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Background: muscle mass (MM) plays an important role in the physical function of hemodialysis patients; however, muscle mass measurement can be unreliable and expensive. In contrast, the measurement of physical function (PF) is simple and inexpensive and may serve as an alternative. The aim of this study was to correlate the measurement of MM by computed tomography (CT) with physical function measurements and physical activity (PA) levels in HD patients. Methods: this was a cross-sectional study that included 38 HD patients from a single HD clinic. Each participant had a CT scan to measure mid-thigh muscle mass. Physical function tests were assessed using the six-minute walk test (SMWT), handgrip strength (HGS) test, 5 x sit-tostand test (STS5), timed up and go test (TUGT) and Short Physical Performance Battery (SPPB), while physical activity levels were measured using the Godin-Shephard leisure-time physical activity questionnaire. Correlation analysis was used to examine the relationship between variables. Results: handgrip strength was strongly positively correlated with thigh muscle area (r = 0.656, p ≤ 0.001) and weakly correlated with arm muscle area (r = 0.396, p = 0.002), SMWT (r = 0.373, p = 0.004), SPPB (r = 0.269, p = 0.041) and physical activity (r = 0.323, p = 0.013). There was also a trend for an inverse correlation between handgrip strenght and TUGT (r = -0.235, p = 0.076). Positive correlations were found between the thigh muscle area and the SPPB (r = 0.339, p = 0.009) and PA (r = 0.293, p = 0.025), while there was a trend for an inverse correlation between thigh muscle area and STS5 (r = -0.256, p = 0.052). Conclusion: several measures of PF and strenght were correlated with objectives measurements of MM, thus provide options for low-cost measurements related to muscle mass. [ABSTRACT FROM AUTHOR]

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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Enfermería is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Despite the recommendations of the clinical guidelines, the percentage of central venous catheters (CVC) continues to be above the recommended standards. We do not know whether the increasing use of catheters is due to unavoidable or avoidable factors and, in the latter case, it would be in our power to modify these results.The aim of this study was to analyze the causes that condition the use of CVC in a prevalent hemodialysis (HD) population in order to identify those modifiable factors on which to act in order to achieve the objectives of the guidelines. Methods: Retrospective, descriptive and observational study in all prevalent patients on chronic hemodialysis belonging to 7 hemodialysis centers in Madrid, Castilla-León and Galicia in a cross-sectional study carried out in June 2021 (637 patients). The following were analyzed: age, sex, nationality, etiology of CKD, the vascular access with which they started hemodialysis, the number of previous failed arteriovenous fistulas (AVF), time since the start of HD, time since the placement of the CVC for the first time, the situation with respect to surgery and the causes of being a CVC carrier. In patients whose cause was refusal to undergo AVF, patients were asked about the cause of the refusal by directed questioning. Results: Of the 637 patients studied, 255 (40%) had a CVC, 346 had an AVF (54.3%) and 36 (5.7%) had a prosthesis. Of the 255 patients with CVC, 20.4% (52 p) were awaiting vascular access (AVF/prosthesis), 10.2% (26 p) had an AVF but could not be used and 69.4% (177 p) were not considered candidates for surgery (due to vascular surgery (16.9%; 43 pac), nephrology (16.5%, 42 pac) and patient refusal (36%; 92 pac). The most frequent cause for refusal of AVF was fear and patient preference. One of the most important factors associated with CVC use in prevalent patients was having started hemodialysis with a CVC. The greatest use of CVC at the start of HD was significantly associated with having more than one AVF performed, or starting HD urgently and not having been followed up and evaluated in the ACKD consultation. Conclusions: There is a high percentage of patients with a central venous catheter due to modifiable causes, which makes it necessary to systematically evaluate the process of creating AVF in order to enhance the planning, creation and maintenance of vascular access from the ACKD clinic, and to achieve the objective of the guidelines. Resumen: Introducción: A pesar de las recomendaciones de las guías clínicas, el porcentaje de catéteres venosos centrales (CVC) sigue estando por encima de los estándares recomendados. Desconocemos si la utilización creciente de catéteres tiene su origen en factores inevitables o evitables y, en este último caso, estaría en nuestra mano modificar estos resultados.El objetivo de este estudio ha sido analizar las causas que condicionan el uso de CVC en una población prevalente en hemodiálisis (HD)con el fin de identificar aquellos factores modificables sobre los que actuar para conseguir los objetivos de las guías. Métodos: Estudio retrospectivo, descriptivo y observacional en el total de pacientes prevalentes en hemodiálisis crónica pertenecientes a 7 centros de hemodiálisis extrahospitalarios de Madrid, Castilla-León y Galicia en un corte transversal realizado en junio 2021 (637 pacientes). Se analizan: edad, sexo, nacionalidad, etiología de la ERC, el acceso vascular con el que iniciaron hemodiálisis, el número de Fístulas arteriovenosas (FAV) previas fallidas, tiempo desde el inicio de la HD, tiempo desde la colocación del CVC por primera vez, la situación respecto a la cirugía y las causas de ser portador de CVC. En los pacientes cuya causa fue la negativa a realizarse una FAV se preguntó a los pacientes por la causa de la misma mediante interrogatorio dirigido. Resultados: De los 637 pacientes estudiados, 255 (40%) eran portadores de CVC, 346 portadores de FAV (54,3%) y 36 (5,7%) llevaban una prótesis. De los 255 pacientes portadores de CVC, el 20,4% ( 52 p) estaba pendiente de realización del acceso vascular (FAV/ prótesis), un 10,2% (26 p) tenían la FAV realizada pero no se podía utilizar y un 69,4% (177 p) no se consideraron candidatos a cirugía (por cirugía vascular (16,9%; 43 pac), por nefrología (16,5%, 42 pac) y por negativa del paciente(36%; 92 pac). La causa más frecuente para la negativa a la FAV fue el miedo y las preferencias de los pacientes. Uno de los factores más importantes asociados al uso de CVC en pacientes prevalentes fue haber iniciado hemodiálisis mediante un CVC. El mayor uso de CVC al inicio de HD se asoció significativamente con tener más de una FAV realizada, o iniciar HD de manera urgente y no haber sido seguido y evaluado en la consulta de ERCA. Conclusiones: Existe un elevado porcentaje de pacientes con catéter venoso central por causas modificables que hace necesaria la evaluación sistemática del proceso de creación de FAV para potenciar la planificación, creación y mantenimiento del acceso vascular desde la consulta de ERCA, y alcanzar el objetivo de las guías.

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Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La diabetes mellitus se mantiene como una de las causas más prevalentes de enfermedad renal crónica, la cual, en su último estadio se hace subsidiaria de un tratamiento renal sustitutivo, como la hemodiálisis. Los problemas vasculares derivados de la diabetes unidos a complicaciones propias de la hemodiálisis pueden crear en estos pacientes nuevos problemas de salud, entre los que destaca el pie diabético. Objetivo: Conocer y sintetizar la evidencia científica existente sobre los factores de riesgo y los cuidados de enfermería del pie diabético en los pacientes en hemodiálisis. Material y Método: Se llevó a cabo una revisión integrativa siguiendo las recomendaciones de la declaración PRISMA, en las bases de datos WOS, Pubmed y SCOPUS, empleando los descriptores DESC/MESH: ‘’Diabetic Foot’’, ‘’Foot ulcer’’, ‘’Hemodialysis’’, ‘’Amputation’’. Se incluyeron artículos con menos de 10 de antigüedad, en inglés y español. Resultados: Se incluyeron 10 artículos (2 revisiones sistemáticas, 1 guía de práctica clínica y 7 estudios observacionales). Como principales variables emergieron la incidencia, morbilidad y mortalidad del pie diabético, los factores de riesgo asociados, y la prevención y cuidados de enfermería del mismo. Conclusiones: En los pacientes en hemodiálisis el pie diabético supone un aumento de la morbilidad y mortalidad, con gran impacto negativo en su calidad de vida. La enfermedad arterial periférica, mala salud de los pies y conocimientos escasos sobre el tema, son factores desencadenantes de problemas en los pies de estos pacientes. Por tanto, es fundamental fomentar la prevención y promover el autocuidado por parte de los pacientes.

Objetivo: Analizar las prácticas enfermeras en hemodiálisis, a nivel nacional, en relación a la fijación de las agujas de punción de las fístulas arteriovenosas. Material y Método: Estudio descriptivo transversal, realizado en abril-mayo 2024, mediante cuestionario online, dirigido a enfermeras de hemodiálisis de toda España. Variables recogidas: sociodemográficas, tipo de centro, factores relacionados con la salida de agujas, material/técnicas de fijación y conocimiento sobre recomendaciones. Resultados: Participaron 363 enfermeras, 83,5% mujeres, edad media: 44,09±10,7años, experiencia media: 15,18±10,94 años; un 72,7% trabajaban en centros públicos. Según los encuestados, los factores que más influyen en la salida de agujas son “Estado de la piel del paciente”(96,7%) y “Técnica de fijación”(93,9%); siendo los menos influyentes “Tener un Sistema de evaluación del riesgo”(53,4%) y “Tipo de dispositivo de punción”(51%). El 35,4% empleaban técnicas de fijación Chevron y Mariposa; siendo un 55,1% si consideramos también Método-U/Método-H. El material de fijación más utilizado fue el esparadrapo de papel (75,3%), considerándolo un 57,7 % como el más seguro. El 66,7% desconocían la existencia de documentos publicados con recomendaciones y un 65,4% no disponían en sus unidades de protocolos que recogieran estos aspectos. Los profesionales que trabajan en centros concertados/privados disponen de protocolos para fijación de agujas(p

Introducción: La enfermedad renal crónica se sitúa entre las diez primeras causas de muerte en España, siendo una patología infradiagnosticada. La enfermedad renal y el cáncer tienen una asociación multifactorial y bidireccional. La Kidney Disease Improving Global Outcomes, estima una incidencia de neoplasias del 12-25%. La Sociedad Española de Nefrología ha puesto en marcha un grupo de trabajo multidisciplinar denominado Onconefrología con el objetivo de dar mejor respuesta a las necesidades de estas personas. Objetivo: Determinar la incidencia y prevalencia de neoplasias en personas en hemodiálisis, así como describir los tipos de cáncer más comúnmente diagnosticados y las variables relacionadas. Material y Método: Estudio de cohortes retrospectivo y unicéntrico de enero 2021-diciembre 2023, en una Unidad de Hemodiálisis. Se recogieron datos sociodemográficos y clínicos de una base de datos específica de nefrología y de la historia clínica. Resultados: Se detectaron 30 pacientes con algún tipo de neoplasia; prevalencia 31% e incidencia del 17% (83% hombres, edad media 73±11 años). El 73% dislipémicos, 50% diabéticos, 93% hipertensos, 73% enfermedad cardiovascular, Índice de Charlson 9,9±2,6 puntos, 30% obesos y 50% fumadores. Etiología de enfermedad renal: derivada del tumor (27%) y nefropatía diabética (17%). Un 7% tuvo trasplante previo. Neoplasias más comunes: 40% genitourinarias-20% hematológicas. Un 27% presentó más de un tumor. Tratamiento oncológico: 33% médico-quirúrgico y 33% quimioterapia-inmunoterapia. La mortalidad fue superior en los oncológicos (40%). Conclusiones: Se encontró una alta incidencia y prevalencia de neoplasias y una elevada mortalidad. Los resultados deben ser confirmados con estudios prospectivos.

Introducción: El rol de la enfermera en hemodiálisis cobra importancia ante el incremento de esta terapia en las personas con enfermedad renal crónica, porque sus cuidados mejoran la calidad de vida y seguridad de los pacientes. Objetivo: Determinar la percepción de los pacientes con terapia de hemodiálisis respecto al rol de enfermería en el norte de Perú. Material y Método: Estudio de diseño descriptivo y corte transversal. La población estuvo conformada por 85 pacientes de un centro de hemodiálisis en Perú. Para la recolección de datos se utilizó como técnica la encuesta y como instrumento un cuestionario de 17 ítems, tuvo validez de juicio de expertos y una confiabilidad de alfa de Cronbach de 0,8. Resultados: Se obtuvieron 85 cuestionarios, con un índice de rechazo

Introducción: El fallo primario incluye la trombosis precoz y los fallos de maduración. Objetivos: Determinar los factores de riesgo asociados al fallo primario de fístulas nativas y su relación con la supervivencia. Analizar las diferencias ecográficas entre fístulas maduras y fístulas con fallos de maduración. Material y Método: Estudio observacional y retrospectivo. Variables: sociodemográficas, antropométricas, comorbilidades, parámetros sanguíneos y ecográficos. Análisis estadístico: Descriptivo. Regresión logística. Método de Kaplan-Meier. Resultados: Muestra 65 fístulas nativas, 72,3% hombres. Edad 69,7 años. 60% fístulas maduras y 40% fístulas con fallo primario (20% fallo de maduración y 20% trombosis precoz). Factores de riesgo de fallos maduración: diámetros arteriales

Background and objective: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters. Materials and methods: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods. Results: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008). Conclusions: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results. Resumen: Antecedentes y objetivo: La activación del paciente es un concepto que se refiere a la voluntad de gestionar su salud y atención médica. Para evaluarla, se ha desarrollado y validado una medida de activación del paciente (PAM). Diversos estudios informan baja activación en pacientes con enfermedades crónicas. No obstante, la información sobre activación de pacientes en tratamiento con hemodiálisis es escasa. El objetivo del presente estudio es describir el nivel de activación de pacientes en tratamiento crónico de una unidad de HD y su relación con los parámetros de control de la enfermedad. Materiales y métodos: Estudio observacional transversal en pacientes con enfermedad renal crónica avanzada en tratamiento crónico con HD. Se incluyeron 96 pacientes. La activación se midió con el cuestionario PAM-13. Se estudió su relación con variables descriptivas (edad, sexo, comorbilidad, estudios, hábitat) y variables de control de la enfermedad (acceso vascular, flujo sangre, potasemia, fosfatemia, ganancia interdialítica). Para ello se emplearon como métodos estadísticos la prueba de correlación de Spearman, modelo de regresión lineal múltiple y modelo logístico. Resultados: La puntuación media (SD) de PAM-13 fue 63.19 (15.21). La activación se asociaba significativamente con el acceso vascular (P = 0.003), flujo de sangre (P = 0.024), y ganancia interdialítica de los pacientes (P = 0.008). Conclusiones: La activación de pacientes en tratamiento crónico con hemodiálisis es baja. Una mayor activación se relaciona con disponer de fístula arteriovenosa, con mayor flujo sanguíneo y con menor ganancia interdialítica. Son necesarios futuros estudios que confirmen y apliquen nuestros resultados.

Introduction: Changes in plasma sodium concentration (pNa, expressed in mEq/L) are common in hemodialysis (HD) patients. Hemodialysis monitors can estimate pNa by using an internal algorithm based on ion dialysance measurements. The present study studies the accuracy of the correlation between the pNa estimated by the dialysis monitor and that measured by the biochemistry laboratory at our center. Material and methods: A single-centre prospective observational study in patients on a chronic HD program with the 6008 CAREsystem monitor and standard sodium (138 mmol/L) and bicarbonate (32 mmol/L) prescriptions. Venous blood samples were drawn from each patient before and after each HD session to ensure inter- and intra-individual validity. The pNa was measured in the biochemistry laboratory using indirect potentiometry and simultaneously the estimated pNa by the HD monitor was recorded at the beginning and at the end of the HD session. For statistical analysis, a scatterplot was made, and Spearman’s correlation quotient was calculated. In addition, the differences between both methods were represented as Bland-Altman diagrams. Results: The pre-dialysis pNa measured in the laboratory was 137.49 ± 3.3, and that of the monitor, 137.96 ± 2.91, with a correlation with R2 value of 0.683 (p

Latar belakang. Mortalitas anak dengan penyakit ginjal kronik paling sering disebabkan oleh komplikasi kardiovaskular yang dapat terjadi sejak stadium awal penyakit. Pada anak yang menjalani hemodialisis, banyak faktor untuk terjadinya disfungsi kardiovaskular, seperti kadar hemoglobin, laju ultrafiltrasi yang tinggi dan derajat kelebihan cairan. Teknik ekokardiografi dua dimensi dengan speckle tracking echocardiography merupakan metode yang sensitif untuk menilai penurunan fungsi jantung pada stadium awal. Di Indonesia, saat ini penelitian metode tersebut belum banyak dilakukan pada anak dengan penyakit ginjal kronik yang menjalani hemodialisis. Tujuan. Untuk mengetahui sensitivitas dan spesifisitas speckle-tracking echocardiography dalam mendeteksi disfungsi jantung subklinis pada anak dengan penyakit ginjal kronik yang menjalani hemodialisis. Metode. Penelitian potong lintang dilakukan terhadap 33 pasien hemodialisis anak di Unit Dialisis Pediatrik Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Data demografis dan klinis diperoleh dari rekam medik elektronik. Penilaian dan interpretasi ekokradiografi dilakukan oleh dokter kardiologi anak. Hasil. Hampir sebagian besar subyek memiliki disfungsi jantung subklinis dengan pemeriksaan global longitudinal strain speckle-tracking echocardiography. Sensitivitas dan spesifisitas sebesar 90% dan 70%. Kesimpulan. Pemeriksaan global longitudinal strain speckle-tracking echocardiography memiliki sensitivitas yang baik dalam mendeteksi disfungsi jantung subklinis pada anak yang menjalani hemodialisis.

Hemodialisis (HD) adalah pilihan utama dalam perawatan pada pasien penyakit ginjal kronis (PGK). Sejak menjalani HD pasien biasanya mengalami dua kanulasi di fistula mereka dua kali per minggu dan mengalami nyeri jarum setidaknya 192 kali setahun. Nyeri pada pemasangan arteriovena fistula (AVF) merupakan sumber ketidaknyamanan yang dirasakan pasa pasien dalam menjalankan perawatan kesehatan. Tujuan penulisan ini adalah untuk mengetahui penurunan intensitas nyeri pemasangan arteriovena fistula pada pasien hemodialisis menggunakan teknik valsava meneuver. Jenis studi kasus ini adalah analisis deskriptif dengan metode singlecase . Subyek dalam studi kasus ini sebanyak 1 pasien dengan mengukur intensitas nyeri sebelum dan sesudah dilakukan valsava meneuver pada duakali periode hemodialisis dengan menggunakan instrumen numerical pain rating scale. Nyeri yang dialami subyek studi kasus sebelum tindakan valsava meneuver berada diskala 6 sedangkan nyeri yang dirasakan setelah tindakan valsava meneuver berada diskala 4. Valsava meneuver yang dilakukan dapat menurunkan intensitas nyeri pemasangan AVF pada pasien yang menjalani hemodialisis. Valsava meneuver dapat diterapkan pada pasien yang menjalani hemodialisis sebagai tindakan nonfarmakologis untuk menurunkan intensitas nyeri pemasangan AVF.

Introduction: among the groups more affected by the COVID-19 pandemic were patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2. Objective: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment. Method: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included. Results: for that, 189 patients were studied, who received chronic HD treatment in the hospital unit, 22 patients were diagnosed with COVID-19 (12 %) in that period. The mean age was 71 years, 10 were women, the Charlson index was 6.59 points, diabetes mellitus 10, vintage HD 51.6 months, 2 patients had previously received a currently non-functioning kidney transplant, 16 had arteriovenous fistula as vascular access, and 6 had central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V pool was 1.7. Sixteen patients had body composition measurement, a strong association (p < 0.05) was identified between mortality and BMI, as well as mortality and FTI. Furthermore, the differences between deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, finding significant differences with p < 0.05 in the value of triglycerides and ferritin. Conclusions: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, were significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic kidney disease (CKD) is an increasingly prevalent pathology in today's society. The prevalence of CKD increases progressively with aging, together with other diseases such as type 2 diabetes, high blood pressure, and arteriosclerosis. In patients with advanced chronic kidney disease, vascular access is required to start hemodialysis as renal replacement therapy. Vascular access for hemodialysis becomes the key point of treatment since without functioning vascular access there is no possibility of performing it. Creation of an arteriovenous fistula (AVF) in the upper extremity for hemodialysis; connects the arteries and veins of the upper body. It can be a native connection or a polytetrafluoroethylene grafted connection. The native AVF is preferred as the ideal type of vascular access, mainly because of its long duration, longer survival, and low complication rate. AVF can be performed in any upper extremity without complications, but the general advice is to choose the nondominant arm first, to encourage and support the patient's movement in the dominant extremity, and to provide as much comfort as possible during hemodialysis sessions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Angiología is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: Los pacientes con enfermedad renal crónica (ERC) en fase avanzada se ven sometidos a métodos de sustitución de la función renal, como la hemodiálisis y el trasplante renal. La resiliencia constituye un factor protector que propicia la adaptación ante eventos adversos que pueden surgir durante el proceso de cambio. Objetivos: Comparar la resiliencia y sus dimensiones en dos grupos de pacientes con ERC según su método de sustitución de la función renal y por género, independientemente del grupo de pertenencia. Material y Método: El estudio fue transversal analítico y se utilizó la escala validada de resiliencia de Connor-Davidson de 25 ítem. Las variables fueron los niveles de la resiliencia y sus dimensiones. Se incluyeron, además, género y edad. Resultados: Participaron 88 pacientes del hospital universitario Arnaldo Milián Castro, del total 53 (52 %) fueron del masculino, 44 recibiendo hemodiálisis y 44 con trasplante renal. Los pacientes de hemodiálisis mostraron valores medios superiores en cuanto a la resiliencia (M=79), persistencia, tenacidad y autoeficacia (M=26) y adaptabilidad y redes de apoyo (M=17); en tanto los de trasplante destacaron en control bajo presión (M=22); control y propósito (M=15) y espiritualidad (M=9). Por género, el masculino mostró promedios superiores en todas las variables. La prueba U de Man Whitney arrojó diferencias estadísticamente significativas en un grupo de variables para ambas formas de agrupación. Conclusiones: Existen diferencias significativas de la resiliencia y los factores que la condicionan en los grupos de hemodiálisis y trasplante; así como en los grupos por género.

Introducción: Existen diferentes métodos de primera generación para la detección de estenosis. Objetivo: Determinar la precisión de los métodos de primera generación en la detección de estenosis en fístulas arteriovenosas nativas. Material y Método: Estudio observacional retrospectivo. Muestra: Pacientes con fístulas arteriovenosas nativas funcionantes. Métodos de primera generación: exploración física, test manuales: test de aumento del pulso y test de elevación del brazo, métodos indirectos, Kt/V y recirculación de la fístula arteriovenosa. El diagnóstico de estenosis fue confirmado mediante ecografía doppler. Se calculó sensibilidad, especificidad, valor predictivo positivo (VPP), valor predictivo negativo (VPN) y precisión de los métodos de primera generación basándose en la ecografía doppler. Resultados: Muestra 39 pacientes, 79,48% hombres. El ecógrafo detectó 19 estenosis, ninguna significativa. Exploración física: sensibilidad 31,5%, especificidad 80%, VPP 60%, VPN 55,1%, precisión 56,4%. Test aumento del pulso: sensibilidad 5,2%, especificidad 90%, VPP 33,3%, VPN 50%, precisión 48,7%. Test elevación del brazo: sensibilidad 52,6%, especificidad 70%, VPP 62,5%, VPN 60,8%, precisión 61,5%. Métodos indirectos: sensibilidad 15,7%, especificidad 55%, VPP 25%, VPN 40,7%, precisión 35,9%. Kt/V: sensibilidad 10,5%, especificidad 75%, VPP 28,5%, VPN 46,8%, precisión 43,5%. Recirculación de la FAV: sensibilidad 10,5%, especificidad 100%, VPP 100%, VPN 54,1%, precisión 56,4%. Conclusiones: Todos los métodos de primera generación presentan alta especificidad y baja sensibilidad. El grado de estenosis (significativa o no significativa) podría influir en la sensibilidad de la exploración física, pero no en la especificidad. El test de elevación del brazo es el método de primera generación más preciso en la detección de estenosis.

Descripción caso: Mujer de 58 años, recién llegada a nuestro país como refugiada desde Ucrania a raíz del conflicto bélico. En su país de origen es diagnosticada de nefropatía lúpica con enfermedad renal crónica avanzada orientada a hemodiálisis. Cuando comienza la guerra, está pendiente de realización de fístula arteriovenosa. Acude a urgencias para su valoración y se decide inicio de tratamiento renal sustitutivo por la progresión de su enfermedad. La paciente sólo habla ucraniano, presentando una importante barrera idiomática que dificulta todo el proceso de atención sanitaria. Descripción del plan de cuidados: Se realiza una valoración de la paciente según los patrones funcionales de Marjory Gordon, se identifican los Diagnósticos de enfermería siguiendo terminología NANDA (North American Nursing Diagnosis Association), se plantean objetivos NOC (Nursing Outcomes Classification) e intervenciones NIC (Nursing Interventions Classification). Evaluación del plan: La evaluación del plan de cuidados se lleva a cabo tras la realización de las intervenciones (infografías, uso Google translate), analizando los indicadores asociados a cada objetivo NOC y su evolución durante el periodo en el que se realiza el seguimiento de la paciente. Conclusiones: En este caso clínico, la aplicación del Proceso de Atención de Enfermería y el diseño de estrategias para reducir las dificultades de comunicación dieron como resultado la superación de la barrera idiomática, haciendo posible la identificación de las necesidades que la paciente presentaba. De esta forma, se logró la resolución de las dudas que planteaba sobre su tratamiento, así como el abordaje del resto de problemas de salud detectados.

Introduction: Early mortality in patients with chronic kidney disease represents a major health problem, which is why the design of novel prognostic models is a priority. Objective: Design an artificial neural network for the prediction of mortality in patients with chronic kidney disease on hemodialysis. Methods: A prospective cohort analytical study was conducted in patients with chronic kidney disease on hemodialysis during the period from January 1, 2013 to December 31, 2017. A total of 36 attributes were analyzed in 392 patients. The multilayer perceptron was used to design an artificial neural network composed of 12 variables. Finally, the classification table, the discriminatory capacity of the algorithm and the normalized importance of the prognostic variables were evaluated. Results: The artificial neural network presented overall correct classification percentages of a 96.3% in the training sample and a 96.7% in the validation sample. The discriminatory capacity was very good, area ROC of 0.989. The most important normalized predictors of mortality were cardiovascular disease, albumin, and sepsis. Conclusions: The artificial neural network contributes to the stratification of mortality risk of patients with chronic kidney disease on hemodialysis. The model has good discriminatory capacity and indicators of statistical effectiveness. The prognostic variables identified are easy to determine and interpret, which is why it is considered a predictive tool with useful implementation in medical decision making in the clinical setting.

We discuss two recent cases from our hospital in which two patients with ESKD receiving periodical hemodialysis (HD) and SarS-Cov-2 infection suffered movement disorders, being the onset related to the HD sessions in both. First case is a 78 year-old woman who is admitted with generalized myoclonic status epilepticus and second case is a 46 year-old male who starts repeatedly suffering myoclonus during his hemodialysis sessions on day +10 after testing positive (asymptomatic infection). There are two main hypotheses when it comes to myoclonus and CNS disorders in COVID19, post-hypoxic origin and inmunomediated postinfectious origin. We wonder if they could both be interacting in patients with kidney disease, and especially in those who receive hemodialysis, maximizing the risk of suffering this type of disorders. Resumen: Presentamos dos casos de pacientes con enfermedad renal crónica G5D en programa de tratamiento renal sustitutivo (TRS) con hemodiálisis (HD) periódica e infección por SARS-CoV-2 que sufrieron trastornos del movimiento cuya aparición coincidió cronológicamente con las sesiones de hemodiálisis. El primero es una mujer de 78 años que en el día +5 de síntomas sufrió un status epiléptico mioclónico generalizado; y el segundo un varón de 46 años que en el día +10 de positividad comenzó a experimentar durante las sesiones de hemodiálisis episodios de mioclonías en miembros superiores. Las dos hipótesis con mayor fuerza para explicar la aparición de mioclonías y trastornos del sistema nerviosos central (SNC) en la enfermedad COVID-19 actualmente son el origen posthipóxico y el origen postinfeccioso inmunomediado. Es posible que la interacción entre ambos factores en pacientes con enfermedad renal, y especialmente en hemodiálisis, potencie el riesgo de sufrir estas alteraciones.

Background/Aim: The prevalence of cognitive impairment (CI) is high in hemodialysis patients. In this study, the relationship between CI and serum carnitine, plasma omega-3, omega-6 and omega-3/omega-6 fatty acid ratio was evaluated in hemodialysis patients. Materials and methods: Sixty two patients [male: 40 (64.5%), mean age 51 ±13 years] were included in this cross-sectional study. Serum total and free-carnitine levels were determined by ELISA. Plasma omega-3 [eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)] and omega-6 [arachidonic acid (AA), dihomo gamma linoleic acid (DGLA)] levels were measured using LC-ESI-MS/MS. According to the Montreal Cognitive Assessment (MoCA) scores, ≤24 points were considered as CI. MoCA score ≤24 and >24 were determined as Group 1 and Group 2, respectively. Results: Group 1 had significantly higher AA + DGLA/EPA + DHA ratios and lower free-carnitine, DHA and EPA + DHA levels compared to Group 2 (P = 0.008, P = 0.040, P = 0.032, P = 0.032, respectively). Group 1 had a statistically lower education level (P 24 se determinaron como grupo 1 y grupo 2, respectivamente. Resultados: El grupo 1 tenía proporciones de AA + DGLA/EPA + DHA significativamente más altas y niveles más bajos de carnitina libre, DHA y EPA + DHA en comparación con el grupo 2 (p = 0,008, p = 0,040, p = 0,032 y p = 0,032, respectivamente). El grupo 1 tenía un nivel educativo estadísticamente más bajo (p

Not all medical expenses were paid promptly in 2018, which resulted in a deficit for BPJS Kesehatan. If DJS cannot meet the costs of health services, it will have an impact on other people who need care. Kidney failure is one of the catastrophic diseases with the highest costs, costing up to 6.5 trillion rupiah in 2021, an increase of 190% compared to 2020. This is also due to the increase in the number of sufferers, followed by an increase in cases of kidney failure. Some of the procedures include CAPD, hemodialysis, and organ transplantation, which can cost up to hundreds of millions of rupiah per patient. This research aims to forecast the prevalence rate of kidney failure in Indonesia for 2023–2025 using the Exponential Smoothing method and the literature study method. The results showed that people aged >45 years were more likely to get kidney failure. Compared to women, the prevalence for men is higher, which serves as a warning to the community to maintain a healthy lifestyle. Following the hypothesis, the total cost of kidney failure will increase with the increase in hemodialysis patients and cases. The total cost of treatment is expected to be between 7 and 10 trillion rupiah in 2023-2025. It is known that the cost containment scheme has succeeded in overcoming the problem of cost control in several countries. The United States uses cost sharing as a cost control scheme for the treatment of ESRD (End-Stage Kidney Disease). Therefore, Indonesia can also implement a cost-sharing scheme that is based on the forecasting results of kidney failure costs. This scheme is appropriate to overcome the problem of controlling insurance costs.

Mannitol has been used for many years as an osmotic agent in the management of various medical conditions, including cerebral edema and glaucoma. However, its use has been associated with complications such as changes in blood volume and the internal milieu, leading to its progressive substitution by hypertonic saline solutions. In addition, it has been used to prevent and manage acute kidney injury, particularly in surgical patients, and to preserve diuresis in conditions that may promote acute tubular necrosis. Mannitol has also been used in hemodialysis patients to prevent and treat acute complications such as intradialytic hypotension, cramps, and dialysis disequilibrium syndrome. However, most of the studies are retrospective and of low power. Despite the known associated complications, mannitol continues to be used in many centers due to its availability and easy administration. This review aims to evaluate the efficacy and safety of mannitol in managing kidney diseases. [ABSTRACT FROM AUTHOR]

Introduction: The use of hemodialysis as a substitute treatment for renal function is very important, since renal failure is a complication of multiple pathologies, among which we find diabetes and hypertension (main public health problems in Mexico). However, hemodialysis is not exempt from complications that can occur from the placement of the access, despite the use of imaging tools. Objective: To determine the prevalence of complications of venous access for hemodialysis that occurred between 2018 and 2021. Method: Observational, descriptive, retrospective and cross-sectional study, all patients undergoing venous access placement for hemodialysis by Interventional Radiology were included. Results: One hundred one venous accesses were placed, of which 56.4% were men, and the mean age was 56.28 ± 17.21 years. A significant relationship was found between complications and age, anatomical insertion and number of previous catheters placed (p < 0.05). Conclusions: Complications in the placement of venous access occur mainly late and are related to the number of previous venous accesses placed and that the patient is elderly. [ABSTRACT FROM AUTHOR]

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Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)