The present study investigated whether vitamin E supplementation reduced oxidative stress in erythrocytes and improved vitamin E status in patients undergoing hemodialysis (HD). Plasma and erythrocyte α-tocopherol, plasma ascorbic acid, and iron status were determined in 11 regular HD patients prior to and post-dialysis, before and during oral supplementation of vitamin E, 400 IU daily for two months. HD patients were categorized into two groups according to their plasma ascorbic acid levels. We found that only the vitamin C sufficient group (>40 μM, Group I) had reliable measurements of erythrocyte α-tocopherol concentrations before vitamin E supplementation. In Group I prior to dialysis, erythrocyte α-tocopherol concentrations increased in response to vitamin E supplementation from 6.7 ± 0.7 μmol/L packed cells to 9.8 ± 0.6 (μmol/L packed cells (p<0.04). Moreover, there was a positive correlation (p<O.001) between plasma and erythrocyte α-tocopherol levels in Group I subjects. Additionally, vitamin E supplementation significantly increased hematocrits (39.9% ± 1.9% to 42.3% ±1.6%, p<0.004) post-dialysis only in Group I subjects. On the contrary, there was no change in hematocrits during vitamin E supplementation in the vitamin C deficient group (<40 μM, Group II). With respect to measures of iron status and recombinant human erythropoietin (rHuEPO) dose, no differences between before and during vitamin E supplementation were observed in two groups ofpatients. In summary, our data suggest that oral vitamin E supplementation protected erythrocytes from oxidative stress and improved vitamin E status in HD patients, but only in patients with adequate vitamin C status. / Graduation date: 2003

Text in English with abstracts in English and isiZulu / Poor adherence to their prescribed diet, medications and treatment contributes to increased mortality and morbidity in patients with end-stage renal disease. These patients must change their diet when receiving dialysis treatment, but cultural beliefs and practices can affect their adherence to the prescribed diet. The purpose of this qualitative, descriptive, exploratory study was to improve health education on prescribed diet adherence to patients living on haemodialysis at a haemodialysis unit in eThekwini Municipality. Data from a sample of 20 patients was collected using semi-structured interviews and analysed using qualitative content analysis. The findings revealed that haemodialysis patients’ prescribed diet adherence was influenced by cultural and religious views, and by family support. Food availability, patients’ geographical location and patients’ financial means hindered their adherence to their prescribed diet. A multi-disciplinary health care team including nurses, should be sensitive to patients’ different cultural beliefs and practices when providing health education. / Ukungabambeleli endleleni emisiwe yokudla, amakhambi nasekwelashweni kunomthelela ekwandiseni izimpawu zesifo sezinso esingapheli (ESRD) futhi kwandisa isibalo sabantu ababulawa yilesisifo. Iziguli ezinalesisifo zidinga ukushitsha indlela yokuphila, iziphuzo kanye nokulandela indlela emisiwe yokudla kakhulukazi mabe ngaphansi kokwelashwa ngokuhlanzwa kwegazi ngomshini (dialysis). Izinkolelo zamasiko nendlela zokuphila ezihambisana namasiko kwenze imfundiso nge ezempilo maqondana nendlela emisiwe yokudla yaba lukhuni. Inhloso yalolucwaningo bekuwukwandisa ulwazi nemfundiso ngezempilo mayelana nokulandela indlela emisiwe yokudla kwiziguli izithola ukulashwa ngokuhlanzwa kwegazi ngomshini (haemodialysis) esikhungweni esikuMasipala weTheku. Kusetshenziwe indlela yokwenza ucwaningo esezingeni elifanele, Imininingwano eqoqiwe eqembini (sample) leziguli ezingamashumi amabili (20) ezithola ukwelashwange haemodialyisis. Imininigwane iqoqwe kusetshenziswa izingxoxo ezihleliwe. Imigomo elawula ukuhlaziya ilandeliwe yonke ngenkathi kwenziwe lolucwaningo. Lolucwaningo luveze ukuthi indlela yokudla emisiwe yeziguli ezikwi dialysis iphazanyiswa imobono yamasiko, inkolo kanye nokusekelwa nokuzimbandakanya kwamalungu omndeni. Izinselelo ezinjengokutholakala, indawo isiguli esihlala kuyo nezinkinga zemali zivimbela ukubambelela endleleni emisiwe yokudla. Abasebenzi bezempilo kumele banakekele indima edlalwa izinkolelo namasiko uma befundisa ngezempilo ezigulini eziphethwe izinso. / Nursing Science / M.A. (Nursing Science)