ABSTRACT
The arterio-venous fistula (AVF) remains the ideal vascular access for patients on maintenance hemodialysis (HD). The aim of this study was to evaluate the complications associated with AVF and was conducted at the Ekbatan Hospital dialysis center in the years 2006 and 2007. In this descriptive cross-sectional study, 90 patients with AVF were enrolled. For each patient, data related to age, gender, time of AVF surgery, duration of renal failure, duration on dialysis, number of fistulas and their sites and, data related to complications of AVF were entered in a check list and analyzed with SPSS software (version :11). Majority of the study patients were in the age-group of 41-60 years and there was a male preponderance (56.7%). The mean duration from the time AVF surgery was performed was 26 +/- 29.8 months, the mean duration of ESRD was 48.1 +/- 45.52 months and the mean duration on dialysis was 28.6 +/- 30.81 months. Most of the patients (75.6%) had undergone AVF surgery only once and in the majority (61.1%), the fistula was in the left arm. The most frequent complication seen in our patients was aneurysm (51%), followed by venous hyper-tension (16.7%), infection (4.4%), thrombosis (3.3%) and arterial steal syndrome (1.1%). Our study indicates that the prevalence of complications of AVF is high and greater attention should be paid to the prevention of these complications. Early diagnosis and appropriate treatment is essential to improve the quality of life in patients on HD.
Subject(s)
Arteriovenous Shunt, Surgical/adverse effects , Kidney Failure, Chronic/therapy , Renal Dialysis , Upper Extremity/blood supply , Adult , Aneurysm/epidemiology , Aneurysm/etiology , Cross-Sectional Studies , Female , Humans , Hypertension/epidemiology , Hypertension/etiology , Hypertension/physiopathology , Iran/epidemiology , Ischemia/epidemiology , Ischemia/etiology , Kidney Failure, Chronic/epidemiology , Male , Middle Aged , Prevalence , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Thrombosis/epidemiology , Thrombosis/etiology , Time Factors , Venous PressureABSTRACT
Inadequacy of dialysis is one of the determinants of morbidity and mortality in patients undergoing dialysis. The aim of this study was to assess the effect of increasing blood flow rate during hemodialysis (HD) on the adequacy of dialysis. In this study, 42 patients on maintenance HD were assessed. Body weight and blood urea nitrogen (BUN) levels before and after HD sessions were recorded on all the study patients. Volume of ultrafiltration, the duration of dialysis, percentage of filter clearance and flow rate of the dialysate were collected and documented in a checklist. Both Kt/V and urea reduction ratio (URR) were determined at two different blood pump speeds, i.e. 200 and 250 mL/min. During HD, hemodynamic status and vital signs of patients were monitored and controlled. After collecting the necessary data, efficiency of dialysis was calculated using the standard formula. Descriptive and analytical statistics was carried out to analyze the data. Using blood flow rate of 200 mL/min, 16.7% of patients had Kt/V higher than 1.3 and URR higher than 65. On the other hand, with flow rate of 250 mL/min, 26.2% of patients had Kt/V higher than 1.3 and 35.7% of subjects had URR higher than 65. Paired t-test with 95% confidence showed a significant difference in dialysis efficiency between two groups. Our data further confirm that increasing the blood flow rate by 25% is effective in increasing dialysis adequacy in HD patients.
Subject(s)
Kidney Failure, Chronic/therapy , Renal Dialysis/methods , Adult , Blood Flow Velocity/physiology , Female , Humans , Kidney Failure, Chronic/mortality , Male , Metabolic Clearance Rate/physiology , Middle Aged , Treatment OutcomeABSTRACT
We carried out a semi-experimental study with simple randomized sampling to study the effects of applying a continuous care model on the quality of life of 36 spouses of haemodialysis patients in Hamedan, Islamic Republic of Iran. Participants took part in group discussions and training on the continuous care approach and completed the Perceived Quality Of Life (PQOL) questionnaire before and after the intervention. Mean scores on the physical, social and cognitive dimensions, as well as happiness and total scores significantly increased after the intervention. Applying a continuous care model has positive effects on the caregivers of chronic patients.
Subject(s)
Caregivers , Continuity of Patient Care/organization & administration , Models, Nursing , Quality of Life/psychology , Renal Dialysis , Spouses , Adult , Attitude to Health , Caregivers/education , Caregivers/psychology , Cost of Illness , Empathy , Female , Humans , Iran , Male , Middle Aged , Nurse-Patient Relations , Nursing Evaluation Research , Patient Care Planning/organization & administration , Professional-Family Relations , Program Evaluation , Regression Analysis , Renal Dialysis/nursing , Renal Dialysis/psychology , Spouses/education , Spouses/psychology , Surveys and QuestionnairesABSTRACT
We carried out a semi-experimental study with simple randomized sampling to study the effects of applying a continuous care model on the quality of life of 36 spouses of haemodialysis patients in Hamedan, Islamic Republic of Iran. Participants took part in group discussions and training on the continuous care approach and completed the Perceived Quality Of Life [PQOL] questionnaire before and after the intervention. Mean scores on the physical, social and cognitive dimensions, as well as happiness and total scores significantly increased after the intervention. Applying a continuous care model has positive effects on the caregivers of chronic patients