Submitted in partial fulfillment of the requirements for the degree of Masters in Technology: Clinical Technology, Durban University of Technology, 2009. / Exercise assessment, counseling and training are not widely offered to patients with chronic kidney disease. Haemodialysis patient’s participation in exercise and an adequate assessment of exercise effects on haemodialysis outcome are needed so that more interventions can be developed to improve the well being of those patients with chronic kidney disease. Exercise is not routinely advocated in patients with end-stage renal disease receiving maintenance haemodialysis. Lack of widespread awareness of exercise in haemodialysis literature may be contributing to these shortcomings in clinical practice. Purpose of the study This study was aimed to establish the effect of exercise during haemodialysis on pedal oedema and solute removal. This is the first time that such a study was undertaken in dialysis units in South Africa. Methodolgy In a quasi-experimental design, thirty-four end-stage renal failure patients on three times weekly haemodialysis program from Bloemfontein and Newcastle MediClinic Renal Units participation in the study. Ethical approval for the study was obtained from Durban University of Technology Ethics Committee. Seventeen patients were in the intervention group (aged between 25 and 60) and seventeen in the control group (aged between 18 and 60). The intervention group did not exercise for the first three months of the study in order to establish a baseline period. Thereafter, exercising took place from the fourth to the ninth month. Patients pedaled on an exercise cushion for fifteen minutes every hour to achieve a total of sixty minutes of exercise over a four-hour dialysis session. Patients in the control group did not pedal on the exercise cushion during the nine-month study period. Pre and post haemodialysis measurements of creatinine, urea and potassium using the Alkaline Picrate, Urease and Ion Selective Electrode methods respectively were done for each patient monthly over the nine month period. Oedema of the lower limb was evaluated by measuring the right and left ankle circumference, in centimeters before and after dialysis. Urea Kt/V was also measured before and after haemodialysis for each patient over the study period. Results Statistical analysis of results showed a significant 30% reduction in urea levels and a 46% reduction in creatinine levels in the intervention group at the end of the nine month period, a 12% reduction in the potassium levels in the intervention group which was 4% more than the control group. The urea Kt/V in the intervention group showed a 9% greater reduction than the control group. There was a significant improvement in oedema of 45% of the right ankle for the first three months of exercise and thereafter there was a an increase in ankle size in the last three months which was a 13% reduction in oedema compared to baseline. There was a significant improvement in oedema of 60% of the left ankle for the first five months of exercise and thereafter there was an increase in ankle size in the last month which showed a 25% reduction compared to baseline. The reason for the increase in ankle size in both ankles in the last three months in inconclusive and future investigation is recommended. Conclusion The results of this study demonstrated benefits of exercise during haemodialysis on solute removal and oedema perhaps due to the acute increases in blood flow and therefore increasing perfusion of skeletal muscles.

No description available.

A dissertation submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of requirements for the degree of Master of Science in the School of Molecular and Cell Biology. Johannesburg, 2016. / Telomeres play significant roles in maintaining genome stability, regulating cell proliferation and apoptosis. The role of telomere biology and telomerase reactivation has been studied extensively in cancers. Telomerase has been previously associated with driving chronic kidney disease (CKD) advancement and most frequently due to HIV infection. However, the mechanism by which telomerase activation contributes towards disease progression beyond its canonical function of telomere maintenance is poorly understood. Telomerase is a ribonucleoprotein whose main function is telomere maintenance. Telomerase activity is dependent on expression of the rate-limiting human telomerase reverse transcriptase (hTERT) component. In addition to telomere maintenance, hTERT is implicated in other non-telomere related functions that promote cellular proliferation. Expression of hTERT is predominantly regulated at the transcription level where variation in promoter and minisatellite (MNS16A) sequences alter its expression. This variation has been implicated to confer susceptibility to diseases such as cancer and ageing disorders in non-African populations. Data on variation and pathogenicity of telomere-associated genes in African populations is limited and warrants further research. Thus bioinformatics analysis was performed to elucidate variation within the human TERT gene and promoter in different populations. The promoter, MNS16A and relative telomere length (RTL) were also evaluated in 159 African study participants with and without CKD. TERT common variants are equally distributed across populations with limited data on connection to the effects of the variants in African populations. Further bioinformatics analyses revealed significant difference (p<0.0001) in distribution of promoter variant rs2853669 between African and non-African populations. No common promoter mutations were identified in our study population. Interestingly, the long MNS16A variant suggested to increase TERT expression was significantly overrepresented in individuals with CKD regardless of HIV status. For the first time, a strong association of the long MNS16A variant with CKD regardless of HIV status is reported, implicating MNS16A as a potential risk factor in CKD.

No description available.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 242-253). Available also in a digital version from Dissertation Abstracts.

Thesis--M.D., University of Hong Kong. / Typewritten.

Thesis (M.D.)--University of Hong Kong, 1987.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Medicine / Master / Doctor of Medicine

A study was done to examine factors that facilitate adherence to haemodialysis therapy amongst patients with chronic renal failure and the sources of support available to them. A self developed questionnaire was used to collect data from the respondents. The respondents were purposive and conveniently selected according to the set criteria. The sample consisted of 118 respondents that were selected from four hospitals, two provincial hospitals and two private hospitals. Permission to conduct the study was requested by means of written letters to all people concerned. Letters granting permission were obtained from the two provincial hospitals. The Heads of the Renal Units of the two private hospitals gave verbal permission. Data was analyzed using the Statistical Package for the Social Sciences (SPSS 11.5). Demographic data was analysed through frequency counts. Crosstabulations using Chi-square analysis was performed to test the relationship between the factors that facilitate adherence to haemodialysis therapy and the indicators for adherence. The results were presented in the form of Tables and Figures (Graphs). From the findings the researcher concluded that in order for a haemodialysis patient to adhere to therapy restrictions, the following should be adequate: physical factors, socio-economic factors, psychosocial factors which also encompasses cultural factors. Health education proved to be having a very good impact. Higher level of education is not that essential as long as the patient can read, write and understand the instructions. Religious factors did not have much effect on facilitation of adherence to haemodialysis therapy. / Thesis (M.A.)-University of KwaZulu- Natal, Durban, 2004.