying their acceptance or refusal of kidney therapy, and understanding of their psychologic content. Examinations were carried out of chronic renal insufficiency patients' attitudes toward renal treatments, and a questionnaire suitable for its assessment was developed. METHODS: Suppositions of patients before and after renal transplantation were explored by means of semistructured interviews...
September 2016: Transplantation Proceedings
Timothy K Fung, Yu Leung Ng, Man Fai Lam, Kelvin K W Lee
♦ Background: Nonadherence to hand hygiene and aseptic regimen, dialysis environment guidelines, and catheter and exit-site care guidelines are risk factors of peritonitis. However, little is known about the psychosocial factors that account for the nonadherent behavior of patients undergoing peritoneal dialysis (PD). Applying the health belief model, this study seeks to enhance the understanding of psychosocial influences on patients' nonadherent behavior to the 3 regimen components. ♦ Methods: Through referrals by 7 Hong Kong renal patient support groups, we surveyed patients undergoing PD treatment...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
Suman Chandra Nath, Eiji Nagamori, Masanobu Horie, Masahiro Kino-Oka
Human induced pluripotent stem cells (hiPSCs) secrete essential autocrine factors that are removed along with toxic metabolites when the growth medium is exchanged daily. In this study, after determining the minimum inhibitory level of lactic acid for hiPSCs, a medium refining system was constructed by which toxic metabolites were removed from used culture medium and autocrine factors as well as other growth factors were recycled. Specifically, about 87 % of the basic fibroblast growth factor and 80 % of transforming growth factor beta 1 were retained in the refined medium after dialysis...
September 16, 2016: Bioprocess and Biosystems Engineering
Anne Rebafka
BACKGROUND: Whether or not patients follow the advice given by their healthcare professional is commonly referred to as adherence. In the case of kidney transplantation, transplant recipients need to take immunosuppressive drugs on a regular basis to prevent rejection of their transplant. However, medication adherence can be problematic for many patients. OBJECTIVES: This critical appraisal of evidence aimed to gain insights into factors contributing to adherence and non-adherence in recipients of kidney transplants, and to explore patients' perceptions regarding adherence to immunosuppression...
September 15, 2016: Journal of Renal Care
Paulo César Brandão Veiga Jardim, Weimar Kunz Sebba Barroso de Souza, Renato Delascio Lopes, Andréa Araújo Brandão, Marcus V Bolívar Malachias, Marco Mota Gomes, Heitor Moreno Júnior, Eduardo Costa Duarte Barbosa, Rui Manoel Dos Santos Póvoa
BACKGROUND: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. OBJECTIVE: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment...
August 2016: Arquivos Brasileiros de Cardiologia
Diana Jalal, Molly McFadden, Jamie P Dwyer, Kausik Umanath, Erwin Aguilar, Yoram Yagil, Barbara Greco, Mohammed Sika, Julia B Lewis, Tom Greene, Simin Goral
Introduction Oral phosphate binders are the main stay of treatment of hyperphosphatemia. Adherence rates to ferric citrate, a recently approved phosphate binder, are unknown. Methods We conducted a post-hoc analysis to evaluate whether adherence rates were different for ferric citrate vs. active control in 412 subjects with end stage kidney disease (ESKD) who were randomized to ferric citrate vs. active control (sevelamer carbonate and/or calcium acetate). Adherence was defined as percent of actual number of pills taken to total number of pills prescribed...
September 12, 2016: Hemodialysis International
Simon R Knowles, Chantal F Ski, Robyn Langham, Emmet O'Flaherty, David R Thompson, Susan L Rossell, Gaye Moore, Ya-Seng Arthur Hsueh, David J Castle
BACKGROUND: Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis...
2016: Trials
Stephanie Thompson, Scott Klarenbach, Anita Molzahn, Anita Lloyd, Iwona Gabrys, Mark Haykowsky, Marcello Tonelli
OBJECTIVES: For people with end-stage renal disease requiring haemodialysis, exercise can improve aspects of quality of life (QoL). However, the relative benefits and risks of different types of exercise in this population are unknown. Therefore, this pilot study aimed to evaluate the feasibility of a main study evaluating the efficacy of cycling and resistance exercise each performed during the haemodialysis treatment on QoL. METHODS: In this factorial (2×2) pilot trial, 31 haemodialysis patients were randomised to cycling, resistance, cycling and resistance, or an attention control...
2016: BMJ Open
Sneha Sehwag, Madhusweta Das
Whole jamun based functional confection (WJFC) was developed from an optimized blend (through response surface methodology) containing 26.585 % paste of jamun pulp with adhering skin, 2 % jamun seed powder, hydrocolloid mixture (2.289 % agar, 1.890 % pectin and 27.236 % polydextrose), antimicrobials (0.022 % benzoic acid and 0.085 % sorbic acid), and 40 % added water. The confection also contained 0.08 % sucralose, 0.06 % citric acid and 100 mg CaCl2.2H2O/g pectin. The confection was found to be rich in minerals like Ca, Mg, K, Na and P, with prebiotic activity and low glycemic index (48...
June 2016: Journal of Food Science and Technology
Joanna L Hudson, Rona Moss-Morris, David Game, Amy Carroll, Joseph Chilcot
BACKGROUND: There is significant psychological distress in adults with end-stage kidney disease (ESKD). However, psychological treatments tailored to address the unique challenges of kidney failure are absent. We identified psychological correlates of distress in ESKD to develop a cognitive-behavioural therapy (CBT) treatment protocol that integrates the mental health needs of patients alongside their illness self-management demands. METHODS: Studies which examined relationships between distress and psychological factors that apply in the context of ESKD including: health threats, cognitive illness representations and illness management behaviours were narratively reviewed...
July 26, 2016: Journal of Renal Care
Shaimaa A Senosy, Ekram M El Shabrawy
BACKGROUND: The prevalence of HCV infection among hemodialysis patients (HD) varies from country to country and from one center to another. Despite the existence of guidelines for a comprehensive infection control program, Egypt is one of the countries with high HCV prevalence. In Egypt, the prevalence of HCV in haemadalysis patients (2015) was 50.7%. OBJECTIVES: (1) To detect the prevalence of hepatitis C virus (HCV) infection and HCV seroconversion among all hemodialysis patients in Beni-Suef governorate, and (2) To detect factors associated with HCV seroconversion...
June 2016: Journal of the Egyptian Public Health Association
Rita M Heeb
Phosphate binders to treat hyperphosphataemia are part of the medication regime of every dialysis patient. Phosphate binders are taken with every meal (three times a day). Generally, the medication adherence rates of phosphate binders are very low. This is due to inconveniences like their bad taste or their size which makes them hard to swallow. Also nephrologists have differing opinions on phosphate binders as they are aware of the dialysis patients' difficulties to deal with the amount of drugs they are prescribed...
June 2016: Medizinische Monatsschrift Für Pharmazeuten
Julie Y Chen, Eric Y F Wan, Karina H Y Chan, Anca K C Chan, Frank W K Chan, Cindy L K Lam
BACKGROUND: Haemodialysis (HD) is one of the life-saving options for patients with end stage renal disease but demand for this treatment exceeds capacity in publicly funded hospitals. One novel approach to addressing this problem is through a shared-care model whereby government hospitals partner with qualified private HD service providers to increase the accessibility of HD for needy patients. The aim of this study is to evaluate and enhance the quality of care (QOC) provided in such a shared-care programme in Hong Kong, the Haemodialysis Public-Private Partnership Programme (HD-PPP)...
2016: BMC Nephrology
Denis Fouque, Jing Chen, Wei Chen, Liliana Garneata, S J Hwang, Kamyar Kalantar-Zadeh, Joel D Kopple, William E Mitch, Giorgina Piccoli, Vladimir Teplan, Philippe Chauveau
BACKGROUND: Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis. METHODS: We reviewed the recent literature addressing low protein diets supplemented with ketoacids/essential aminoacids prescribed during chronic kidney disease and their effects on metabolic, nutritional and renal parameters since 2013. RESULTS: We show new information on how to improve adherence to these diets, on metabolic improvement and delay of the dialysis needs, and preliminary data in chronic kidney disease associated pregnancy...
July 7, 2016: BMC Nephrology
Jule Pinter, Camilla S Hanson, Jonathan C Craig, Jeremy R Chapman, Klemens Budde, Fabian Halleck, Allison Tong
BACKGROUND: Kidney transplantation offers improved survival and quality of life to an increasing number of elderly patients with end-stage kidney disease. However, elderly kidney transplant recipients may face unique challenges due to a higher burden of comorbidity, greater cumulative risk of immunosuppression-related complications and increasing frailty. We aimed to describe the perspectives of elderly kidney transplant recipients. METHODS: Electronic databases were searched to April 2015...
September 2016: Nephrology, Dialysis, Transplantation
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