Background and Purpose: Physical activity is significantly lower in the end-stage renal disease (ESRD) population compared with age-matched sedentary controls. Self-efficacy is a significant contributing factor to exercise behaviour in the healthy and various chronic disease populations; however, little information is available on self-efficacy and exercise in the ESRD population. The purpose of this study was to examine the relationship between self-efficacy and physical activity levels in individuals with ESRD and to determine factors which may contribute to this relationship. Participants: Patients (127 hemodialysis and 5 peritoneal dialysis) were recruited from the Kingston General Hospital renal units. Methods: Self-efficacy was measured using the Exercise Self-Efficacy Scale (ESES) and the Chronic Disease Self-Efficacy Scale (CDSES). Physical activity was measured using the Human Activity Profile (HAP). Responses on the HAP resulted in 2 scores: the maximum activity score (MAS) and the adjusted activity score (AAS). Contributing factors, such as age, co-morbidities, length on dialysis (vintage), medications, dialysis efficacy (Kt/V), albumin, prealbumin, total protein, protein catabolic rate (PCR) and hemoglobin (HgB) were collected from patient records. Results: The average MAS and AAS scores were 62.5±15.6 and 49.1± 21.0 (SD), respectively, which are substantively lower than those in the healthy population. Serum albumin was the sole contributing factor to physical activity such that AAS in those with lower levels of albumin (24-30g/L, 31-34 g/L) was less than those with higher levels of albumin (p<0.05). Both MAS and AAS were significantly lower in those with diabetes (n=66) compared to those without (n=66), as was the difference between MAS and AAS. Age and self-efficacy explained 51% of the variance in MAS. Age, self-efficacy and serum albumin level explained 59% of variance in AAS. Discussion and Conclusion: Individuals on dialysis have lower functional capability within their maximal energy ability at any age and this difference is more pronounced among those with diabetes. Physical activity was substantially influenced by an individual’s self-efficacy, age and serum albumin level. These findings indicate that self-efficacy must be taken into account and used to promote greater participation in physical activity in the ESRD population. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2010-04-27 09:47:12.764

Research to improve artificial renal replacement therapies is varied across the many different parts of a hemodialysis system. Work largely focuses on developing a better dialyzer - the component that is directly responsible for removing wastes from the blood - but less study is devoted to the entire hemodialysis system. This work seeks to improve hemodialysis in two ways: by proposing a new renal replacement therapy that does not rely on traditional hemodialysis components, and by investigating the feasibility of adapting current hemodialysis practices to a portable format. While an alternative renal replacement therapy may be the best solution to today's dialysis problems, this work further focuses on reducing hemodialysis to a portable format through systematic engineering design. In that process, a detailed system model is made in Simulink that can account for the large number of inputs of such a system - the blood flow rate, dialyzer size, treatment time, etc. - allowing for detailed exploration of the design space. Once the model is completed, it is verified through in vitro experiments carried out with porcine blood. Additionally, the model is verified against published human hemodialysis data. After model verification, hemodialysis concepts are generated that allow for maximum portability under different patient conditions.

Lic.-avh. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 2 uppsatser.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, 2003. / Kaynakça var.

Thesis ( M.Sc.). / Written for the Dept. of Epidemiology and Biostatistics. Title from title page of PDF (viewed 2008/05/29). Includes bibliographical references.

Thematic Paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2008. / LICL has E-Thesis 0038 ; please contact computer services. LIRV has E-Thesis 0038 ; please contact circulation services.

Thesis (M.N.)--Memorial University of Newfoundland, 2003. / Typescript. Bibliography: leaves 176-183. Also available online.

Thesis (M.N.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 188-195.

Thesis (M.S.)--University of Toledo, 2006. / "In partial fulfillment of the requirements for the degree of Master of Science in Nursing." Major advisor: Jane C. Evans. Includes abstract. Document formatted into pages: v, 53 p. Title from title page of PDF document. Bibliography: pages 42-43.

Η μακροπρόθεσμη έκθεση της περιτοναϊκής μεμβράνης σε μη βιοσυμβατά περιτοναϊκά διαλύματα οδηγεί σε δομικές αλλαγές και στην απώλεια της υπερδιήθησης. Σκοπός της παρούσας μελέτης είναι να περιγράψουμε τις ιστολογικές αλλαγές της περιτοναϊκής μεμβράνης που παρατηρούνται: α) σε ουραιμικούς ασθενείς που ξεκινούν θεραπεία υποκατάστασης της νεφρικής λειτουργίας με περιτοναϊκή κάθαρση και β) σε ασθενείς που ήδη υποβάλλονται στη μέθοδο για ικανό χρονικό διάστημα. Επίσης να καθορίσουμε κατά πόσο οι μορφολογικές αυτές αλλαγές επηρεάζουν τα λειτουργικά χαρακτηριστικά του περιτοναίου. Μέθοδος: Στη μελέτη περιλήφθηκαν 19 ασθενείς (ομάδα Α) οι οποίοι υποβλήθηκαν σε βιοψία περιτοναίου κατά την τοποθέτηση του περιτοναϊκού καθετήρα και πριν την έναρξη της περιτοναϊκής κάθαρσης (CAPD) και 18 ασθενείς οι οποίοι υποβλήθηκαν σε βιοψία περιτοναίου μετά από 4 χρόνια σε CAPD (ομάδα Β). Οι ιστολογικές παράμετροι που ελέχθησαν ήταν η μεσοθηλιακή επιφάνεια, η υπομεσοθηλιακή ζώνη, η κατάσταση του συνδετικού ιστού και η κατάσταση των αγγείων. Για την εκτίμηση των λειτουργικών χαρακτηριστικών του περιτοναίου και της επάρκειας της μεθόδου εφαρμόσθηκαν η δοκιμασία εξισορρόπησης της περιτοναϊκής μεμβράνης (PET), η συνολική εβδομαδιαία κάθαρση κρεατινίνης (wClcr) και το συνολικό εβδομαδιαίο KT/V της ουρίας (wKT/V). Αποτελέσματα: Οι κύριες ιστολογικές αλλαγές και στις δύο ομάδες ασθενών ήταν η απώλεια των μεσοθηλιακών κυττάρων, η πάχυνση της υπομεσοθηλιακής ζώνης και η υαλίνωση των αγγείων. Το πάχος της υπομεσοθηλιακής ζώνης και στις δύο ομάδες ασθενών ήταν σημαντικά υψηλότερο έναντι φυσιολογικών μαρτύρων (630μm και 1140μm vs. 50μm αντίστοιχα, p <0.05). Αν και δε βρέθηκε σημαντική διαφορά μεταξύ των μορφολογικών αλλαγών του περιτοναίου στους ασθενείς της ομάδας Α και στους ασθενείς της ομάδας Β, υπήρξε μια τάση για σοβαρότερου βαθμού βλάβες στους τελευταίους. Το PET, η wClcr και το wKT/V δεν παρουσίασαν στατιστικά σημαντικές διαφορές στις δύο ομάδες ασθενών, ούτε στους ασθενείς της ομάδας Β κατά την έναρξη και μετά από 4 χρόνια εφαρμογής της μεθόδου. Κανένας σημαντικός συσχετισμός δεν παρατηρήθηκε μεταξύ των ιστολογικών αλλαγών και των λειτουργικών δοκιμασιών και στις δύο ομάδες ασθενών. Συμπεράσματα: Σημαντικές δομικές αλλαγές του περιτοναίου παρατηρούνται στους ουραιμικούς ασθενείς και αυτές οι αλλαγές επιδεινώνονται με την εφαρμογή της CAPD. Οι δομικές αυτές αλλαγές δεν ακολουθούνται από λειτουργικές αλλαγές κατά τη διάρκεια των πρώτων τεσσάρων ετών σε CAPD. / The long-term exposure of peritoneal membrane to bioincompatible dialysis solutions leads to structural changes and loss of ultrafiltration capability. Objective: The aim of the present study is to describe the histological changes of peritoneum that are observed: a) in uremic patients and b) in patients that are in peritoneal dialysis for a period of time. Also to determine the possible relation of histological changes with the transport characteristics of peritoneal membrane and with adequacy of dialysis. Method: Thirty nine patients (M/F=18/19) that underwent a peritoneal biopsy in the initiation of treatment (group A, N=19) or after 4 years in continous ambulatory peritoneal dialysis (CAPD) (group B, N=18) were included in the study. The morphological changes of mesothelial cells and vascular compartment as well as the thickness of submesothelial collagenous zone were estimated. The relations of these changes to peritoneal equilibration test (PET) and to adequacy of dialysis (total weekly creatinine clearance (wClcr) and urea KT/V) were also investigated. Results: The main histological changes in both groups of patients were loss of mesothelial cells and decrease of normal mesothelial surface, thickening of submesothelial collagenous zone and presence of vascular hyalinosis. The thickness of submesothelial collagenous zone in both groups of patients was significantly higher compared to that of controls (630μm and 1140μm vs.50 μm respectively, p <0.05). Although no significant difference was found between morphologic changes of peritoneal membrane in uremic patients starting on CAPD and those on peritoneal dialysis for a mean period of 4 years, there was a trend towards more severe lesions in the latter. The PET, Clcr and urea KT/V were not significantly different in the two groups of patients. These parameters also showed no significant changes when examined in the initiation of CAPD and after four years in peritoneal dialysis in the same patients (group B). No significant correlations were observed between histological changes and PET, Clcr and KT/V in both groups of patients. Conclusions: Significant structural changes of peritoneal membrane are observed in uremic patients and these changes are deteriorated with CAPD treatment. Structural changes are not followed by functional changes during the first four years on CAPD.