Literature review kidney disease
Mortality associated with end-stage kidney disease ESKD is high [ 2 ]. The incidence of treated ESKD is rising in the western world, with a corresponding increase in the incidence literaturw diabetes and cardiovascular disease, especially in ethnic minority groups. Survival on dialysis has been shown to be poorer in the older age group, especially in patients with increased comorbidity and in those whose functional status at the start of dialysis is poor [ 3 ].
Whilst renal transplant rates vary between different countries [ 4 ], the liberalization in the acceptance of older people into renal replacement therapy RRT programmes, together with changes in population demographics and the fact that kidney transplantation is less suitable for this group of disese patients, means that dialysis may be the only treatment option kidbey for an increasing number of patients aged 65 years and over [ 5 ].
Recent health policy changes in the OECD countries [ 6,7 ] literture that end of life care may be more appropriate for some of these people, and maximum conservative management programmes where residual renal function is supported, haemoglobin levels maintained and symptoms dixease have been introduced into many renal units, particularly in the United Kingdom [ 6 ].
The onset of ESKD and subsequent ligerature of dialysis as a treatment option involves a change in lifestyle for both patients and close persons [ 8 ].
Even before end-stage disease is reached, as renal function deteriorates, patients frequently require additional support, and it is often family members who provide this [ 9 ]. In the UK it is estimated that 9 out of 10 carers of patients with either physical or neurological disabilities will be close relatives. In particular read article home haemodialysis is undertaken, family members have been involved in supporting patients [ 10,11 ].
Xia H, Ebben J, Ma JZ, Collins AJ. Sample sizes also tended to be small, with a median sample of 55 participants for the quantitative and 15 participants for the qualitative studies. However, Shlipak et al. However, the application of these guidelines in clinical practice can be limited by their length each approximately pages and complexity.
Studies have shown that good family support is associated with successful adaptation to dialysis and compliance with dietary restrictions [ 12,13 ]. There is therefore a need for health professionals to be aware of the important contribution that close persons make to the care of renal patients, to communicate effectively with them and to provide bereavement support for this group when appropriate [ 15 ]. The literature on close persons of patients with renal disease has identified two main areas of impact.
Symptom the kidney disease literature review cannot
Secondly, some patients become frail and lose functional independence, leaving family members to provide greater physical support. Family members may have health and social care needs of their own that need to be addressed [ 16,17 ]. Qyinan [ 18 ] reported that close persons commonly felt overwhelmed and stressed, although this review was limited to an rreview base of four articles and considered home dialysis only.
Campbell [ 19 ] teview findings from the general carer literature to illustrate demands of ageing partners with ESKD. Diseaee other chronic illnesses literaature as stroke [ 20 ] or in palliative care for cancer and mental health [ geview ], interventions aimed at providing family members with training teview support patients with their rehabilitation, or to address unmet needs as a result of the patient's illness, have been developed and evaluated.
Results have been mixed. However, before such interventions can be developed in ESKD, it is important to understand better the emotional and physical needs of close persons. This review aims to identify all click here involving close persons caring for ESKD literature review kidney disease, to describe the main findings and literaturs the methodology. Specific attention has been paid to a studies exploring the impact of ESKD on close persons, in particular for those close persons where the patients are either withdrawing from dialysis or being provided with end of life care and b diseaee looking at the provision of health care for close persons.
Methodology Search strategies A literature search for relevant articles was conducted in five databases: Medline diseaesEmbase —CINAHL —PsycINFO — and AMED —employing the following key words: These keywords were used both in word search options and exploded as thesaurus terms to obtain the maximum number of articles.
This urges us to develop preventive strategies for patients with any stage of renal disease. Saeed F, Kousar N, Qureshi K, Laurence TN. Hematocrit level associated mortality in hemodialysis patients, by Ma JZ, Ebben J, Xia H, Collins AJ. Family life Tables 1 and 2 In only one study, close persons rated their quality of life as excellent and reported few pressures resulting from their carer responsibilities literature review kidney disease 27 ], whilst in all others, ESKD and dialysis were shown to increase the close person's sense of responsibility and lead to a poorer quality of life when compared with age-matched controls [ 28 ]. There are 2 commercially literature review kidney disease preparations approved for use in CKD by the U. They found that, compared to stages 1 and 2 having kidney diseases of stage 3 or stages 4 and 5 are associated with substantial increase both in the risk of development of cardiovascular diseases. Treatment of CKD Complications Anemia. Sesso R, Belasco AG.
The abstracts for each article were read to check for inclusion into the main review, using the following criteria: Published in peer-reviewed journals. Research studies with an introduction, a methodology and results section and a conclusion. Involve close persons, defined as either a family member or the person identified by the patient as an informal carer. By an informal carer, we mean a person who provides the majority of a patient's physical and emotional care diseasr and who is neither a click nor in the employment of statutory services.
Use a sample of close persons caring for adult ESKD please click for source over 18 years.
- There was considerable variation in population sample selection.
- Charnow, Editor February 04, Urological complications occur frequently following transplantation of deceased cardiac donor DCD kidneys but do not affect graft survival, researchers in the Netherlands have concluded.
- Late diagnosis of chronic renal failure and mortality on maintenance dialysis.
Non-English language articles were considered if the English translation of the abstract met the above criteria. Using these criteria, articles literrature identified from the five databases in Medline, in Embase, 80 in CINAHL, 8 in AMED and 34 in PsycINFO. One was later excluded on closer inspection, as it was specifically a validation study of a fatigue severity litreature. Of the remaining 36 studies, risease exclusively looked at family members, 12 specifically at the patient-family dyad and 3 at the family-health professional dyad.
Review of literature on chronic kidney disease of unknown etiology CKDu in Sri Lanka. Fabbian F, Casetta I, De GA, Pala M, Tiseo R, Portaluppi F, et al. Furthermore, stent outcomes were relatively worse than CABG in diabetic patients. Charnow, Editor February 04, Bulbomembranous BM urethral strictures are the most common grade 2 or higher urinary toxicity following high dose rate brachytherapy HDRBaccording to Australian investigators. Evenson KR, Rosamond WD, Morris DL. Poor long-term literature review kidney disease after acute myocardial infarction among patients on long-term dialysis.
Whilst the latter two types of studies did not concentrate solely on family concerns, we literatkre to include them in the analysis, because these findings further contribute to the limited number of studies in this field. Thirty-six studies were included in the review. Results Initial exploration of the 36 reviewed studies We undertook an exploration of the aims of these studies, their study design, the sample of participants and the outcome measures highlighted in the quantitative studies.
No studies of health provision for close persons of patients with ESKD were identified.
Kidney review literature disease manage complete
Four studies looking at end of life issues explored the following themes for close persons: End of life care may be provided by the renal multi-disciplinary team alone, or it may involve referral for specialist palliative care advice. Such advice is likely to include symptom control, attention to spiritual and psychological issues for patients literatire, where possible, involvement of their families in decision-making.
Whilst most studies were interested in the direct impact on close persons only, one triangulated close person data with patient data. Study ddisease The majority see more studies reviewed used a cross-sectional design; there was only one longitudinal study. Sample The total rfview was predominantly female, with mean ages ranging from 41 to 68 years analysis possible in only 18 studies.
Sample sizes also tended to be small, with a median sample of 55 participants for the quantitative and 15 participants for the litdrature studies.
Most of the sample was recruited in studies where associated patients were undergoing haemodialysis or peritoneal dialysis. Three studies also involved kidney transplant patients. Only five studies looked at close persons dealing llterature end of life issues or with patients withdrawing from dialysis.
Thirteen studies actively sought close persons who also considered themselves to be informal carers, of which eight provided full definitions of what they meant by this term. All studies included spouses as part of their sample, of which eight specifically concentrated on this group alone. Adult children were included in seven of these studies and parents in five. Outcome measures quantitative studies A wide variety of outcome measures were used to rate health-related quality of life, anxiety, depression, coping strategies and patient disease severity.
Was disease kidney literature review areas
Some studies used standardized outcome measures; others used simple self-rated tools. The remaining six studies came from the following countries: Main findings The 36 studies have shown diseasr results. They have mainly explored the following areas associated with caring for an ESKD patient: There diseass been very few studies looking at palliative care issues and these have primarily concentrated on dealing with end of life issues rather than the provision of supportive care in the pre-terminal phase.
Family life Tables 1 and 2 In only one study, close persons rated their quality of life as excellent and reported few pressures resulting from their carer responsibilities [ 27 ], whilst in all others, ESKD and dialysis were shown to increase the close person's sense of responsibility and lead to a poorer quality of life when compared with age-matched controls [ 28 ]. Close persons found living with an ESKD patient on dialysis stressful [ 29 ] and experienced increased fatigue [ 30 ]. The dominating effect of caring visease an ESKD patient often led close persons to neglect their own health.
For those who cisease time to have a break from their carer responsibilities, there were health benefits [ 31 ].