Background: Tuberculosis (TB) now ranks as the leading cause of death from a single infectious agent worldwide. Patients on dialysis are particularly vulnerable to TB infection due to immune dysfunction. Despite this, there is a paucity of incidence data on TB in dialysis patients in high burden settings such as South Africa. The aim of this study was to determine the incidence of TB in chronic kidney disease stage 5 patients on dialysis (CKD-5D) at a single centre in the Eastern Cape, South Africa and to identify risk factors associated with TB infection. Methods: We conducted a retrospective cohort study of all consenting prevalent CKD-5D patients between April 2010 and March 2014 at the Livingstone Tertiary Hospital Renal Unit in the Eastern Cape, South Africa. TB was defined as “definite” or “probable” according to WHO criteria. Results: One hundred and eleven patients were enrolled: they were predominantly black African (73%) and female (53%); mean age was 42 years (SD ±9years). The prevalence of HIV infection was 11%: all were on antiretroviral treatment and all had suppressed viral loads. Sixty eight patients were on haemodialysis (HD) and 43 patients were on peritoneal dialysis (PD). Nineteen patients were diagnosed with 20 episodes of TB; 14 cases were pulmonary and 6 cases extrapulmonary. Of the patients with TB, 2 were HIV infected. Of the 20 TB cases, 7 (35%) were definite TB cases and 13 (65%) had probable TB. The calculated incidence rate was 4505 per 100 000 patient years. Only informal housing and a history of hospitalization were significantly associated with a diagnosis of TB. Conclusion: Dialysis patients in the Eastern Cape region of South Africa are at extremely high risk for the acquisition of TB with an incidence rate that is 4.1 times that of the local Nelson Mandela Bay population and over 5 times that reported in the general population for the country as a whole. Only informal housing and a history of hospitalization were identified as positive risk factors in this young population with a low HIV prevalence. Isoniazid prophylaxis in this high risk group might be of benefit but further studies are required to inform such treatment.

Background:Various amalgamation diseases which the ESRD patient of may suffer from have already had quite a lot of research to latter stage abroad .Recently, Abroad research find The ESRD patient in carry on extended dialysis can exert an influence or appear melancholy mood to psychological condition their treat .Extended dialysis may influence its medical resource to use or increase mortality.It gradually become to a topic. Objectives¡GThis study explores the prevelance of ESRD with melancholia and finds out if there are any significant difference upon demography status, comorbodities, dialysis therapy, utilization of health care between ESRD with melancholia and without melancholia.As well as we will discuss the risk factors of ESRD patient with melancholia. Methods¡GWe conducted secondary data analysis with admnstrative data of National Health Insurance between 2000, 2002, 2004 and 2006. We firstly seleced the patients diagnosed as ESRD and melancholia, and merged the data set and other related variables.The data was analyzed by Chi-square test, t-test and logistic regression. Result¡GThe prevelance of ESRD with melancholia were 0.47%(2000), 0.73%(2002),1.27%(2004), 1.34%(2008)¡FESRD patients with and without melancholia was significant difference (p < 0.0001) between sex, dialysis therapy, dialysis duration, and the regions of hospital organizations, class of hospital organizations. ESRD patients with and without melancholia was significant difference (p < 0.0001) between age, comorbidities, dialysis duration, outpatient visits and expenditures. Conclusion¡GThe study was benefited by large sample of adminstative data, but there were some limitation of precision of diagnoses and payment issue of health care system, therefore, we strongly suggested further study could be conducted by research questionnaires to make up the weakness of adminstatrative data.

Background: According to 2010 U.S. Renal Data System 2010Annual Data Report, the incidence and prevalence of End-Stage Renal Disease is the worst of the world in Taiwan. Sleep complaints are common in dialysis patients, and impacts negatively on health. It has become highly important issue. Objectives: This study explored the prevalence of ESRD with sleep disorder. We focused on demography status, comorbidities, dialysis therapies and utilization of health care to define the risk factors of disease. Methods: We conducted secondary data analysis with admnstrative data of National Health Insurance between 2000, 2002, 2004 and 2006. We firstly seleced the patients diagnosed as ESRD and Dyssomnia, and merged the data set and other related variables.The data was analyzed by Chi-square test, t-test and logistic regression. Result: The prevalence of ESRD with sleep disorder for the four years were 2.1%¡B2.7%¡B6.4% and 7.3%, respectively. Female patient has higher risk than male .Higher comorbidity score also lead to higher risk, dialysis therapies in hemodialysis/peritoneal were 16.45¡B16.48¡B8.23 and 7.91 in OR. There were significant differences in regions of hospital organizations (northern compared with the eastern, OR were 3.47, 2.73, 1.94 and 2.29, class of hospital organizations (compared with Physician Clinics), there are more cases in Regional Hospitals, except 2006. Outpatient expenses and visits are both positive correlation in all years. Conclusion: The risk factors of suffering sleep disorder in ESRD patients are sex, comorbidities and dialysis therapies. It is a relatively common but frequently unrecognized, therefore, we strongly suggested further study could be conducted by research questionnaires to make up the weakness of adminstatrative data.

<p>  </p> <p>This research evaluates Kidney Health Initiative's (KHI)   four kidney replacement therapy (KRT) technology priority groups in the roadmap:</p> <p>1) Literature review of technology citations for each of the four KHI priority groups for safety and efficacy data with a patient centered focus. Additionally, the incorporation and integration of KHI minimum technical design criteria in six areas into the development process.</p> <p>2) Clinical PICO analysis of the critical clinical outcomes that the discovery and innovation from the specific technology priority group addresses</p> <p>3) Critical evaluation of KRT technologies on patients with ESKD by expert clinicians and scientists in KRT through Delphi method with targeted questionnaires</p>