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Objectives To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis. Methods The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks. Results The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F=15.23, p

Abstract Background Patients undergoing hemodialysis are exposed to psychological problems, such as despair, which in turn can be a trigger for them to abandon the treatment process. This study aimed to determine the effect of positive thinking training on hope and adherence to treatment in hemodialysis patients. Methods This randomized controlled trial was performed on 80 hemodialysis patients referred to two hemodialysis centers in Shiraz, Iran. They were randomly divided into an intervention and a control group. Eight sessions of positive thinking skills training carried out individually on the patients' bedsides. The primary and secondary outcomes were hope and adherence to treatment, respectively. The data were collected using Snyder Hope Questionnaire, End-Stage Renal Disease Adherence Questionnaire, laboratory tests, and weight measurements. Data were analyzed by Chi-square and Paired and Independent T-test using SPSS software version 18. Results After the intervention, the mean score of hope was significantly higher in the intervention group (42.1 ± 6.1) than in the control group (38.7 ± 6.5) (p = 0.024). Moreover, after the intervention, the mean score of adherence to treatment was significantly higher in the intervention group (1070.2 ± 80.1) compared to the control group (1018.4 ± 105.3) (p = 0.019). In addition, blood urea nitrogen, phosphate and inter-dialytic weight gain were lower in the intervention group compared to the control group after the intervention. Conclusions The findings showed that positive thinking interventions could lead to improvement in hope and adherence to treatment in hemodialysis patients. Positive thinking training could be used in caring of hemodialysis patients to improve their hope and adherence to treatment. Trial registration RCT Registry: Iranian Registry of Clinical Trials; RCT registration number: IRCT20180915041044N1; Registration date: 19/12/2018.

Background: Patients undergoing hemodialysis are exposed to psychological problems, such as despair, which in turn can be a trigger for them to abandon the treatment process. This study aimed to determine the effect of positive thinking training on hope and adherence to treatment in hemodialysis patients. Methods: This randomized controlled trial was performed on 80 hemodialysis patients referred to two hemodialysis centers in Shiraz, Iran. They were randomly divided into an intervention and a control group. Eight sessions of positive thinking skills training carried out individually on the patients' bedsides. The primary and secondary outcomes were hope and adherence to treatment, respectively. The data were collected using Snyder Hope Questionnaire, End-Stage Renal Disease Adherence Questionnaire, laboratory tests, and weight measurements. Data were analyzed by Chi-square and Paired and Independent T-test using SPSS software version 18. Results: After the intervention, the mean score of hope was significantly higher in the intervention group (42.1 ± 6.1) than in the control group (38.7 ± 6.5) (p = 0.024). Moreover, after the intervention, the mean score of adherence to treatment was significantly higher in the intervention group (1070.2 ± 80.1) compared to the control group (1018.4 ± 105.3) (p = 0.019). In addition, blood urea nitrogen, phosphate and inter-dialytic weight gain were lower in the intervention group compared to the control group after the intervention. Conclusions: The findings showed that positive thinking interventions could lead to improvement in hope and adherence to treatment in hemodialysis patients. Positive thinking training could be used in caring of hemodialysis patients to improve their hope and adherence to treatment. Trial registration RCT Registry: Iranian Registry of Clinical Trials; RCT registration number: IRCT20180915041044N1; Registration date: 19/12/2018. [ABSTRACT FROM AUTHOR]

Background: Incremental hemodialysis (HD) is considered a valid alternative for patients with residual kidney function. Evidence concerning its effect on vascular access is scarce. We present our 12-year experience of an incremental hemodialysis program with the aim of evaluating survival and complications of arteriovenous fistula in these patients compared to the thrice-weekly scheme., Methods: From January 1st, 2006 to December 31st, 2017, 220 incident patients started hemodialysis, 132 (60%) of whom began hemodialysis with two sessions per week and 88 (40%) with three sessions per week. Demographic and clinical variables were assessed at the start of treatment. Data regarding arteriovenous fistula survival and complications were collected., Results: Both groups had similar baseline sociodemographic and clinical characteristics. A total of 188 (85%) patients were dialyzed with an arteriovenous fistula during follow-up. Eighty-three patients had one or more fistula complications, with no differences between incremental and conventional groups (p = 0.55). Fistula survival rates showed no significant difference between the two groups, whether analyzed from the date of fistula creation (Log Rank p = 0.810) or from the date of initial fistula cannulation (Log Rank p = 0.695)., Conclusions: We found no differences in arteriovenous fistula survival or complication rate between patients who started HD with an incremental versus a conventional treatment scheme. Randomized controlled clinical trials may be warranted to achieve a higher degree of evidence., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)

ABSTRACT Objective: To measure the average direct cost of procedures performed by health professionals, in a Dialysis Center, for the management of complications of vascular access for hemodialysis. Method: Quantitative, exploratory-descriptive case study type research. The average direct cost was calculated by multiplying the time spent by health professionals by the unit cost of direct labor, adding this to the input costs (materials/ medicines/solutions). Results: The following average direct costs were obtained: US$0.72, US$2.00 and US$1.41 for “administration of easy-to-dilute, difficult-to-dilute, and undiluted antibiotics”, respectively; $2.61 for “central venous catheter dressing with topical antibiotic”; $48.05 for “alteplase infusion”; US$183.68 for “insertion of central venous catheter for hemodialysis”; and $1.31 for “arteriovenous fistula puncture”. Conclusion: Material and drug costs significantly contributed to the composition of the average total direct cost of most procedures.

Objective: The number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden on their family caregivers. To develop care and support for both the patient and their family caregiver, it is crucial to understand how caregivers experience their caregiving situation. Therefore, this study aimed to explore family caregivers' experiences of burden and coping when caring for a family member receiving haemodialysis in the Sri Lankan context., Design: Qualitative study with an exploratory design., Setting: Family caregivers were recruited at a haemodialysis unit of a main government sector hospital in Sri Lanka between October and November 2021., Participants: A purposive sampling of 11 family caregivers who cared for a family member receiving haemodialysis in a main government teaching hospital in Sri Lanka for at least 3 consecutive months. Data were collected through individual semistructured telephone interviews and analysed using qualitative content analysis., Results: The results showed an overarching theme, 'striving to hold on and not let go', with four categories: (1) feeling exhausted by the care burden, (2) feeling burdened as failing the care responsibility, (3) striving to cope and find meaning in caregiving, and (4) coping with caregiving through others' support., Conclusion: The results show that the family caregivers have a multifaceted burden. They continued caring for their family member receiving haemodialysis while making adjustments to the burdensome caregiving situation despite many constraints and suffering. Psychosocial support and financial assistance, including family counselling, are needed by family caregivers, through a community support system, to ensure endurance during their family members' illness trajectory. Advance care planning is vital to alleviate care uncertainty and to meet the care needs of patients with ESKD, particularly in resource-constrained settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The association between Interdialytic home blood pressure variability (BPV) and the prognosis of patients undergoing maintenance hemodialysis (MHD) largely unknown., Hypothesis: We proposed the hypothesis that interdialytic home BPV exert effect on cardiac and all-cause mortality among individuals undergoing MHD., Methods: A total of 158 patients receiving MHD at the hemodialysis unit of Wuhan Fourth Hospital between December 2019 and August 2020 were included in this prospective cohort study. Patients were divided into tertiles according to the systolic BPV (SBPV), and the primary endpoints were cardiac and all-cause death. Kaplan-Meier analysis was used to assess the relationship between long-term survival and interdialytic home SBPV. In addition, Cox proportional hazards regression models were used to identify risk factors contributing to poor prognosis., Results: The risk of cardiac death and all-cause death was gradually increased in patients according to tertiles of SBPV (3.5% vs. 14.8% vs. 19.2%, p for trend = .021; and 11.5% vs. 27.8% vs. 44.2%, p for trend <.001). The Cox regression analysis revealed that compared to Tertile 1, the hazard ratios for all-cause mortality in Tertile 2 and Tertile 3 were 3.13 (p = .026) and 3.24 (p = .021), respectively, after adjustment for a series of covariates., Conclusions: The findings revealed a positive correlation between increased interdialytic home SBPV and elevated mortality risk in patients with MHD., (© 2024 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.)

Introduction: Chronic kidney disease (CKD) has always been a complicated global challenge, ranking as the 12th leading cause of death worldwide. Hemodialysis, being one of the most opted renal replacement therapies (RRTs) for patients with end-stage renal disease (ESRD), still possesses some limitations in preventing complications, such as malnutrition and mineral bone disease (CKD-MBD). While efforts have focused on controlling CKD-MBD parameters like calcium and phosphate, less attention has been given to dietary interventions. Moreover, the adoption of low-phosphorus diets for hemodialysis patients is very complex due to potential conflicts with the guideline-recommended high-protein dietary approach. This study sought to investigate the relationship between dietary phosphorus intake and nutritional status in CKD patients undergoing regular hemodialysis., Method: This non-randomized cross-sectional study comprising 88 patients was conducted at the Hemodialysis Unit, RSUD Dr. Soetomo, Surabaya, East Java, using a three-day dietary record in March 2022. Relationships between variables were analyzed using Spearman and ANOVA tests., Result: No significant positive association was found between dietary calcium with corrected calcium levels (p = 0.988; r s = -0.002) and between dietary phosphorus with plasma phosphate levels (p = 0.082; r s = 0.187). However, Spearman's analysis revealed a weak but positive correlation between dietary phosphorus and nutritional status (p = 0.022; r s = 0.215*)., Conclusion: Our study highlights a positive relationship between dietary phosphorus and nutritional status among hemodialysis patients, offering insights into potential strategies for optimizing patient care and outcomes., (© 2024 Clonia Milla et al., published by Sciendo.)

ABSTRACT Objective: To analyze the factors involved in nursing care that are related to the safety culture of chronic renal patients on hemodialysis. Method: Integrative literature review, carried out through the steps: problem identification, bibliographic research, data evaluation, data analysis, and report. We adopted the guiding question: “What scientific evidence is there about the factors related to the safety culture in hemodialysis clinics, according to the nursing team?” The search was carried out in the LILACS, Medline / PUBMED, Scopus, CINAHL, Cochrane, and Web of Science (WOS) databases. Results: The sample of this review was composed of five studies. The factors found were: 8 predisposing, 13 disabling, 11 precipitating, and 18 reinforcing. Conclusion: The analysis of literary productions allowed an understanding of the main factors linked to nursing practices that influence the safety culture of patients on hemodialysis.

On January 30 2020, the World Health Organization (WHO) declared the COVID-19 outbreak as epidemiological emergency. Globally, various guidelines have been published for the safety of patients with chronic kidney disease (CKD) and health personnel working in hemodialysis centers. In Mexico, the prevalence of CKD is 12.2% and 60,000 patients receive some modality of renal replacement therapy at the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security). This proposal for action is made in the face of suspected and confirmed cases of COVID-19 in intrahospital hemodialysis units. [ABSTRACT FROM AUTHOR]

Objective: People living with diabetes mellitus (DM) and chronic kidney disease can have difficulty attending multiple appointments to receive DM care. We developed and studied the utility of a DM outreach program to offer in the hemodialysis (HD) unit., Methods: We conducted a quality improvement project in a satellite HD unit in London, Ontario, Canada, between August 1, 2019, and July 31, 2022. We assessed for baseline gaps in DM care among those with DM, performed root-cause analysis with key stakeholders to identify critical drivers of gaps, and conceptualized a certified diabetes educator-led outreach program to offer in the HD unit. We aimed to improve DM self-monitoring, hypo- and hyperglycemia, and DM-related screening. We used run and control charts to track outcome measures over time and modified our outreach program iteratively., Results: Fifty-eight persons with DM receiving HD participated in our program. Support spanned multiple waves of the COVID-19 pandemic. With 4 tests of change, we observed improvement in DM self-monitoring with a modest decline in self-reported hyperglycemia. There were no adverse consequences, and satisfaction with our program was high., Conclusions: Although we did not meet all measures of success during the pandemic, outreach DM support in the HD unit appeared to improve self-monitoring and self-reported hyperglycemia. Similar programs could be modified and implemented in other centres., (Copyright © 2023 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

The presence of fungi in healthcare settings, including hemodialysis units, represents a significant risk for immunocompromised patients. This study aimed to investigate the occurrence of fungi in the air and water of a hemodialysis unit located in a tertiary public hospital in Maceió, Alagoas, Brazil. Over a period of three consecutive months, monthly air samples were collected and analyzed using the spontaneous sedimentation technique on Petri dishes containing Sabouraud Dextrose Agar (SDA). Simultaneously, water samples (100 mL) were collected from four specific water distribution points and subjected plating on SDA. Fungi were phenotypically identified based on their macroscopic and microscopic characteristics. In total, 498 colony-forming units (CFUs) of fungi were isolated, with 86 CFUs originating from the air and 412 CFUs from the water. Regarding the water samples, a higher concentration of fungal CFUs was observed in the potable water from the supply network (229 CFUs). Unexpectedly, 23 CFUs were identified in the reverse osmosis samples and 11 CFUs in the storage tank, which are post-treatment points where the presence of microorganisms is not desired. The fungus Cladosporium spp. was the most prevalent in both air and water samples, followed by Penicillium spp. in the air and Rhodotorula spp. in the water. These findings underscore the need to implement effective control and monitoring measures for fungi in the hemodialysis unit to ensure patient safety.

Background: A high in-hospital mortality has been identified in patients with COVID-19 who develop acute kidney injury, particularly in those who received renal replacement therapy. In our country there are few studies up until now that report the proportion of deaths in this group of patients., Objective: To identify the proportion of deaths in patients with COVID-19 who developed acute kidney injury and required hemodialysis., Material and Methods: an observational, descriptive, cross-sectional, retrospective study was carried out and the total population was studied. It included patients over 18 years of age who required dialysis, who received one or more sessions of conventional hemodialysis. The data were obtained from the electronic file and the registry of the hemodialysis unit. For the descriptive analysis, measures of central tendency were used and the proportion of deaths in patients with COVID-19 was calculated., Results: The study population was made up of 40 patients; the proportion of deaths was 86.1%. The average number of days elapsed from admission to the development of acute kidney injury and dialysis requirement was 5.2 days and the average number of hemodialysis sessions received was 1.7 sessions., Conclusions: In this study it was documented a high proportion of deaths in patients with COVID-19 who developed acute kidney injury and required renal replacement therapy, which coincides with similar studies reported internationally., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Abstract Introduction: Chronic kidney disease (CKD) is associated with high morbidity and mortality rates, main causes related with cardiovascular disease (CVD) and bone mineral disorder (CKD-BMD). Uremic toxins, as advanced glycation end products (AGEs), are non-traditional cardiovascular risk factor and play a role on development of CKD-BMD in CKD. The measurement of skin autofluorescence (sAF) is a noninvasive method to assess the level of AGEs in tissue, validated in CKD patients. Objective: The aim of this study is analyze AGEs measured by sAF levels (AGEs-sAF) and its relations with CVD and BMD parameters in HD patients. Methods: Twenty prevalent HD patients (HD group) and healthy subjects (Control group, n = 24), performed biochemical tests and measurements of anthropometric parameters and AGEs-sAF. In addition, HD group performed measurement of intact parathormone (iPTH), transthoracic echocardiogram and radiographies of pelvis and hands for vascular calcification score. Results: AGEs-sAF levels are elevated both in HD and control subjects ranged according to the age, although higher at HD than control group. Single high-flux HD session does not affect AGEs-sAF levels. AGEs-sAF levels were not related to ventricular mass, interventricular septum or vascular calcification in HD group. AGEs-sAF levels were negatively associated with serum iPTH levels. Conclusion: Our study detected a negative correlation of AGEs-sAF with serum iPTH, suggesting a role of AGEs on the pathophysiology of bone disease in HD prevalent patients. The nature of this relation and the clinical application of this non-invasive methodology for evaluation AGEs deposition must be confirmed and clarified in future studies.

Objective: This study was conducted to determine the relationship between self-care agency and sleepiness in chronic hemodialysis patients., Methods: The study was conducted with 75 patients with chronic renal failure in the hemodialysis unit of a training and research hospital in our country. In the descriptive study, the data were collected through a face-to-face questionnaire. The IBM SPSS Statistics 22.0 program was used to evaluate the data., Results: It was determined that there was no significant relationship between self-care agency and sleepiness total scores in chronic hemodialysis patients (p>0.05) and a significant relationship between sleepiness and drug use compliance and mental status in female patients and between diet compliance and sleepiness in patients younger than 52 years of age (p<0.05)., Conclusion: As a result, it was observed that there was no relationship between self-care agency and sleepiness in chronic hemodialysis patients. We think that working with a larger sample group can lead to clearer results.

Background: Infection is the most frequent complication of central venous catheters used for hemodialysis., Objectives: The purpose of this study was to the determine the central venous catheter-related infection rate at a dialysis center in the Brazilian state of Amazonas and to identify risk factors and the microbiological profile of the infections., Methods: This was an observational study with prospective data collection over a 12-month period by chart analysis and face-to-face interviews with patients undergoing hemodialysis using central venous catheters at a dialysis center., Results: 96 central venous catheters were analyzed in 48 patients. 78 of these were non-tunneled central venous catheters (81.3%) and 18 were tunneled central venous catheters (18.7%), 53.1% of the catheters were exchanged because of infection and blood cultures were obtained from 35.2% of the patients who had catheter-related infections. Gram-negative bacteria were isolated from five of the nine blood cultures in which there was bacterial growth and Gram-positive bacteria were isolated from the other four. The most commonly isolated bacteria was Staphylococcus hominis , found in 22.2% of positive blood cultures., Conclusion: The overall hemodialysis venous catheter infection rate was 10.1 episodes/1000 catheter days, 15.1 episodes/1000 catheters days in non-tunneled catheters and 3.3 episodes/1000 catheters days in tunneled catheters. The infection predisposing factors identified were use of non-tunneled catheters and having 2 hemodialysis sessions per week. Regarding the microbiological profile, over half of the bacteria isolated were Gram-negative., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2023 The authors.)

Background: To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis., Methods: The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks., Results: The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F=15.23, p<0.001) and blood flow rate (F=36.00, p<0.001). As a result of the program, the phosphorus index level, which is a physiological indicator in hemodialysis patients, decreased (F=8.64, p<0.001). Encouragement and support through text messages and practice lists also resulted in an increase in self-efficacy (F=18.62, p<0.001)., Conclusion: The AVF stenosis prevention program in this study resulted in an increase in upper extremity muscle strength through grip strength exercises and was effective in preventing AVF stenosis by increasing the blood flow rate.

Importance: Patients with end-stage kidney disease (ESKD) undergoing long-term hemodialysis often experience a high burden of debilitating symptoms for which effective treatment options are limited., Objective: To compare the effectiveness of a stepped collaborative care intervention vs attention control for reducing fatigue, pain, and depression among patients with ESKD undergoing long-term hemodialysis., Design, Setting, and Participants: Technology Assisted Stepped Collaborative Care (TĀCcare) was a parallel-group, single-blinded, randomized clinical trial of adult (≥18 years) patients undergoing long-term hemodialysis and experiencing clinically significant levels of fatigue, pain, and/or depression for which they were considering treatment. The trial took place in 2 US states (New Mexico and Pennsylvania) from March 1, 2018, to June 31, 2022. Data analyses were performed from July 1, 2022, to April 10, 2023., Interventions: The intervention group received 12 weekly sessions of cognitive behavioral therapy delivered via telehealth in the hemodialysis unit or patient home, and/or pharmacotherapy using a stepped approach in collaboration with dialysis and primary care teams. The attention control group received 6 telehealth sessions of health education., Main Outcomes and Measures: The coprimary outcomes were changes in fatigue (measured using the Functional Assessment of Chronic Illness Therapy Fatigue), average pain severity (Brief Pain Inventory), and/or depression (Beck Depression Inventory-II) scores at 3 months. Patients were followed up for 12 months to assess maintenance of intervention effects., Results: There were 160 participants (mean [SD] age, 58 [14] years; 72 [45%] women and 88 [55%] men; 21 [13%] American Indian, 45 [28%] Black, 28 [18%] Hispanic, and 83 [52%] White individuals) randomized, 83 to the intervention and 77 to the control group. In the intention-to-treat analyses, when compared with controls, patients in the intervention group experienced statistically and clinically significant reductions in fatigue (mean difference [md], 2.81; 95% CI, 0.86 to 4.75; P = .01) and pain severity (md, -0.96; 95% CI, -1.70 to -0.23; P = .02) at 3 months. These effects were sustained at 6 months (md, 3.73; 95% CI, 0.87 to 6.60; P = .03; and BPI, -1.49; 95% CI, -2.58 to -0.40; P = .02). Improvement in depression at 3 months was statistically significant but small (md -1.73; 95% CI, -3.18 to -0.28; P = .02). Adverse events were similar in both groups., Conclusions and Relevance: This randomized clinical trial found that a technology assisted stepped collaborative care intervention delivered during hemodialysis led to modest but clinically meaningful improvements in fatigue and pain at 3 months vs the control group, with effects sustained until 6 months., Trial Registration: ClinicalTrials.gov Identifier: NCT03440853.

Background: Bloodstream infections (BSI) are a leading cause of morbidity and mortality in hospitalized patients worldwide. A blood culture is the primary tool for determining whether a patient has BSI and requires antimicrobial therapy, but it can result in an inappropriate outcome if the isolated microorganisms are deemed contaminants from the skin. Despite the development of medical equipment and technology, there is still a percentage of blood culture contamination. The aims of this study were to detect the blood culture contamination (BCC) rate in a tertiary care hospital in Palestine and to identify the departments with the highest rates along with the microorganisms isolated from the contaminated blood samples., Method: Blood cultures that were taken at An-Najah National University Hospital between January 2019 and December 2021 were evaluated retrospectively. Positive blood cultures were classified as either true positives or false positives based on laboratory results and clinical pictures. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. A p-value of less than 0.05 was considered statistically significant for all analyses., Results: Out of 10,930 blood cultures performed in the microbiology laboratory from 2019 to 2021, 1479 (13.6%) were identified as positive blood cultures that showed microbial growth. Of these, 453 were blood culture contaminations, representing 4.17% of total blood cultures and 30.63% of the positive blood culture samples. The highest rate of contamination was in the hemodialysis unit (26.49%), followed by the emergency department (15.89%). Staphylococcus epidermidis was the most prevalent (49.2%), followed by Staphylococcus hominis (20.8%) and Staphylococcus haemolyticus (13.2%). The highest annual contamination rate was observed in 2019 (4.78%) followed by 2020 (3.95%) and the lowest was in 2021 (3.79%). The rate of BCC was decreasing, although it did not reach statistically significant levels (P value = 0.085)., Conclusion: The rate of BCC is higher than recommended. The rates of BCC are different in different wards and over time. Continuous monitoring and performance improvement projects are needed to minimize blood culture contamination and unnecessary antibiotic use., (© 2023. The Author(s).)

O objetivo foi avaliar a produção científica na enfermagem brasileira sobre nefrologia nas teses e dissertações publicadas de 2001 a 2007. Foi realizado um estudo bibliométrico apartir dos teses e dissertações de enfermagem catalogadas no Centro de Estudos e Pesquisas em Enfermagem. Detectou-se 50 trabalhos sobre nefrologia, predominando: 45 (90%) dissertações; 30 (60%) no estado de São Paulo; 18 (36%) em clínicas de diálise; 39 (78%) sujeitos foram pacientes. Quanto aos tipos de estudos predominaram: 26 (52%) exploratórios, 28 (56%) levantamento e 27 (54%) quantitativos. De acordo com o tema, a hemodiálise teve maior destaque, com 21 (42%) publicações. As pesquisas científicas voltadas para essa temática possibilitam uma assistência multi e interdisciplinar, de forma individualizada, sistematizada e humanizada a essa clientela.El objetivo fue evaluar la producción científica en la enfermería brasileña sobre nefrología en las tesis y disertaciones publicadas de 2001 a 2007. Es un estudio bibliometrico, realizado con las tesis y desertaciones de enfermería catalogadas en el Centro de Estudios e Investigaciones en Enfermería. Se detectaron 50 trabajos sobre de nefrología, predominando: 45 (90%) disertaciones; 30 (60%) en el Estado de São Paulo; 18 (36%) en clínicas de diálisis; 39 (78%) la muestra fueron los pacientes. Los tipos de estudios predominaron: 26 (52%) exploratorios, 28 (56%) levantamiento y 27 (54%) cuantitativos. De acuerdo con el tema, la hemodiálisis tuvo mayor destaque, con 21 (42%) publicaciones. Las investigaciones científicas dirigidas a esta temática posibilitan una asistencia multi e inter-disciplinar, de forma individualizada, sistematizada y humanizada a estos pacientes.The purpose was to evaluate the scientific production in Brazilian nursing about nephrology in theses and dissertations published from 2001 to 2007. A bibliometric study was carried out with the nursing tesis and dissertations according to the Center of Studies and Researches in Nursing catalog. It was found 50 works on nephrology, predominating: 45 (90%) dissertations; 30 (60%) in the state of São Paulo; 18 (36%) in clinics of dialysis; 39 (78%) samples were patients. Considering the types of study, it predominated: 26 (52%) exploratory, 28 (56%) survey and 27 (54%) quantitative. Concerning the theme, hemodialysis predominated with 21 (42%) publications. Scientific researches on this theme make possible a multi and interdisciplinary assistance to these clients, in an individualized, systematized and humanized way.

Objectives: Hepatitis C virus elimination is complex. The objective was to analyze measures to eliminate virus transmission in a hemodialysis unit. Methods: Case study composed of multiple units of analysis. The scenario is the hemodialysis unit of a Brazilian public hospital. Population composed of health service records. Descriptive analyzes were performed and the beginning of the event was considered as the moment of increased incidence of HCV. The intentional and purposeful collection of information for understanding the event and implementing interventions. Results: The subunits of analysis were related to: clinical-epidemiological profile, active search, transmission routes, management protocol and results achieved. In August 2019, out of 45 patients, six were reactive for anti-HCV. All received treatment. Patients had exposure to contaminated medical equipment, objects or hands of professionals. Preventive measures were adopted and routine techniques were corrected. Situational Analysis Committee guided the management of the event. No new cases were detected. Conclusions: Strategies for the microelimination of the C virus in a dialysis environment are demonstrated and it shows the multidisciplinary efforts in conducting the event., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Gomide, Pereira, Camargo, Rodrigues, Souza, Melo, Pereira and Oliveira.)

End stage kidney disease (ESKD), a public health concern, has overwhelming effects on individuals' holistic wellbeing. Hemodialysis, albeit a life-saving treatment for patients with ESKD, can lead to muscle atrophy, weakness, and decreased quality of life mostly due to an inactive lifestyle. This quasi-experimental, pre-post design was used to study the effects of exercise on physiologic and psychologic outcomes of patients with ESKD at a hemodialysis unit in Lebanon. Patients acted as their own controls and were assessed before and after introducing the exercise program. Data were collected on quality of life of patients as well as their dialysis adequacy. Results showed that while there was a significant improvement in the dialysis adequacy post-exercise intervention, quality of life was not affected., Competing Interests: The authors reported no actual or potential conflict of interest in relation to this nursing continuing professional development (NCPD) activity., (Copyright© by the American Nephrology Nurses Association.)

Estudo de abordagem qualitativa realizado em uma clínica de hemodiálise, no interior do Paraná, com pacientes em tratamento hemodialítico. O objetivo consistiu em conhecer situações significativas para o paciente renal crônico vivenciadas no espaço-contexto de hemodiálise. Os resultados apontaram dificuldades associadas ao processo de comunicação, falta de informações e o desconhecimento de aspectos que envolvem o tratamento. Ficou patente a atribuição de importância à família, a relação com os demais usuários e com os membros da equipe de saúde, como forma de contribuir para o processo de recuperação e de adaptação, em meio às adversidades impostas pela doença e tratamento. Aspectos relacionados à apresentação e estética do ambiente também emergiram como fatores que interferem na satisfação dos clientes.Estudio de abordaje cualitativo realizado en una clínica de hemodiálisis, en el interior del estado de Paraná, Brasil. A través de entrevistas semiestructuradas, nos propusimos a conocer situaciones significativas para los pacientes renales crónicos, vivenciadas en el espacio-contexto del tratamiento hemodialítico. Los resultados apuntaron a dificultades asociadas al proceso de comunicación, generando incómodo y sensación de desamparo, principalmente en el comienzo del tratamiento. Resultó clara la atribución de importancia a la familia, a la relación con los otros usuarios del servicio y con los miembros del equipo de salud, como forma de contribuir al proceso de recuperación y de adaptación, en medio no solo a las adversidades que la enfermedad y el tratamiento imponen. Aspectos relacionados a la presentación, estética e higienización del ambiente también han sido mencionadas como factores que interfieren en la satisfacción de los clientes.A qualitative study performed at a hemodialysis clinic in the interior of Paraná. Semi-structured interviews were used to look at significant situations for chronic renal patients, experienced in the space and context of hemodialytic treatment. The results indicated difficulties associated with the communication process, causing discomfort and a feeling of helplessness, especially at the beginning of the treatment. It was shown that importance was assigned to the family, to the relationship with the other service users and with the members of the health care team, as a way of contributing to the recovery and adaptation process, amidst the adversities imposed by the disease and treatment. Aspects related to the presentation, esthetics and cleanliness of the environment also emerged as factors that interfere in client satisfaction.