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[PMID]:28469119
[Au] Autor:Okaka EI; Okwuonu CG
[Ad] Endereço:Department of Medicine, Renal Unit, University of Benin Teaching Hospital, University of Benin, Benin City, Nigeria.
[Ti] Título:Blood pressure variation and its correlates among patients undergoing hemodialysis for renal failure in Benin City, Nigeria.
[So] Source:Ann Afr Med;16(2):65-69, 2017 Apr-Jun.
[Is] ISSN:0975-5764
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Blood pressure (BP) variation is commonly encountered during hemodialysis (HD) procedure. Both intradialysis hypotension and hypertension have implications for outcome of treatment and overall morbidity and mortality of the patients. METHODOLOGY: A retrospective study was carried out in the dialysis unit of a tertiary health institution in Benin City among patients who had HD for acute kidney injury (AKI) or chronic kidney disease (CKD) over a 3-year period. Data retrieved included age, gender, type of kidney disease, cause of kidney disease, systolic BP at onset of dialysis and at end of dialysis, and diastolic BP (DBP) at onset of and at end of dialysis. RESULTS: Complete data were available for 217 patients. One hundred and seven patients (49.3%) had no significant change in BP; 30.9% had intradialytic hypertension (IDHT) while 19.8% had intradialytic hypotension (IDH). IDH was more prevalent among patients with diabetic kidney disease while IDHT was more common among patients with hypertensive nephropathy (P = 0.002). Female patients had higher mean BP parameters compared to male patients pre- and post-dialysis, but only changes in DBP were statistically significant (P = 0.029). Patients with CKD had higher mean BP parameters pre- and post-dialysis compared to patients with acute AKI and the differences were statistically significant. CONCLUSION: Females had higher mean BP parameters than males. Patients with CKD had higher mean BP parameters compared with AKI patients. IDHT is a significant problem among patients on HD in our center. Measures to curtail this trend should be instituted with the goal of reducing morbidity and mortality.
[Mh] Termos MeSH primário: Lesão Renal Aguda/terapia
Pressão Sanguínea/fisiologia
Hipertensão Renal/terapia
Hipertensão/etiologia
Hipotensão/etiologia
Nefrite/terapia
Diálise Renal/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Unidades Hospitalares de Hemodiálise
Hospitais Universitários
Seres Humanos
Masculino
Meia-Idade
Nigéria/epidemiologia
Prevalência
Insuficiência Renal Crônica/complicações
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4103/aam.aam_29_16


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[PMID]:28663226
[Au] Autor:Miskulin DC; Gul A
[Ad] Endereço:Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts; and dmiskulin@tuftsmedicalcenter.org.
[Ti] Título:Infection Monitoring in Dialysis Units: A Plea for "Cleaner" Data.
[So] Source:Clin J Am Soc Nephrol;12(7):1038-1039, 2017 07 07.
[Is] ISSN:1555-905X
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Unidades Hospitalares de Hemodiálise
Diálise Renal
[Mh] Termos MeSH secundário: Infecção Hospitalar
Hepatite C
Seres Humanos
Falência Renal Crônica
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.2215/CJN.05220517


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[PMID]:28599722
[Au] Autor:Clavagnier I
[Ad] Endereço:Lycée des métiers de la santé et du social François Rabelais, Ifsi, 9, rue Francis-de-Croisset, 75018 Paris, France. Electronic address: isabelle.clavagnier@laposte.net.
[Ti] Título:[Telemedicine, remote collaboration].
[Ti] Título:La télémédecine, une collaboration à distance..
[So] Source:Rev Infirm;66(232):24-26, 2017 Jun - Jul.
[Is] ISSN:1293-8505
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:In the archipelago of Saint-Pierre and Miquelon, the dialysis unit of François-Dunan hospital is managed by a nurse. During haemodialysis sessions, she is supported by telemedicine thanks to a partnership established between this unit and that of the ECHO association based in Le Mans. Real remote collaboration has developed over time between the nurse and the nephrologist despite the 4 000 km between them.
[Mh] Termos MeSH primário: Comunicação Interdisciplinar
Colaboração Intersetorial
Relações Médico-Enfermeiro
Consulta Remota/organização & administração
Telemedicina/organização & administração
[Mh] Termos MeSH secundário: Competência Clínica
França
Unidades Hospitalares de Hemodiálise/organização & administração
Seres Humanos
Nefrologia/organização & administração
Enfermeiras Clínicas/organização & administração
Autonomia Profissional
Diálise Renal/enfermagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170611
[St] Status:MEDLINE


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[PMID]:28416321
[Au] Autor:McIntyre C; McQuillan R; Bell C; Battistella M
[Ad] Endereço:Department of Pharmacy, University Health Network, Toronto, Ontario, Canada; Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Targeted Deprescribing in an Outpatient Hemodialysis Unit: A Quality Improvement Study to Decrease Polypharmacy.
[So] Source:Am J Kidney Dis;70(5):611-618, 2017 Nov.
[Is] ISSN:1523-6838
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Polypharmacy in hemodialysis patients can result in adverse patient outcomes. Deprescribing tools can reduce polypharmacy, yet no method exists for an outpatient hemodialysis population. DESIGN: Quality improvement study. SETTING & PARTICIPANTS: 240 patients in a tertiary-care outpatient hemodialysis unit. QUALITY IMPROVEMENT PLAN: We aimed to: (1) develop a deprescribing tool for target medications with poor evidence for efficacy and safety, (2) determine its effectiveness in decreasing polypharmacy, and (3) monitor patient safety and satisfaction. OUTCOMES: The primary outcome was the proportion of target medications completely deprescribed after 4 weeks. Secondary outcomes were the proportion of target medications completely deprescribed after 6 months, average number of medications per patient before and after deprescription, and proportion of successful deprescriptions for each target medication. MEASUREMENTS: Number of medications deprescribed at 4 weeks and 6 months. Patient safety and satisfaction were monitored using drug-specific monitoring parameters. RESULTS: A deprescribing tool for specific medications was developed and implemented in the hemodialysis unit. 5 medication classes were selected: quinine, diuretics, α -blockers, proton pump inhibitors, and 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins). All 240 patients in the unit were screened using the deprescribing tool. There were 171 of 240 (71%) patients prescribed at least 1 of the 5 target medications, and after applying the tool, 35 of 40 (88%) eligible patients had the medications deprescribed. There were 31 of 40 (78%) target medications completely deprescribed. 6 months after the study, only 5 of 31 (16%) medications discontinued were represcribed. At the end of the study, 57% of patients were taking fewer medications than at baseline. No adverse events were observed. LIMITATIONS: Single-center study that relied on patient self-reporting of medication use and adherence to our recommendations. CONCLUSIONS: Deprescribing tools can be applied successfully in an outpatient hemodialysis unit to reduce polypharmacy while maintaining patient safety and satisfaction.
[Mh] Termos MeSH primário: Antagonistas Adrenérgicos alfa/uso terapêutico
Desprescrições
Diuréticos/uso terapêutico
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Falência Renal Crônica/terapia
Relaxantes Musculares Centrais/uso terapêutico
Polimedicação
Inibidores da Bomba de Prótons/uso terapêutico
Melhoria de Qualidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Assistência Ambulatorial
Feminino
Unidades Hospitalares de Hemodiálise
Seres Humanos
Masculino
Meia-Idade
Ontário
Quinina/uso terapêutico
Diálise Renal
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic alpha-Antagonists); 0 (Diuretics); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Muscle Relaxants, Central); 0 (Proton Pump Inhibitors); A7V27PHC7A (Quinine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE


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[PMID]:28152286
[Ti] Título:Five-Star works for those who matter most- patients.
[So] Source:Nephrol News Issues;30(9):12, 2016 Aug.
[Is] ISSN:0896-1263
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/normas
Unidades Hospitalares de Hemodiálise/normas
Qualidade da Assistência à Saúde
Diálise Renal/normas
[Mh] Termos MeSH secundário: Seres Humanos
Defesa do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170406
[Lr] Data última revisão:
170406
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE


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[PMID]:28001019
[Au] Autor:Centers for Medicare & Medicaid Services (CMS), HHS
[Ti] Título:Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities--Third Party Payment. Interim final rule with comment period.
[So] Source:Fed Regist;81(240):90211-28, 2016 12 14.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This interim final rule with comment period implements new requirements for Medicare-certified dialysis facilities that make payments of premiums for individual market health plans. These requirements apply to dialysis facilities that make such payments directly, through a parent organization, or through a third party. These requirements are intended to protect patient health and safety; improve patient disclosure and transparency; ensure that health insurance coverage decisions are not inappropriately influenced by the financial interests of dialysis facilities rather than the health and financial interests of patients; and protect patients from mid-year interruptions in coverage.
[Mh] Termos MeSH primário: Unidades Hospitalares de Hemodiálise/legislação & jurisprudência
Cobertura do Seguro/legislação & jurisprudência
Reembolso de Seguro de Saúde/legislação & jurisprudência
Falência Renal Crônica/economia
Medicare/legislação & jurisprudência
Diálise Renal/economia
[Mh] Termos MeSH secundário: Conflito de Interesses/economia
Conflito de Interesses/legislação & jurisprudência
Revelação
Trocas de Seguro de Saúde/economia
Trocas de Seguro de Saúde/legislação & jurisprudência
Unidades Hospitalares de Hemodiálise/economia
Seres Humanos
Cobertura do Seguro/economia
Medicare/economia
Direitos do Paciente
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170110
[Lr] Data última revisão:
170110
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:161222
[St] Status:MEDLINE


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Texto completo SciELO Chile
[PMID]:27905652
[Au] Autor:Salas SP; Vukusich A; Catoni MI; Valdivieso A; Roessler E
[Ti] Título:[Conflicts of interest in nephrology].
[Ti] Título:Conflictos de intereses en nefrología..
[So] Source:Rev Med Chil;144(8):1053-1058, 2016 Aug.
[Is] ISSN:0717-6163
[Cp] País de publicação:Chile
[La] Idioma:spa
[Ab] Resumo:Since doctors disposed of effective tools to serve their patients, they had to worry about the proper management of available resources and how to deal with the relationship with the industry that provides such resources. In this relation-ship, health professionals may be involved in conflicts of interest that they need to acknowledge and learn how to handle. This article discusses the conflicts of interest in nephrology. Its objectives are to identify those areas where such conflicts could occur; to help to solve them, always considering the best interest of patients; and to help health workers to keep in mind that they have to preserve their autonomy and professional integrity. Conflicts of interest of professionals in the renal area and related scientific societies, with the industry producing equipment, supplies and drugs are reviewed. Dichotomy, payment for referral, self-referral of patients and incentives for cost control are analyzed. Finally, recommendations to help preserve a good practice in nephrology are made.
[Mh] Termos MeSH primário: Conflito de Interesses
Unidades Hospitalares de Hemodiálise/ética
Relações Interprofissionais/ética
Nefrologia/ética
Prática Profissional/ética
[Mh] Termos MeSH secundário: Unidades Hospitalares de Hemodiálise/economia
Seres Humanos
Indústrias
Autorreferência Médica/ética
Médicos/ética
Autonomia Profissional
Sociedades Médicas/ética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE


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[PMID]:27796027
[Au] Autor:Quintaliani G; Di Luca M; Di Napoli A; Viglino G; Postorino M; Amore A; Andrulli S; Bellasi A; Brunori G; Buongiorno E; Castellino S; D'Amelio A; De Nicola L; Gesualdo L; Di Landro D; Feriozzi S; Strippoli G; Teatini U; Santoro A
[Ti] Título:[Census of the renal and dialysis units by Italian Society of Nephrology: structure and organization for renal patient assistance in Italy (2014-2015)].
[Ti] Título:Censimento a cura della Società Italiana di Nefrologia delle strutture nefrologiche e delle loro attività in Italia nel 2014-2015: l'organizzazione..
[So] Source:G Ital Nefrol;33(5), 2016 Sep-Oct.
[Is] ISSN:1724-5990
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:BACKGROUND: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted a census of the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to the year 2014. METHODS: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit. RESULTS: 615 renal units were identified. From these 615 units, 332 were public renal centres (of which 318 centres answered to the census) and 283 were private dialysis centres (of which 113 centres answered to the census). The results show 6 public renal units pmp. Renal biopsies were 4624 (81 pmp). The nephrology beds are about 41 pmp. There are 7.304 nurses working in HD wards, 1.692 in the nephrology wards and only 613 for outpatients clinics. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/organização & administração
Censos
Unidades Hospitalares de Hemodiálise/organização & administração
Nefrologia
Diálise Renal/estatística & dados numéricos
Insuficiência Renal/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Itália
Registros como Assunto
Sociedades Médicas
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE


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[PMID]:27796026
[Au] Autor:Quintaliani G; Di Luca M; Di Napoli A; Viglino G; Postorino M; Amore A; Andrulli S; Bellasi A; Brunori G; Buongiorno E; Castellino S; D'Amelio A; De Nicola L; Gesualdo L; Di Landro D; Feriozzi S; Strippoli G; Teatini U; Santoro A
[Ti] Título:[Census of the renal and dialysis units by Italian Society of Nephrology: nephrologist's workload for renal patient assistance in Italy (2014-2015)].
[Ti] Título:Censimento a cura della Società Italiana di Nefrologia delle strutture nefrologiche e della loro attività in Italia nel 2014-2015: il lavoro del nefrologo..
[So] Source:G Ital Nefrol;33(5), 2016 Sep-Oct.
[Is] ISSN:1724-5990
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:BACKGROUND: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted acensusof the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to theyear 2014. METHODS: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit. RESULTS: Renal and dialysis activity was performed by over 2718 physicians (45 pmp). The management of the acute renal failure was one of the most frequent activities in the public renal units (12,206 patients in ICU and 140.00 dialysis sessions). There were performed about 9000 AV fistulas and 1700 central vascular catheters insertions. In the census, there are a lot of data regarding organization, workforce and workload of the renal unit in Italy. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/organização & administração
Instituições de Assistência Ambulatorial/estatística & dados numéricos
Censos
Unidades Hospitalares de Hemodiálise/organização & administração
Unidades Hospitalares de Hemodiálise/estatística & dados numéricos
Nefrologia/estatística & dados numéricos
Diálise Renal/estatística & dados numéricos
Insuficiência Renal/terapia
Carga de Trabalho
[Mh] Termos MeSH secundário: Instituições de Assistência Ambulatorial/recursos humanos
Unidades Hospitalares de Hemodiálise/recursos humanos
Seres Humanos
Itália/epidemiologia
Nefrologia/recursos humanos
Prevalência
Registros como Assunto
Insuficiência Renal/epidemiologia
Sociedades Médicas
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE


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[PMID]:27455086
[Au] Autor:Senosy SA; El Shabrawy EM
[Ad] Endereço:Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
[Ti] Título:Hepatitis C virus in patients on regular hemodialysis in Beni-Suef Governorate, Egypt.
[So] Source:J Egypt Public Health Assoc;91(2):86-9, 2016 Jun.
[Is] ISSN:2090-262X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The prevalence of HCV infection among hemodialysis patients (HD) varies from country to country and from one center to another. Despite the existence of guidelines for a comprehensive infection control program, Egypt is one of the countries with high HCV prevalence. In Egypt, the prevalence of HCV in haemadalysis patients (2015) was 50.7%. OBJECTIVES: (1) To detect the prevalence of hepatitis C virus (HCV) infection and HCV seroconversion among all hemodialysis patients in Beni-Suef governorate, and (2) To detect factors associated with HCV seroconversion. MATERIALS AND METHODS: Multicenter retrospective medical records review design was conducted in 13 hemodialysis units in Beni-Suef governorate during May - June 2015; all ESRD (End stage renal disease) patients undergoing hemodialysis were included in the sample. A predesigned questionnaire was used. RESULTS: The prevalence of the HCV at begin of dialysis was 60.9% and the rate of HCV seroconversion was 9.7%. Univariate analysis confirmed that history of blood transfusion, the non-adherence to infection control guidelines, lack of isolation strategies and history of Shistosomiasis were significant risk factors for seroconversion. Meanwhile multivariate logistic regression analysis confirmed that history of blood transfusion, and history of shistosomiasis were significantly associated with HCV seroconversion. CONCLUSION: HCV infection still remains a predominant problem among patients on maintenance HD in Beni- Suef governorate History of blood transfusion and history of shistosomiasis were significant risk factors for acquiring HCV infection in these patients.
[Mh] Termos MeSH primário: Hepacivirus/isolamento & purificação
Anticorpos Anti-Hepatite C/sangue
Hepatite C/diagnóstico
Hepatite C/epidemiologia
Diálise Renal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Egito
Unidades Hospitalares de Hemodiálise
Hepatite C/sangue
Seres Humanos
Prevalência
Estudos Retrospectivos
Fatores de Risco
Estudos Soroepidemiológicos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Hepatitis C Antibodies)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160726
[St] Status:MEDLINE
[do] DOI:10.1097/01.EPX.0000484091.57255.c0



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