No abstract available.
Humans ; Kidney Failure, Chronic* ; Psychology*

Health Status ; Humans ; Kidney Failure, Chronic ; psychology ; therapy ; Quality of Life

Since end-stage renal disease leads to a variety of problems such as disability,reduced quality of life,and mental and psychological disorders,it has become a serious public health problem around the globe.Renal palliative care integrates palliative care philosophy in the care for patients with end-stage renal disease.As a planned,comprehensive,patient-centered care,renal palliative care focuses on the patient's symptoms and needs,aiming to reduce the suffering throughout the course of the disease,including but not limited to end-of-life care.This study reports the palliative care practice for a patient on maintenance dialysis in the Blood Purification Center of Peking Union Medical College Hospital and reviews the present situation of palliative care in end-stage renal disease.
Humans ; Palliative Care/psychology* ; Quality of Life ; Kidney Failure, Chronic/therapy* ; Terminal Care/psychology* ; Renal Dialysis/psychology*

Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on the key issues related to pediatric kidney transplantation such as growth, neurocognitive function, nonadherence, and posttransplantation infectious complications, including lymphoproliferative disease, to broaden the understanding of pediatricians who provide pre-and postoperative care to children with end-stage renal disease.
Child ; Graft Survival ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Postoperative Care ; Rejection (Psychology) ; Survivors

PURPOSE: Professional hemodialysis (HD) nursing tends to be task-oriented and lack consideration of the client's viewpoint. This study aims to interpret the process of psychosocial adaptation to dealing with HD in people with end-stage renal disease (ESRD). METHODS: A grounded theory guided this study. Theoretical sampling included 15 people receiving HD at the HD center of a hospital from July to November 2010. Participants received an information sheet in writing, a verbal invitation, and informed consent forms before interviews were conducted. A constant comparative data analysis was analyzed using open, axial and selective coding. The computer software ATLAS.ti assisted data management. Credibility, transferability, dependability, and confirmability ensured the rigor of study process. RESULTS: This study identified "adopting life with hemodialysis", which captures the process of the psychosocial adaptation in people with ESRD as one transformation. Four categories that evolved from "adopting HD life" are (a) slipping into, (b) restricted to a renal world, (c) losing self control, and (d) stuck in an endless process. CONCLUSIONS: The findings of this investigation indicate the multidimensional requirements of people receiving maintenance dialysis, with an emphasis on the deficiency in psychosocial and emotional care. The study's findings contribute to clinical practice by increasing the understanding of the experience of chronic HD treatment from the recipient's viewpoint. The better our understanding, the better the care provided will meet the needs of the people receiving HD.
*Adaptation, Psychological ; Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic/*psychology/therapy ; Male ; Middle Aged ; Qualitative Research ; Renal Dialysis/*psychology

BACKGROUND AND OBJECTIVES: The sense of smell plays an important role in the quality of life. Loss of smell is common in the elderly and it results from respiratory diseases, certain disease states (Alzheimer disease, chronic renal failure (CRF), multiple sclerosis), medications, and surgical interventions. Many studies have shown a declining odor perception in the CRF patients. The objectives of the present study were to test odor identification ability in patients with CRF and the effect of hemodialysis on olfactory recognition, and to examine the possible correlations between smell identification test score and various clinical parameters. MATERIALS AND METHOD: We performed a case-control study comparing the Cross- Cultural Smell Identification Test (CC-SIT) scores of CRF patients with hemodialysis, and those without hemodialysis, and age-sex matched healthy controls. RESULTS: Healthy controls had significantly high CC-SIT scores compared to those of CRF patients without hemodialysis. No significant differences were observed in the CC-SIT scores between CRF patients with hemodialysis and healthy controls and in CRF patients before and after the hemodialysis session. No significant positive correlation was found between CC-SIT score and creatinine clearance in the dialysis group. CONCLUSION: Acute removal of uremic toxins by hemodialysis does not correct olfactory disturbances. Odor perception is severly impaired in patients with CRF and is related to the degree of renal impairment.
Aged ; Case-Control Studies ; Creatinine ; Dialysis ; Humans ; Identification (Psychology) ; Kidney ; Kidney Failure, Chronic* ; Odors ; Quality of Life ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Smell

Medical co-morbidities are very common in patients with psychiatric conditions. Although respecting one's autonomy to make treatment decisions is the ethical default position, the capacity to make such decisions may need to be assessed, especially when patients are in relapse of their psychiatric condition, and/or when the decisions made are high-risk and possibly fatal. This case report highlights the ethical issues of refusing potential life-saving treatment in a patient who is in relapse of her schizoaffective disorder. In particular, the assessment of decisional capacity and the role of the doctors (if the patient lacks capacity) are discussed. Recommendations are also made on how to better manage such situations.
Adult ; Female ; Humans ; Kidney Failure, Chronic ; therapy ; Mental Competency ; Patient Care ; ethics ; Patient Participation ; psychology ; Personal Autonomy ; Schizophrenia

Sexual dysfunction is a highly prevalent problem among patients with chronic renal failure, which affects patients in the quality of life. However, it has not received enough attention. The genesis of sexual dysfunction is multifactorial, including physiological, psychological and organic factors. This review summarized the incidence, main manifestation, evaluation, risk factors and treatments associated with sexual dysfunction in patient of the chronic renal failure.
Female ; Humans ; Kidney Failure, Chronic ; complications ; physiopathology ; psychology ; Male ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Sexual Dysfunctions, Psychological ; etiology ; therapy

BACKGROUND: The quality of life (QoL) of patients with end-stage renal disease (ESRD) is very poor, plausibly due to both psychosocial and medical factors. This study aimed to determine the relationship among psychosocial factors, medical factors, and QoL in patients with ESRD undergoing hemodialysis (HD). METHODS: In total, 55 male and 47 female patients were evaluated (mean age, 57.1 ± 12.0 years). The QoL was evaluated using the Korean version of World Health Organization Quality of Life Scale-Abbreviated Version. The psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, Pittsburgh Sleep Quality Index, and Zarit Burden Interview. The medical factors were assessed using laboratory examinations. Correlation and canonical correlation analyses were performed to investigate the association patterns. RESULTS: The QoL was significantly correlated with the psychosocial factors, and to a lesser extent with the medical factors. The medical and psychosocial factors were also correlated. The canonical correlation analysis indicated a correlation between QoL and psychosocial factors (1st canonical correlation = 0.696, P < 0.001; 2nd canonical correlation = 0.421, P = 0.191), but not medical factors (1st canonical correlation = 0.478, P = 0.475; 2nd canonical correlation = 0.419, P = 0.751). The medical and psychosocial factors were also correlated (1st canonical correlation = 0.689, P < 0.001; 2nd canonical correlation = 0.603, P = 0.009). CONCLUSION: Psychosocial factors influence QoL in patients with ESRD, and should thus be carefully considered when caring for these patients in clinical practice.
Anxiety ; Depression ; Female ; Humans ; Kidney Failure, Chronic ; Male ; Psychology* ; Quality of Life* ; Renal Dialysis* ; Statistics as Topic* ; World Health Organization

BACKGROUND: Kidney transplantation (KT) is the optimal treatment for end stage renal disease. However, the relative shortage of organs for transplantation (from human leukocyte antigen- or ABO incompatible [ABOi] living donors) has led to ABOi KT as an accepted method to expand the pool of living kidney donors. To date, reports of the outcomes of ABOi KT are limited; therefore this study aims to evaluate the outcomes of ABOi KT in recipients. METHODS: We identified 45 patients who underwent live-donor ABOi KT between February 2007 and November 2011 at Maryknoll Medical Center. All of them were treated according to the scheduled protocol of plasmapheresis with low dose intravenous immunoglobulin, and low dose rituximab- or tacrolimus-based triple immunosuppressant regimens. Clinical parameters and the incidence of rejections in these patients were analyzed. RESULTS: We had three cases (6.6%) of biopsy-proven acute antibody-mediated rejections and one case (2.2%) of acute cellular rejection, all of which were successfully treated. The median follow-up duration was 20 months (range, 2~59). Antibody depletion was scheduled according to baseline anti-ABO antibody titer (tube method: median immunoglobulin G titer/immunoglobulin M titer 64 [range, 8~4,096]/16 [range, 2~256], respectively). Although there was no patient death, one patient lost his graft due to nonadherence to immunosuppressants. CONCLUSIONS: Our analysis of ABOi KT has shown excellent and promising outcomes. These practices may therefore represent an acceptable option for expanding the pool of living kidney donors.
Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunosuppression ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Leukocytes ; Plasmapheresis ; Rejection (Psychology) ; Tissue Donors ; Transplants