Displaying publications 1 - 20 of 24 in total

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  1. 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/methods*
  2. Ho SE, Ho CC, Norshazwani N, Teoh KH, Ismail MS, Jaafar MZ, et al.
    Clin Ter, 2013;164(6):499-505.
    PMID: 24424213 DOI: 10.7417/CT.2013.1627
    AIMS: The objective of the study was to examine the quality of life amongst the end stage renal disease (ESRD) haemodialysis patients in Malaysia.

    MATERIALS AND METHODS: A cross sectional descriptive study was conducted on 72 ESRD patients at a Dialysis Centre in Malaysia. The modified KDQOL-SF™ subscales, kidney disease-targeted scale and 36 item health survey scale questionnaires were used.

    RESULTS: The overall health rating was 66.73 ± 11.670 indicating good quality of life. There was no significant difference between quality of life for the different domains according to gender (p >0.05). However, there were significant differences between quality of life in the domain of burden of kidney disease. Physical functioning deteriorated significantly with age (p=0.012) while social functioning was lowest in the 50-65 years age group (p=0.037). Those who had no morbidities had significantly better scores on the effects of kidney (p=0.036), burden of kidney disease (p=0.011) and physical functioning (p=0.025).

    CONCLUSIONS: Patients undergoing haemodialysis have been found to have good quality of life despite having ESRD. It is therefore of paramount importance to constantly monitor the standard of care for these patients to enable them to live their life to the fullest.

    Matched MeSH terms: Renal Dialysis/methods*
  3. Irfan M, Idris A
    Mater Sci Eng C Mater Biol Appl, 2015 Nov 1;56:574-92.
    PMID: 26249629 DOI: 10.1016/j.msec.2015.06.035
    Polyethersulfone (PES) based membranes are used for dialysis, but exposure to blood can result in numerous interactions between the blood elements and the membrane. Adsorption and transformation of plasma proteins, activation of blood cells, adherence of platelets and thrombosis reactions against PES membrane can invoke severe blood reactions causing the increase rate of mortality and morbidity of hemodialysis (HD) patients. In order to minimize blood immune response, different biomimetic, zwitterionic, non-ionic, anticoagulant molecules and hydrophilic brushes were immobilized or blended with PES polymers. These additives modified the nature of the membrane, enhanced their biocompatibility and also increased the uremic waste dialysis properties. In this review, current perspectives of the different additives which are used with PES are highlighted in relation with PES membrane-associated blood reactions. The additive's purpose, compatibility, preparation techniques, methods of addition to polymer and influence on the chemistry and performance of hemodialysis membranes are described.
    Matched MeSH terms: Renal Dialysis/methods*
  4. Fauziah K, Go KW, Ghazali A, Zaki M, Lim TO
    BMC Nephrol, 2017 Apr 03;18(1):123.
    PMID: 28372556 DOI: 10.1186/s12882-017-0537-2
    BACKGROUND: Pre-produced bicarbonate concentrates (PPC) are still widely used in developing countries despite its cost and risk but Central Concentrate System (CCS) is lacking in data to support its wider adoption.

    METHODS: We conducted an 8-week randomized crossover study on 16 Hemodialysis machines to compare CCS versus PPC. Performance is assessed by solute concentrations while safety is assessed by microbial count, endotoxin level and adverse event reporting.

    RESULTS: Microbial counts and endotoxin levels were monitored on 48 occasions during the 8-week study for the CCS arm of the study. The levels were all below the action limit during the study. No patient reported any adverse events. Dialysate Sodium, Chloride and Bicarbonate concentrations were measured on a total of 128 occasions for each arm of the study. The relative deviations of Sodium, Chloride and Bicarbonate concentration were within ±5% of their nominal values for both. The 95% Confidence Intervals for the ratio of the mean solute concentrations on the CCS to PPC lie within the tolerance limit of ±5%.

    CONCLUSION: Modern CCS is bacteriologically safe and its performance statistically equivalent to PPC.

    Matched MeSH terms: Renal Dialysis/methods*
  5. Zailani MZ, Ismail AF, Sheikh Abdul Kadir SH, Othman MH, Goh PS, Hasbullah H, et al.
    J Biomed Mater Res A, 2017 05;105(5):1510-1520.
    PMID: 28000366 DOI: 10.1002/jbm.a.35986
    In this study, poly (1,8-octanediol citrate) (POC) was used to modify polyethersulfone (PES)-based membrane to enhance its hemocompatibility. Different compositions of POC (0-3%) were added into the polyethersulfone (PES) dope solutions and polyvinylpyrrolidone (PVP) was used as pore forming agent. The hemocompatible POC modified PES membranes were fabricated through phase-inversion technique. The prepared membranes were characterized using attenuated total reflectance-Fourier transform infrared (ATR-FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), Atomic-force microscopy (AFM), contact angle, Zeta-potential, membrane porosity and pore size and pure water flux (PWF) and BSA rejection. The hemocompatibility of the modified PES membranes was evaluated by human serum fibrinogen (FBG) protein adsorption, platelet adhesion, activated partial thromboplastin time (APTT) and prothrombin time (PT), and thrombin-antithrombin III (TAT), complement (C3a and C5a) activation and Ca2+ absorption on membrane. Results showed that by increasing POC concentration, FBG adsorption was reduced, less platelets adhesion, prolonged APTT and PT, lower TAT, C5a and C3a activation and absorb more Ca2+ ion. These results indicated that modification of PES with POC has rendered improved hemocompatibility properties for potential application in the field of blood purification, especially in hemodialysis. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1510-1520, 2017.
    Matched MeSH terms: Renal Dialysis/methods
  6. Taghipour A, Olfatifar M, Rostami A, Foroutan M, Vasigala V, Norouzi M
    Hemodial Int, 2020 01;24(1):12-21.
    PMID: 31804770 DOI: 10.1111/hdi.12796
    Intestinal parasitic infection (IPI) is the main cause of gastrointestinal complications in hemodialysis patients due to their impaired immune systems. We conducted a systematic review and meta-analysis to evaluate the prevalence and odds ratio (OR) of IPIs in this population. Relevant eligible studies were identified by searching the PubMed, Science Direct, Scopus, Web of Science, and Google scholar databases up to January 30, 2019. A random-effects meta-analysis model was used to estimate the pooled prevalence, OR, and 95% confidence intervals (CI). Twenty-two studies, from Turkey, Iran, Brazil, Egypt, Saudi Arabia, Pakistan, and Malaysia met eligibility criteria for analysis, and included 11 using a case-control design (980 patients and 893 controls) and 11 studies using a cross-sectional design (a total of 1455 participants). Cross-sectional studies suggested that the pooled prevalence of IPIs in hemodialysis patients was 24% (95% CI, 14-36%; 307/1455). In studies using a case-control design, the pooled prevalence of IPIs in hemodialysis patients (30%, 330/980) was found to be significantly higher than controls (10%, 115/893) (OR, 3.40; 95%CI, 2.37-4.87). With respect to the parasites, Cryptosporidium spp. (OR, 4.49; 95%CI, 2.64-7.64) and Blastocystis sp. (OR, 4.03; 95%CI, 1.20-13.51) were significantly higher in hemodialysis patients compared to the controls. The current study revealed a high prevalence of IPIs in hemodialysis patients from countries in which the baseline prevalence of parasitic infection is high. We recommend that periodic screenings for IPIs in such countries should be incorporated into the routine clinical care of hemodialysis patients.
    Matched MeSH terms: Renal Dialysis/methods
  7. Rehman IU, Chohan TA, Bukhsh A, Khan TM
    Medicina (Kaunas), 2019 Oct 17;55(10).
    PMID: 31627446 DOI: 10.3390/medicina55100699
    : Chronic kidney disease (CKD)-associated pruritus is a common and disturbing condition which has a negative impact on sleep quality, as well as overall health-related quality of life of patients receiving hemodialysis. To date, no systematic review has been undertaken, and there is a lack of concise evidence that statistically quantifies the impact of pruritus based on published data. A systematic search was done for original articles published in peer-reviewed English journals from database inception on 20 December, 2018, in the following databases: PubMed, MEDLINE, EMBASE, Ovid, CINHAL, ProQuest, and Scopus. A total of 9217 research articles were identified. After removal of duplicates and screening for titles and abstracts, 28 articles were selected. The prevalence of disturbed sleep was 4-94%, while the pooled proportion on random effect in the study was 40% (95% CI = 0.30 to 0.49); I2 = 99.8%. However, the prevalence of disturbed sleep quality and quantity due to pruritus was 9-76%, and the pooled proportion on random effect in the study was 50% (95% CI = 0.37 to 0.64); I2 = 99.8%. Patients undergoing hemodialysis who are affected by CKD-associated pruritus have a higher chance of experiencing sleep disturbances. The prevalence of disturbed sleep due to CKD-associated pruritus was found to be 9-76% in the included studies for patients receiving hemodialysis therapy.
    Matched MeSH terms: Renal Dialysis/methods
  8. Bee Yean O, Zoriah A
    J Tradit Chin Med, 2019 02;39(1):1-14.
    PMID: 32186018
    OBJECTIVE: To evaluate current evidence on the efficacy and safety of Cordyceps sinensis (cordyceps) or its fermented products used as an adjunctive treatment in patients undergoing maintenance hemodialysis.

    METHODS: The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, China National Knowledge Infrastructure (CNKI) and Wanfang Database were searched for relevant randomized controlled trials up to March 2016. Two review authors independently selected trials for inclusion, extracted data, assessed the methodological quality and rated the quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluation approach.

    RESULTS: Twelve studies involving 655 participants were included. Evidence of low to moderate-quality showed that cordyceps plus conventional treatment compared to conventional treatment alone significantly improved C-reactive protein [standardized mean difference (SMD) -0.61; 95% confidence intervals (CI) -1.00 to -0.22], high-sensitivity C-reactive protein [weighted mean difference (WMD) -3.44 mg/L; 95% CI -3.89 to -2.99], serum albumin (WMD 3.07 g/L; 95% CI 1.59 to 4.55), malondialdehyde (WMD -1.95 nmol/L; 95% CI -2.24 to -1.66), and hemoglobin (WMD 9.56 g/L; 95% CI 3.65 to 15.47) levels. However, there was no significant improvement for serum creatinine and low-density lipoprotein cholesterol. Overall, most trials either did not monitor adverse events or poorly documented them.

    CONCLUSION: Given the small number of trials included, the unclear methodological quality of the included trials, and the high heterogeneity in pooled analyses, the evidence obtained in this review is insufficient to recommend the use of cordyceps as adjunctive treatment in hemodialysis patients.

    Matched MeSH terms: Renal Dialysis/methods*
  9. Ashraf MA, Islam A, Butt MA, Hussain T, Khan RU, Bashir S, et al.
    Int J Biol Macromol, 2021 Nov 30;191:872-880.
    PMID: 34571131 DOI: 10.1016/j.ijbiomac.2021.09.131
    Mixed matrix membranes (MMMs) of cellulose acetate/poly(vinylpyrrolidone) (CA/PVP) infused with acid functionalized multiwall carbon nanotubes (f-MWCNTs) were fabricated by an immersion phase separation technique for hemodialysis application. Membranes were characterized using FTIR, water uptake, contact angle, TGA, DMA and SEM analysis. The FTIR was used to confirm the bonding interaction between CA/PVP membrane matrix and f-MWCNTs. Upon addition of f-MWCNTs, TGA thermograms and glass transition temperature indicated improved thermal stability of MMMs. The surface morphological analysis demonstrated revealed uniform distribution of f-MWCNTs and asymmetric membrane structure. The water uptake and contact angle confirmed that hydrophilicity was increased after incorporation of f-MWCNTs. The membranes demonstrated enhancement in water permeate flux, bovine serum albumin (BSA) rejection with the infusion of f-MWCNTs; whereas BSA based anti-fouling analysis using flux recovery ratio test shown up to 8.4% improvement. The urea and creatinine clearance performance of MMMs were evaluated by dialysis experiment. It has been found that f-MWCNTs integrated membranes demonstrated the higher urea and creatinine clearance with increase of 12.6% and 10.5% in comparison to the neat CA/PVP membrane. Thus, the prepared CA/PVP membranes embedded with f-MWCNTs can be employed for wide range of dialysis applications.
    Matched MeSH terms: Renal Dialysis/methods
  10. Hudson R, Pascoe EM, See YP, Cho Y, Polkinghorne KR, Paul-Brent PA, et al.
    J Vasc Access, 2024 Jan;25(1):193-202.
    PMID: 35686506 DOI: 10.1177/11297298221099134
    AIM: To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia.

    BACKGROUND: AVFs are preferred for haemodialysis access but are limited by high rates of early failure.

    METHODS: A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (n = 209) and Malaysian (n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors.

    RESULTS: Participants' mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31-0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25-0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62-2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62-2.16) were similar.

    CONCLUSIONS: The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

    Matched MeSH terms: Renal Dialysis/methods
  11. Khalatbari Soltani S, Jamaluddin R, Tabibi H, Mohd Yusof BN, Atabak S, Loh SP, et al.
    Hemodial Int, 2013 Apr;17(2):275-81.
    PMID: 22998533 DOI: 10.1111/j.1542-4758.2012.00754.x
    Inflammation and lipid abnormalities are two important risk factors for cardiovascular disease in hemodialysis (HD) patients. The present study was designed to investigate the effects of flaxseed consumption on systemic inflammation and serum lipid profile in HD patients with lipid abnormalities. This was an unblinded, randomized clinical trial. Thirty HD patients with dyslipidemia (triglyceride >200 mg/dL and/or high-density lipoprotein-cholesterol (HDL-C) <40 mg/dL) were randomly assigned to either a flaxseed or control group. Patients in the flaxseed group received 40 g/day ground flaxseed for 8 weeks, whereas patients in the control group received their usual diet, without any flaxseed. At baseline and at the end of week 8, 7 mL of blood was collected after a 12- to 14-hour fast and serum concentrations of triglyceride, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), HDL-C, and C-reactive protein (CRP) were measured. Serum concentrations of triglyceride (P < 0.01), total cholesterol (P < 0.01), LDL-C (P < 0.01), and CRP (P < 0.05) decreased significantly in the flaxseed group at the end of week 8 compared with baseline, whereas serum HDL-C showed a significant increase (P < 0.01). These changes in the flaxseed group were significant in comparison with the control group. The study indicates that flaxseed consumption improves lipid abnormalities and reduces systemic inflammation in HD patients with lipid abnormalities.
    Matched MeSH terms: Renal Dialysis/methods*
  12. Koh KH, Tan HH
    Med J Malaysia, 2006 Mar;61(1):109-11.
    PMID: 16708747 MyJurnal
    Acute severe intoxication with carbamazepine is associated with seizures, coma and respiratory depression. Traditionally, charcoal haemoperfusion is used to remove the drug. We present a case of carbamazepine intoxication, successfully treated with three hours of high-flux haemodialysis. Thus, haemodialysis using high-flux membranes is a feasible and effective therapeutic option for carbamazepine intoxication.
    Matched MeSH terms: Renal Dialysis/methods*
  13. Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH
    Ther Apher Dial, 2016 Oct;20(5):453-461.
    PMID: 27151394 DOI: 10.1111/1744-9987.12406
    Hypertension is prevalent in 75-80% of hemodialysis patients and remains the most controversial prognostic marker in end stage kidney disease patients. In contrast to the general population where systolic blood pressure of ≤120 mm Hg is considered normal, a debate remains regarding the ideal target blood pressure in hemodialysis patients. Using the PUBMED and EMBASE databases, the research studies that evaluated the relationship between blood pressure measurements and mortality in hemodialysis patients were searched. Thirteen studies were identified from different regions of the world. Five studies reported low predialysis systolic blood pressure as a prognostic marker of mortality. Other studies showed varying results and reported postdialysis systolic blood pressure as well as ambulatory blood pressure as better predictors of mortality and emphasized their optimized control. One study in this review concluded that there is no direct relationship between mortality and blood pressure if the patients are on anti-hypertensive medications. The observed all-cause mortality varied from 12% to 36%, whereas the cardiovascular mortality varied from 16% to 60%. On the basis of studies included in the current review, a low predialysis systolic blood pressure (<120 mm Hg) is shown to be a widely accepted prognostic marker of mortality while ambulatory blood pressure best predicts CV mortality. Therefore, we recommend that apart from routine BP (pre, post and intradialysis) monitoring in centers, assessment of ambulatory BP must be mandatory for all patients to reduce CV mortality in hemodialysis patients.
    Matched MeSH terms: Renal Dialysis/methods*
  14. Eng CSY, Bhowruth D, Mayes M, Stronach L, Blaauw M, Barber A, et al.
    Nephrol Dial Transplant, 2018 05 01;33(5):847-855.
    PMID: 29136192 DOI: 10.1093/ndt/gfx287
    Background: Fluid balance is pivotal in the management of children with chronic kidney disease (CKD) and on dialysis. Although many techniques are available to assess fluid status, there are only a few studies for children, of which none have been comparable against cardiovascular outcome measures.

    Methods: We performed a longitudinal study in 30 children with CKD5-5D and 13 age-matched healthy controls (71 measurements) to determine a correlation between optimal weight by bioimpedance spectroscopy (Wt-BIS) and clinical assessment (Wt-CA). The accuracy of Wt-BIS [relative overhydration (Rel-OH)] was compared against indicators of fluid status and cardiovascular measures.

    Results: There was poor agreement between Wt-CA and Wt-BIS in children on dialysis (P = 0.01), but not in CKD5 or control subjects. We developed a modified chart to plot Rel-OH against systolic blood pressure (SBP) z-score for the appropriate representation of volume status and blood pressure (BP) in children. In total, 25% of measurements showed SBP >90th percentile but not with concurrent overhydration. Rel-OH correlated with peripheral pulse pressure (P = 0.03; R = 0.3), higher N-terminal pro-brain natriuretic peptide (P = 0.02; R = 0.33) and left ventricular end-diastolic diameter (P = 0.05; R = 0.38). Central aortic mean and pulse pressure significantly associated with the left ventricular end-diastolic diameter (P = 0.03; R = 0.47 and P = 0.01; R = 0.50, respectively), but not with Rel-OH. SBP was positively associated with pulse wave velocity z-score (P = 0.04). In total, 40% of children on haemodialysis and 30% on peritoneal dialysis had increased left ventricular mass index.

    Conclusions: BIS provides an objective method for the assessment of hydration status in children on dialysis. We noted a marked discrepancy between BP and hydration status in children on dialysis that warrants further investigation.

    Matched MeSH terms: Renal Dialysis/methods*
  15. Rehman IU, Chan KG, Munib S, Lee LH, Khan TM
    Medicine (Baltimore), 2019 Sep;98(36):e16812.
    PMID: 31490367 DOI: 10.1097/MD.0000000000016812
    Chronic kidney disease (CKD)-associated pruritus is one of the most common symptoms found in patients who undergo dialysis for CKD, leading to a compromised quality of life. This study aimed to investigate the association between CKD-associated pruritus and the quality of life in patients undergoing hemodialysis in Pakistan.A cross-sectional multicenter study was carried out from July 2016 to April 2017 in 2 tertiary care hospitals in Pakistan. Patients aged 18 years and above of both genders, undergoing hemodialysis, understood the Urdu language, and were willing to participate; were included.Of 354 recruited patients with a response rate of 100%, majority (66.1%) of the patients were males. The median (intra-quartile range [IQR]) age of patients was 42.0 [34.0-50.0] years. The prevalence of pruritus was 74%. The median [IQR] score for pruritus was 10.0 (out of possible 25) [8.0-12.0]. Multivariate linear regression revealed a statistically significant association between CKD-associated pruritus with age of patients (β = 0.031; 95% confidence interval [CI] = 0.002-0.061; P = .038), duration of CKD (β = -0.013; 95% CI = -0.023 --0.003; P = .014) and quality of life (β= -0.949; 95% CI = -1.450; -0.449). The median [IQR] score for health-related quality of life was 52.00 [43.00-58.00].Prevalence of CKD-associated pruritus was reported to be 74% and it negatively affected the patient's quality of life. Patients with moderate to severe CKD-associated pruritus have poor quality of life. With an increase in intensity of pruritus, the QOL score decreased among the patients undergoing hemodialysis.
    Matched MeSH terms: Renal Dialysis/methods
  16. Hamzan MI, Hamid AR, Halim AS, Mat Saad AZ
    Hemodial Int, 2020 04;24(2):E33-E36.
    PMID: 32141217 DOI: 10.1111/hdi.12832
    A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical management following a failed endovascular approach to relieve central venous occlusion. She had an obstructed left brachiocephalic vein with a history of numerous central vein catheter placements. Alternative routes for new arteriovenous fistula creation had been exhausted due to previous contralateral upper limb fistula rupture and ligation. To the best of our knowledge, no similar cases of airway obstruction in central venous occlusion occurring in hemodialysis patients with AV fistula have been reported. The importance of identifying the possible emergency red flags in hemodialysis patients with central venous occlusion is important to prevent unwanted consequences.
    Matched MeSH terms: Renal Dialysis/methods
  17. Tumin M, Tafran K, Zakaria RH, Satar NM, Ng KP, Lim SK
    Ann. Transplant., 2015 Dec 22;20:752-6.
    PMID: 26690676 DOI: 10.12659/aot.894427
    BACKGROUND: Malaysia, which currently uses the informed consent system (ICS), is suffering from a severe shortage of organs for transplantation. Family members of dialysis patients (FMDPs) are expected to have a positive attitude toward deceased organ donation (DOD) because they have a close relative in need of a kidney donation. This study explores FMDPs' attitude toward DOD under the ICS and the presumed consent system (PCS).

    MATERIAL/METHODS: The attitude of 350 FMDPs toward DOD under the ICS and PCS were sought between June and October 2013 in 3 dialysis institutions in Kuala Lumpur, Malaysia.

    RESULTS: Under the ICS, 6.6% of respondents were registered donors, 6.6% were ready to register at the time of the survey, 38.6% were willing to donate but not ready to register at the time of the survey, and 48.2% were unwilling to donate organs upon death. If the PCS were implemented, 57.7% of respondents (28.7% of the willing donors and 88.7% of the unwilling respondents) stated that they would officially object to organ donation.

    CONCLUSIONS: FMDPs' attitude toward DOD is not more positive or significantly better than that of the general public (based on earlier studies). The PCS may increase the number of donors, but it may also worsen the attitude of FMDPs toward DOD. Strategies aiming to promote DOD in Malaysia should be revised, and should perhaps be focused on enhancing trust of the medical system.
    Matched MeSH terms: Renal Dialysis/methods
  18. Letchmi S, Das S, Halim H, Zakariah FA, Hassan H, Mat S, et al.
    Nurs Health Sci, 2011 Mar;13(1):60-4.
    PMID: 21392194 DOI: 10.1111/j.1442-2018.2011.00579.x
    The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross-sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise.
    Matched MeSH terms: Renal Dialysis/methods
  19. Barnett T, Li Yoong T, Pinikahana J, Si-Yen T
    J Adv Nurs, 2008 Feb;61(3):300-6.
    PMID: 18197864 DOI: 10.1111/j.1365-2648.2007.04528.x
    AIM: This paper is a report of a study to examine the effectiveness of a patient education programme on fluid compliance as assessed by interdialytic weight gain, mean predialysis blood pressure and rate of fluid adherence.
    BACKGROUND: Patients with end stage renal disease who receive haemodialysis are often non-compliant with their treatment regime, especially adherence to fluid restrictions.
    METHOD: An exploratory study was conducted in 2004-05 using a quasi-experimental, single group design to examine the effectiveness of patient education on fluid compliance in a dialysis centre located in a major teaching hospital in Kuala Lumpur, Malaysia. Twenty-six patients with an interdialytic weight gain of greater than 2.5 kg were identified as non-compliant and recruited to the study. The intervention was carried out over a 2-month period and included teaching and weekly reinforcement about diet, fluids and control of weight gain.
    FINDINGS: Patients' mean interdialytic weight gain decreased following the educational intervention from 2.64 kg to 2.21 kg (P < 0.05) and adherence to fluid restrictions increased from 47% to 71% following the intervention. Predialysis mean blood pressure did not improve following the intervention, although the maximum recording for predialysis systolic pressure dropped from 220 mmHg to 161 mmHg. Whilst no statistically significant associations were detected between interdialytic weight gain and age, educational level, marital status or employment status, women demonstrated a greater decrease in mean interdialytic weight gain than men.
    CONCLUSION: Nephrology nurses often have long-term relationships with their patients and are ideally placed to provide ongoing education and encouragement, especially for those experiencing difficulties in adhering to fluid and dietary restrictions.
    Matched MeSH terms: Renal Dialysis/methods
  20. Chan MW, Cheah HM, Mohd Padzil MB
    Int J Clin Pharm, 2019 Oct;41(5):1282-1289.
    PMID: 31302884 DOI: 10.1007/s11096-019-00878-4
    Background Hyperphosphatemia is a common consequence in end stage renal disease. It is associated with increased cardiovascular risk and mortality, also development of hyperparathyroidism and mineral bone disease. A patient educational program involving physician, pharmacist and dietician was developed to manage hyperphosphatemia among hemodialysis patients. Objective To investigate the efficacy of the program in optimal phosphate control among hemodialysis patients. Setting Kuala Lipis Hospital, Malaysia. Method This was a non-randomized, single-arm community trial running for a period of 6 months. The program consisted of a small group seminar and individual counseling sessions. Two individual counseling sessions were conducted for each patient, focusing on diet and medication adherence, by an accredited dietician and pharmacist respectively. The group seminar was delivered by a multidisciplinary team involving a physician, pharmacist and dietician. Topics included basic knowledge of hyperphosphatemia, phosphate binder and dietary phosphate control. Eligible and consented patients had knowledge and medication adherence assessment, measurement of pre-dialysis serum calcium, albumin, phosphate, haemoglobin and alkaline phosphatase before and after the educational program. Main outcome measure Phosphate level, knowledge and medication adherence assessment. Results Fifty-seven patients completed the program and were included into final data analysis. The median (IQR) phosphate level (mmol/L) was 1.86 (1.45-2.24) before and decreased to 1.47 (1.21-1.91) and 1.49 (1.28-1.81) 3 months and 6 months after PEP (p 
    Matched MeSH terms: Renal Dialysis/methods*
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