Displaying publications 1 - 20 of 284 in total

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  1. Chang E, Lim JA, Low CL, Kassim A
    J Nephrol, 2021 02;34(1):97-104.
    PMID: 33394342 DOI: 10.1007/s40620-020-00903-0
    BACKGROUND: Water crisis is becoming a threat to the well-being of the human population worldwide and use of water for healthcare contributes substantially to this resource depletion. Hemodialysis consumes large quantities of water. A huge volume of high purity dialysis water is required to safely perform dialysis treatment. In this process, up to 60-70% of source water is discarded. Many strategies have been suggested to promote green dialysis, and these include reuse of water, however, very few dialysis facilities have taken the preliminary steps to employ it.

    METHODS: We share our experience in a developing country on an innovative reject-water reuse program combining aquaculture, hydroponic and horticulture activities. This is by far the first report on a "green dialysis" project involving aquaponics that reuse dialysis reverse osmosis (RO) reject water.

    RESULTS: Our expereince suggests that reject water can be reused to promote water conservation with encouraging results. It provides a good and biosecure environment for fish breeding and vegetable farming . This project promotes a reduction in carbon footprint, a reduction in water waste, a sustainable organic food source, may lead to income generation, and provides a shared purpose and sense of pride among staff and dialysis patients.

    CONCLUSIONS: Encompassing "environmental protection" practices into a hemodialysis unit can be done with relatively simple and practical steps.

    Matched MeSH terms: Renal Dialysis*
  2. Sahathevan S, Khor BH, Yeong CH, Tan TH, Meera Mohaideen AK, Ng HM, et al.
    JPEN J Parenter Enteral Nutr, 2021 02;45(2):422-426.
    PMID: 32384179 DOI: 10.1002/jpen.1867
    BACKGROUND: Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatient HD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT).

    METHODS: Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot.

    RESULTS: ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID , VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods.

    CONCLUSION: The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HD patients.

    Matched MeSH terms: Renal Dialysis*
  3. Rozi NRB, Bin Wan Ali WASR, Bin Draman CR, Pasi HB, Rathor MY
    Saudi J Kidney Dis Transpl, 2022 Sep 01;33(5):664-673.
    PMID: 37955458 DOI: 10.4103/1319-2442.389426
    The role of end-of-life care is fundamental for end-stage renal disease (ESRD) patients, who are known to have a high morbidity and mortality rate despite being on dialysis. This requires effective communication and shared decision-making. Thus, exploring patients' knowledge and perceptions is essential to improve the gaps in delivering end-of-life care. This study aimed to describe the knowledge and perceptions of end-of-life care among ESRD patients on hemodialysis (HD). This was a cross-sectional study involving 14 outpatient HD centers in Kuantan, Malaysia. Patients were recruited from March to June 2019. A validated questionnaire was delivered via interview-based surveys by the researcher or trained interviewers. The majority of the respondents had poor knowledge of the disease and end-of-life care. However, more than 70% of the respondents felt that it was important for them to be actively involved in medical decision-making, as well as being prepared and planning for death. End-of-life needs, which included management of symptoms and psychological, social, and spiritual support, were important to most respondents. Additionally, patients with higher educational backgrounds were observed to have higher scores for both knowledge and perceptions (P <0.05). The study found poor knowledge but acceptable perceptions among patients. This highlights the gaps in the current local approach in clinical practice to end-of-life care in ESRD.
    Matched MeSH terms: Renal Dialysis/adverse effects; Renal Dialysis/psychology
  4. Hooi LS
    Med J Malaysia, 2006 Dec;61(5):513-5.
    PMID: 17623948
    Matched MeSH terms: Renal Dialysis*
  5. Ling TW, Khuan L, Baharom A, Arshad MM
    Nephrol Nurs J, 2021 3 9;48(1):31-48.
    PMID: 33683842
    The purpose of this literature review was to explore the qualitative evidence on coping strategies used by patients with end stage kidney disease (ESKD) to manage the challenges and outcomes associated with the condition. A systematic review design following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was used, and a thematic analysis was used to analyze the data. Four themes were identified from the 14 selected studies: external support, emotion management strategies, reliance on faith or spirituality, and self-care practices. Implications of these findings are discussed. Further primary qualitative studies using interviews and focus groups are needed to gain additional in-depth evidence of ESKD-related coping strategies.
    Matched MeSH terms: Renal Dialysis*
  6. Collister D, Mbuagbaw L, Guyatt G, Devereaux PJ, Tennankore KK, Reis G, et al.
    Contemp Clin Trials, 2021 08;107:106466.
    PMID: 34098039 DOI: 10.1016/j.cct.2021.106466
    BACKGROUND/AIMS: To examine how measuring adherence at 3 weeks by self-report and pill counts compares to measurements at 7 weeks in a pre-randomization run-in period.

    METHODS: Study within a trial of an international parallel group randomized controlled trial (RCT) that compares spironolactone to placebo. Adults receiving dialysis enter an 8-week active run-in period with spironolactone. Adherence was assessed by both self-report and pill counts in a subgroup of participants at both 3 weeks and 7 weeks.

    RESULTS: 332 participants entered the run-in period of which 166 had complete data. By self-report, 146/166 (94.0%) and 153/166 (92.2%) had at least 80% adherence at 3 and 7 weeks respectively (kappa = 0.27 (95% C.I. 0.16 to 0.38). By pill counts, the mean (SD) adherence was 96.5% (16.1%) and 92.4% (18.2%) at 3 and 7 weeks respectively (r = 0.32) with a mean (SD) difference of 3.1% (17.8%) and a 95% limit of agreement from -31.7% to +37.9%. The proportion of adherent participants by self-report and pill counts at 3 weeks agreed in 87.4% of participants (McNemar's p-value 0.58, kappa 0.11, p = 0.02) and at 7 weeks agreed in 92.2% (McNemar's p-value 0.82, kappa 0.47, p 

    Matched MeSH terms: Renal Dialysis*
  7. Bharati J, Jha V
    Semin Dial, 2020 11;33(6):490-498.
    PMID: 33030777 DOI: 10.1111/sdi.12924
    Dialysis adequacy is conventionally quantified as net urea clearance. Single pool (sp) Kt/Vurea remains the best studied measure of dialysis adequacy globally. Other measures such as fluid status control, anemia correction, and mineral metabolism are monitored variably. Increasing use of hemodiafiltration across Europe and many parts of Japan and Australia is predicated on studies showing better patient survival with middle molecule clearance. Apart from local clinical practice guidelines, the income level and public health policy of a country determine quality of dialysis services. Among developed nations, small solute clearance adequacy targets are achieved with high frequency. In the United States, dialysis adequacy target is met by focussing on high blood flow rates and large dialyzer size, sometimes at the cost of session time. In Japan, Australia, and Germany, session length is given importance. Dialysis adequacy reporting is restricted and inconsistent in developing nations. The Gulf Cooperation Council countries, Russia and Malaysia, respectively, are close to achieving dialysis adequacy target (spKt/Vurea ≥1.2) universally in their dialysis populations. Patient-reported outcomes are typically measured only in developed countries. Patient survival on dialysis, partly linked to dialysis adequacy, varies greatly around the world, with Japan having the best survival rates. Until the development of better markers of dialysis adequacy, universal consistency in reporting of conventional parameters with a focus on patient-reported measures should be endeavored.
    Matched MeSH terms: Renal Dialysis*
  8. Abu Maloh HIA, Soh KL, Chong SC, Ismail SIF, Soh KG, Abu Maloh DI, et al.
    Clin Nurs Res, 2023 Feb;32(2):288-297.
    PMID: 35915917 DOI: 10.1177/10547738221112759
    Benson's relaxation affects many symptoms among hemodialysis patients. A cluster-randomized active control clinical trial with three repeated measures; pre, 1-week, and 1-month post-intervention sought to evaluate the effectiveness of Benson's Relaxation on pain and perceived stress (P&PS) among hemodialysis patients. Two governmental hospitals were randomly assigned to intervention and control. Thirty-six participants were randomly selected; 18 were intervention, and 18 were controlled. The intervention group performed Benson's Relaxation twice a day for 10 minutes for 8 weeks after a training session. The control group received an educational session about Progressive Relaxation. Findings revealed a statistically significant reduction in the PSS-10 and PRI scores between pre-intervention and 1 month after-intervention (p  .05). Benson's Relaxation significantly relieved P&PS among hemodialysis patients but not after only 1 week of practicing.
    Matched MeSH terms: Renal Dialysis*
  9. Borzych-Duzalka D, Shroff R, Ariceta G, Yap YC, Paglialonga F, Xu H, et al.
    Am J Kidney Dis, 2019 08;74(2):193-202.
    PMID: 31010601 DOI: 10.1053/j.ajkd.2019.02.014
    RATIONALE & OBJECTIVE: Arteriovenous fistulas (AVFs) have been recommended as the preferred vascular access for pediatric patients on maintenance hemodialysis (HD), but data comparing AVFs with other access types are scant. We studied vascular access choice, placement, complications, and outcomes in children.

    STUDY DESIGN: Prospective observational cohort study.

    SETTING & PARTICIPANTS: 552 children and adolescents from 27 countries on maintenance HD followed up prospectively by the International Pediatric HD Network (IPHN) Registry between 2012 and 2017.

    PREDICTOR: Type of vascular access: AVF, central venous catheter (CVC), or arteriovenous graft.

    OUTCOME: Infectious and noninfectious vascular access complication rates, dialysis performance, biochemical and hematologic parameters, and clinical outcomes.

    ANALYTICAL APPROACH: Univariate and multivariable linear mixed models, generalized linear mixed models, and proportional hazards models; cumulative incidence functions.

    RESULTS: During 314 cumulative patient-years, 628 CVCs, 225 AVFs, and 17 arteriovenous grafts were placed. One-third of the children with an AVF required a temporary CVC until fistula maturation. Vascular access choice was associated with age and expectations for early transplantation. There was a 3-fold higher living related transplantation rate and lower median time to transplantation of 14 (IQR, 6-23) versus 20 (IQR, 14-36) months with CVCs compared with AVFs. Higher blood flow rates and Kt/Vurea were achieved with AVFs than with CVCs. Infectious complications were reported only with CVCs (1.3/1,000 catheter-days) and required vascular access replacement in 47%. CVC dysfunction rates were 2.5/1,000 catheter-days compared to 1.2/1,000 fistula-days. CVCs required 82% more revisions and almost 3-fold more vascular access replacements to a different site than AVFs (P<0.001).

    LIMITATIONS: Clinical rather than population-based data.

    CONCLUSIONS: CVCs are the predominant vascular access choice in children receiving HD within the IPHN. Age-related anatomical limitations and expected early living related transplantation were associated with CVC use. CVCs were associated with poorer dialysis efficacy, higher complication rates, and more frequent need for vascular access replacement. Such findings call for a re-evaluation of pediatric CVC use and practices.

    Matched MeSH terms: Renal Dialysis/adverse effects; Renal Dialysis/methods*
  10. Raharjo Y, Ismail AF, Othman MHD, Malek NANN, Santoso D
    Mater Sci Eng C Mater Biol Appl, 2019 Oct;103:109722.
    PMID: 31349515 DOI: 10.1016/j.msec.2019.05.007
    In this work, the novel imprinted zeolite (IZ) was synthesized, and its properties and performance in terms of adsorption of p-Cresol, which represent the protein-bounded uremic toxins in aqueous phase under phosphate buffer saline, were studied and compared with the synthesized zeolite-Y (ZeoY-S) and commercial CBV 100 zeolite-Y (ZeoY-C). The ZeoY-S was synthesized from sodium aluminate, NaOH, H2O and SiO2 under aging for 24 h at room temperature and hydrothermal condition for 24 h at 100 °C, with an initial composition of 10SiO2:Al2O3:4Na2O:180H2O. The ZeoY-S has been modified by using the imprinting technology to produce the IZ via the use of p-Cresol as a template. The p-Cresol successfully imprinted on the zeolite-Y was proved through the multipoint Brunauer-Emmett-Teller (BET) and the performance of IZ that was compared to ZeoY-S and ZeoY-C. Based on the BET results, it proves that the pore size of IZ is in accordance with the target compound, which is p-Cresol at 0.79 nm. This modification was able to adsorb p-Cresol 2.5 and 3.5 times higher than ZeoY-S and ZeoY-C can, respectively. Langmuir and Freundlich adsorption isotherm models, together with the pseudo-first and -second order and intra-particle diffusion kinetics models, were used to investigate the adsorption behavior of p-Cresol on the zeolites. The IZ has 4.30 times greater competitive molecules than ZeoY-S and the properties of IZ were not influenced by the content of other phenolic group uremic toxins as competitive molecules. It can be concluded that the micropores of zeolite as adsorbent can be modified using the imprinting technology in order to increase its sensitivity and selectivity towards p-Cresol.
    Matched MeSH terms: Renal Dialysis*
  11. Pujiastuti TT, Aima H, Lokonathan S, Chiew L
    Enferm Clin, 2020 06;30 Suppl 5:17-20.
    PMID: 32713561 DOI: 10.1016/j.enfcli.2020.01.007
    Hemodialysis is a treatment for patients with kidney failure. One of the main problems in patients on hemodialysis is increasing of interdialytic weight gain (IDWG) due to decreased kidney excretion function. Increasing of interdialytic weight gain cause dangerous conditions and reduce the function of whole-body systems, especially cardiovascular and respiratory systems. These conditions require appropriate intervention. Various references reported intradialysis exercise can be an alternative intervention to reduce interdialytic weight gain. The purpose of this study was to determine the effectiveness of intradialytic exercise intervention to reduce interdialytic weight gain in patients on hemodialysis. A quantitative descriptive analytic study was conducted. Sixty-four patients on hemodialysis were randomly selected in hemodialysis unit. Patients performed intradialytic exercise twice a week for 8 weeks. Statistical analysis with general linear model repeated measure showed there was decrease in the interdialytic weight gain mean in patients on hemodialysis after 3-8 weeks intervention intradialytic exercise with p value of 0.000; <0.05. The interdialytic weight gain mean decrease between 0.281 and 1.438kg. Performed minimal four weeks intradialytic exercise was effective to reduced interdialytic weight gain in patients on hemodialysis. Based on the results of the study, it is suggested for nurses to educate patient on hemodialysis about intradialytic exercise. Intradialytic exercise can be an alternative independent nursing intervention to reduce interdialytic weight gain in patients on hemodialysis.
    Matched MeSH terms: Renal Dialysis*
  12. Balakrishnan S, Aamar A, Rhee S, Zakaria S, Khaliq W
    Med J Malaysia, 2016 Jun;71(3):152-3.
    PMID: 27495894
    Gram-negative endocarditis is rare and it has high mortality if there is a delay in diagnosis and treatment. Gram-negative organisms should be considered in the differential diagnosis of IE in hemodialysis patients. Central lineassociated bloodstream infections (CLABSIs) can be prevented by following sterile measures during catheter insertion and proper management of catheter site.
    Matched MeSH terms: Renal Dialysis*
  13. Wong WK, Chan WK, Ganapathy SS, Lim SK
    Semin Dial, 2023 Mar;36(2):107-116.
    PMID: 35821201 DOI: 10.1111/sdi.13117
    BACKGROUND: Metabolic-dysfunction-associated fatty liver disease (MAFLD) and end stage kidney disease (ESKD) are complications of the metabolic syndrome. Our aim is to study the prevalence of MAFLD and advanced liver fibrosis and the associated factors among hemodialysis patients in a multiracial urban population in Malaysia.

    METHODS: A cross-sectional study of hemodialysis patients from 10 hemodialysis centers was used. FibroTouch examination was performed on all patients. Fatty liver was diagnosed based on ultrasound attenuation parameter ≥248 dB/m while advanced liver fibrosis was diagnosed based on liver stiffness measurement ≥10 kPa.

    RESULTS: This study included 447 hemodialysis patients (median age 59 [50-67], male 55%, Chinese 61%, Malay 20%, Indian 18%). Dialysis vintage was 49 (22-93) months. The prevalence of MAFLD was 43.4%. Independent factors associated with MAFLD were elevated waist circumference (aOR = 10.1, 95% CI = 5.3-19.4, p 

    Matched MeSH terms: Renal Dialysis*
  14. Khan TM, Alhafez AA, Syed Sulaiman SA, Bin Chia DW
    Saudi Pharm J, 2015 Nov;23(6):614-20.
    PMID: 26702255 DOI: 10.1016/j.jsps.2014.10.004
    The aim of this study was to assess the safety and probability of adverse events associated with the use of 75 mg pregabalin post hemodialysis (pHD) among patients with UP.
    Matched MeSH terms: Renal Dialysis
  15. Mohamad Ali A, Uhwut E, Liew S
    Biomed Imaging Interv J, 2012 Jan;8(1):e8.
    PMID: 22970064 MyJurnal DOI: 10.2349/biij.8.1.e8
    Fibrin sheath formation around long-term haemodialysis catheter is a common cause of failed dialysis access. Treatment options include pharmacological and mechanical methods. This paper reports a case of failed dialysis access due to fibrin sheath encasement. Pharmacologic thrombolysis, mechanical disruption using guide wire and catheter exchange had failed to address the issue. Eventually, fibrin sheath stripping using the loop snare technique was able to successfully restore the catheter function.
    Matched MeSH terms: Renal Dialysis
  16. Abidin MNZ, Goh PS, Ismail AF, Othman MHD, Hasbullah H, Said N, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 Aug 01;77:572-582.
    PMID: 28532067 DOI: 10.1016/j.msec.2017.03.273
    A novel approach in the design of a safe, high performance hemodialysis membrane is of great demand. Despite many advantages, the employment of prodigious nanomaterials in hemodialysis membrane is often restricted by their potential threat to health. Hence, this work focusses on designing a biocompatible polyethersulfone (PES) hemodialysis membrane embedded with poly (citric acid)-grafted-multi walled carbon nanotubes (PCA-g-MWCNTs). Two important elements which could assure the safety of the nanocomposite membrane, i.e. (i) dispersion stability and (ii) leaching of MWCNTs were observed. The results showed the improved dispersion stability of MWCNTs in water and organic solvent due to the enriched ratio of oxygen-rich groups which subsequently enhanced membrane separation features. It was revealed that only 0.17% of MWCNTs was leached out during the membrane fabrication process (phase inversion) while no leaching was detected during permeation. In terms of biocompatibility, PES/PCA-g-MWCNT nanocomposite membrane exhibited lesser C3 and C5 activation (189.13 and 5.29ng/mL) and proteins adsorption (bovine serum albumin=4.5μg/cm2, fibrinogen=15.95μg/cm2) as compared to the neat PES membrane, while keeping a normal blood coagulation time. Hence, the PES/PCA-g-MWCNT nanocomposite membrane is proven to have the prospect of becoming a safe and high performance hemodialysis membrane.
    Matched MeSH terms: Renal Dialysis
  17. Abu Maloh HIA, Soh KL, AbuRuz ME, Chong SC, Ismail SIF, Soh KG, et al.
    Clin Nurs Res, 2022 01;31(1):122-135.
    PMID: 34159828 DOI: 10.1177/10547738211024797
    This study aimed to evaluate the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis.
    Matched MeSH terms: Renal Dialysis
  18. Wijewickrama ES, Abdul Hafidz MI, Robinson BM, Johnson DW, Liew A, Dreyer G, et al.
    BMJ Open, 2022 Dec 30;12(12):e065112.
    PMID: 36585149 DOI: 10.1136/bmjopen-2022-065112
    OBJECTIVE: Patients with advanced chronic kidney disease (CKD) or kidney failure receiving replacement therapy (KFRT) are highly vulnerable to COVID-19 infection, morbidity and mortality. Vaccination is effective, but access differs around the world. We aimed to ascertain the availability, readiness and prioritisation of COVID-19 vaccines for this group of patients globally.

    SETTING AND PARTICIPANTS: Collaborators from the International Society of Nephrology (ISN), Dialysis Outcomes and Practice Patterns Study and ISN-Global Kidney Health Atlas developed an online survey that was administered electronically to key nephrology leaders in 174 countries between 2 July and 4 August 2021.

    RESULTS: Survey responses were received from 99 of 174 countries from all 10 ISN regions, among which 88/174 (50%) were complete. At least one vaccine was available in 96/99 (97%) countries. In 71% of the countries surveyed, patients on dialysis were prioritised for vaccination, followed by patients living with a kidney transplant (KT) (62%) and stage 4/5 CKD (51%). Healthcare workers were the most common high priority group for vaccination. At least 50% of patients receiving in-centre haemodialysis, peritoneal dialysis or KT were estimated to have completed vaccination at the time of the survey in 55%, 64% and 51% of countries, respectively. At least 50% of patients in all three patient groups had been vaccinated in >70% of high-income countries and in 100% of respondent countries in Western Europe.The most common barriers to vaccination of patients were vaccine hesitancy (74%), vaccine shortages (61%) and mass vaccine distribution challenges (48%). These were reported more in low-income and lower middle-income countries compared with high-income countries.

    CONCLUSION: Patients with advanced CKD or KFRT were prioritised in COVID-19 vaccination in most countries. Multiple barriers led to substantial variability in the successful achievement of COVID-19 vaccination across the world, with high-income countries achieving the most access and success.

    Matched MeSH terms: Renal Dialysis
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