Thesis (M.Sc.), Memorial University of Newfoundland, Faculty of Medicine, 1998. / Restricted until June 1999. Bibliography: leaves 123-133.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 6 uppsatser.

Thesis (M.H.S.A.)--University of Michigan, 1976.

Thesis (M.H.S.A.)--University of Michigan, 1976.

Thesis (M.S.)--University of Michigan, 1993.

The purpose of this study was to evaluate certain factors that affect the quality of life experienced by the chronic hemodialysis patient population served by the Artificial Kidney Unit at Good Samaritan Hospital and Medical Center, Portland, Oregon. The intent of the study was to discover if there was a significant difference in quality of life between patients who dialyzed at home and patients at the Artificial Kidney Unit (center patients). For the purposes of this study, House, Livingston and Swinburn’s definition of quality of life was used. Their definition states that quality of life is a function of the perceived conditions affecting a selected population and the subjective attitude toward those conditions held by persons in that population. The perceived conditions with which this study is concerned are: activities of daily living, work and finances, physical condition, emotional state, supportive relationships, spiritual aspects, and choices in life. The patients’ perceptions of themselves in relation to each of these areas constitutes their subjective attitudes about them.

Made available in DSpace on 2016-04-27T13:10:24Z (GMT). No. of bitstreams: 1 Juliane Casas.pdf: 1780723 bytes, checksum: 981765aaf3c65f06c377adf5d9653d40 (MD5) Previous issue date: 2014-03-14 / Chronic renal failure patients are exposed to several nutritional issues, including restrictive diet. Adequate nutrition is of vital importance in the treatment of those patients and nutritional education is a very important matter since it can change the patient s behavior and therefore improve their nutritional status, decreasing risks of inadequate diets. Special attention must be directed to electrolytes, proteins, energy and liquid intake. Objectives: To assess the effects of a specific nutritional education program developed for dialytic patients and designed to give information for adequate decisions and contributions to patient s self-care; To assess changes in feeding habits and laboratorial tests that may be induced by the program. Methodology: 27 patients in HD, randomly chosen, who received a course that consisted of classes about: renal failure, HD and nutrition; liquids, dry weight and interdialytic weight gain; electrolytes and proteins. Before and after the course, patients underwent comparative food questionnaires and were evaluated about their nutritional knowledge. Blood levels of albumin, phosphorus, potassium and interdialytic weight gain, body mass index were also compared in the two moments. The course were evaluated through the gain of knowledge and by open questions about the course itself. Results: Patients demonstrated a very low level of comprehension of basic questions about nutrition before the course (24% of correct answers). This comprehension improved after the course (60% of correct answers), but food questionnaires, interdialytic weight gain and laboratorial data were similar in both moments, despite a very good satisfaction evaluation of the course by patients. Conclusions: The educational program induced a gain of knowledge in nutritional aspects for dialysis patients, but did not induce significant changes of the quality/amount of food intake nor in the laboratorial levels. Positive assessment of the program was observed. It s possible that changes in the nutritional aspects and in laboratorial level demand more time of observation / Os pacientes com insuficiência renal crônica em programa hemodialitico (HD) estão expostos a múltiplas questões nutricionais, incluindo dieta restritiva. A nutrição desempenha papel vital no tratamento destes pacientes. A Educação Nutricional é um tema de extrema importância para os pacientes em HD, uma vez que pode provocar mudanças comportamentais capazes de melhorar o estado nutricional e diminuir os riscos a que estes pacientes se submetem com dietas inadequadas. Objetivos:. Avaliar os efeitos de um programa de educação nutricional específico desenvolvido para pacientes em hemodiálise, de forma a auxiliar para a adequação das decisões e contribuir para o autocuidado dos pacientes; Avaliar mudanças induzidas pelo conhecimento sobre nutrição, hábitos alimentares e nos exames laboratoriais dos pacientes. Metodologia: Foram estudados 27 pacientes em HD, escolhidos aleatoriamente e que receberam aulas sobre Insuficiência Renal, HD e Nutrição; líquidos, Peso seco e ganho de peso interdialítico; eletrólitos e Proteínas. Antes e após o curso, os pacientes foram submetidos a inquéritos alimentares e a avaliações sobre assuntos relacionados à nutrição, sendo as respostas destes dois momentos comparadas entre si. Os valores antes e após o programa de albumina, fósforo, potássio, ganho de peso interdialitico e índice de massa corporal também foram comparados. O curso foi avaliado através de questionamento aos pacientes sobre suas impressões, percepções e a importância atribuída às aulas. Resultados: os pacientes demonstraram antes do curso baixo nível de conhecimentos sobre aspectos básicos de nutrição (24% de acerto). Houve melhora de compreensão após o curso (60% de acerto), mas os inquéritos alimentares mostraram-se similares nos dois momentos indicando não ter havido alterações na qualidade e quantidade de sua ingestão alimentar. Também não notamos, após o curso, alterações em relação aos exames laboratoriais e ao ganho de peso interdialitico. O questionário voltado para avaliar o grau de satisfação demonstrou elevada satisfação dos pacientes e a importância da reprodução do curso. Conclusões: O curso melhorou o nível de compreensão dos pacientes sobre os aspectos nutricionais, mas não induziu a mudanças significativas no comportamento alimentar e nos exames laboratoriais. Os pacientes demonstraram elevado grau de satisfação com o curso. É possível que alterações nos hábitos alimentares e possíveis alterações laboratoriais demandem maior tempo de observação

Der Diabetes mellitus zählt zu den Hauptursachen einer terminalen Niereninsuffizienz. Aufgrund der veränderten Erythropoiese ist die Verwendung des HbA1c für die Beurteilung der Stoffwechseleinstellung bei Diabetikern mit einer chronischen Nierenerkrankung im Stadium 5 nach KDOQI immer noch in Frage gestellt. Die vorliegende Arbeit untersuchte die HbA1c-Variabilität in Abhängigkeit der ESA-Dosis und des ESA-Präparates bei Hämodialysepatienten. Zum Einsatz kamen entweder das klassische Epoetin-Analogon Erythropoietin α oder ein Wirkstoff der neueren Generation Methoxy-Polyethylenglycol-Epoetin beta. Es wurden 102 Hämodialysepatienten, darunter 41 Diabetiker und 61 Nicht-Diabetiker, über einen Zeitraum von neun Monaten beobachtet. Von den Untersuchungsteilnehmern erhielten 48 Patienten Epoetin α und 54 Patienten Methoxy-Polyethylenglycol-Epoetin beta. Unsere Daten konnten zeigen, dass es zu einer Beeinflussung des HbA1c durch die Therapie mit ESA-Präparaten kommt. Das als alternativer Stoffwechselparameter fungierende Fructosamin unterlag keiner derartigen Beeinflussung, korrelierte jedoch nur ungenügend mit den höheren Blutzuckerwerten, sodass seine Anwendbarkeit bei Diabetikern ebenfalls erheblich einschränkt ist. In der Gegenüberstellung der beiden ESA-Präparate erzielten beide Wirkstoffe vergleichbare Ergebnisse bezüglich des Erreichens der Hämoglobin-Zielwerte. Methoxy-Polyethylenglycol-Epoetin beta zeigte im Gegensatz zu Epoetin α eine seltener notwendige Dosisanpassung und längere Applikationsintervalle. Aus der vorliegenden Arbeit geht hervor, dass bei Hämodialysepatienten das HbA1c kritisch und mit Bedacht auf mögliche Einflussfaktoren interpretiert werden sollte. Es ist dennoch derzeit der konstanteste Parameter in der Stoffwechselverlaufskontrolle bei Diabetes mellitus.

Submitted in fulfillment of the requirements for Masters in Technology: Clinical Technology Durban University of Technology, 2014. / Background The metabolic syndrome (MS) is a clustering of cardiovascular (CV) risk factors and is noted to be increasing globally. Several studies have shown a link between the MS, chronic kidney disease (CKD) and end-stage renal disease (ESRD) possibly through a process of inflammation. Dialysis therapy may increase inflammation and could worsen MS and increase CV risk and diseases in ESRD patients. ESRD has been associated with increased CV disease in dialysis patients. Although there have been several reports on the prevalence of MS from the general population as well as from other specific groups, there are no known studies in South Africa on the prevalence of MS in ESRD patients on chronic dialysis therapy. The prevalence and risk factors for CV diseases are also currently unknown in the dialysis population in Cape Town. Aim The aim of this study was to determine the prevalence of MS in the dialysis population at Groote Schuur Hospital in Cape Town, to determine the effect of dialysis on MS and its traits and to evaluate CV risk in this patient group. Methods A total of 143 prevalent chronic dialysis patients who consented were used for this study. Demographic and relevant clinical details including systolic and diastolic blood pressures, waist and hip circumference and body mass index were obtained from all patients. Blood was drawn in the fasting state for assessment of full lipogram, glucose, ferritin, iron, calcium and phosphate. The metabolic syndrome was defined using the Adult Treatment Panel III (ATPIII) criteria. To determine the impact of dialysis on MS and its traits in our patients, only incident (new) patients starting dialysis were followed up for assessment of MS traits at timed intervals (at baseline, at 6 months and at 12 months) following initiation of chronic dialysis. To evaluate CV risk in this study, common traditional CV risk factors were assessed and were stratified according to number of risk factors as low ( ≤ 1), moderate (2 – 4) or high ( ≥ 4). Relevant statistical methods were used for analysis. Results Of the 143 patients in the study, 67.8% were on haemodialysis (HD) and 32.2% were on peritoneal dialysis (PD). The mean age of all the patients was 38.5 ± 10.4 years. The MS was present in 37.1% of all patients (PD – 52.2%, HD 29.9%; p = 0.015) and the frequency of increased waist circumference and hypertriglyceridaemia were significantly higher in PD patients than HD patients (p < 0.0001 and p = 0.006 respectively). Hypertension was the most prevalent MS trait in all the patients (89.5%) and was also the most prevalent trait in males (92.4%), females (85.9%) and in HD and PD patients (91.3% and 88.7% respectively). The frequency of CV risk was 3.5, 75.5 and 21.0% respectively for low, moderate and high CV risk and there was no difference in CV risk in HD and PD patients. High CV risk correlated with body mass index (BMI), increased waist circumference (WC), hyperphosphataemia, raised calcium – phosphate product, raised parathyroid hormone (PTH) and elevated C-reactive protein (p < 0.05). There was no significant change in MS prevalence or prevalence of MS traits in patients who were followed up irrespective of gender or modality of dialysis (p > 0.05) Conclusion The prevalence of the MS is higher in dialysis patients compared to the general population in South Africa and among dialysis patients, the prevalence is higher in PD than HD patients. Patients with MS have significantly higher CV risk factors than those without MS. Although dialysis therapy appear to have no significant effects on the prevalence of the MS or its traits in this study, the increased prevalence of the MS and CV risk factors may be related to the underlying disease process associated with ESRD. There is therefore an urgent need to identify and treat dialysis patients with the MS in order to reduce CV morbidity and mortality in this group of patients. Further prolonged prospective studies are needed to clarify the impact of dialysis on the MS and its traits in the ESRD population.

Thesis (MA (Psychology))--University of Stellenbosch, 2005. / The first objective of the present study was to determine whether the Theory of Planned Behaviour (TPB) could predict dietary and fluid adherence among in-centre hemodialysis patients attending government hospitals in the Western Cape.