Management of the Patient with Kidney Disease

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 8219

Special Issue Editors

Medical Biology Centre, School of Nursing and Midwifery, Queen’s University, Belfast BT9 7BL, UK
Interests: well-being; quality of life; palliative care; nephrology; mixed methods; cachexia
Special Issues, Collections and Topics in MDPI journals
Medical Biology Centre, School of Nursing and Midwifery, Queen’s University, Belfast BT9 7BL, UK
Interests: mindfulness; well-being; quality of life; complimentary therapies; Palliative care; nephrology; qualitative
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The nephrology speciality is a dynamic, diverse, and holistic practice specialty centred around working with patients and families to assess and address health and offer support and interventions to prevent disease. The care offered by the healthcare team traverses the life cycle and includes patients in the early stages of kidney disease, those presenting with acute kidney injury, others who commence kidney replacement therapy or receive a kidney transplant, and those who follow a supportive and palliative care pathway. Multi-professional teams are highly skilled professionals who require expertise in a patient population with several associated comorbid conditions, such as cardiovascular disease, diabetes, and hypertension. In addition, many patients are debilitated psychosocially by issues such as depression and anxiety. This calls for a holistic approach to patient care that is both challenging and rewarding. Driven by technological and educational advances, nephrology is a dynamic field offering complex interventions to support the physical and psychological needs of this population. 

This Special Issue seeks articles (original clinical studies and reviews) related to the quality and safe management of patients with kidney disease including supportive interventions. This invitation is addressed to all healthcare professionals (i.e., physicians, nurses, pharmacists, psychologists, dietitians, physical therapists, occupational therapists, physical and behavioural therapists, social workers) who are involved in the care of patients with kidney disease.  

Dr. Clare McKeaveney
Prof. Dr. Helen Noble
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • kidney
  • nephrology
  • kidney transplant
  • acute kidney injury
  • supportive and palliative care
  • multi-professional team
  • renal replacement therapy
  • dialysis

Published Papers (5 papers)

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Research

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11 pages, 1628 KiB  
Article
Assessment of Functional Capacity in Patients with Nondialysis-Dependent Chronic Kidney Disease with the Glittre Activities of Daily Living Test
by Mauro Ribeiro Balata, Arthur Sá Ferreira, Ariane da Silva Sousa, Laura Felipe Meinertz, Luciana Milhomem de Sá, Vinicius Guterres Araujo, Jannis Papathanasiou and Agnaldo José Lopes
Healthcare 2023, 11(12), 1809; https://doi.org/10.3390/healthcare11121809 - 20 Jun 2023
Viewed by 1142
Abstract
This study evaluated the functional capacity measured by the Glittre-ADL test (TGlittre) in patients with nondialysis-dependent chronic kidney disease (NDD-CKD) and analyzed the test’s associations with muscle strength, physical activity level (PAL), and quality of life. Methods: Thirty patients with NDD-CKD underwent the [...] Read more.
This study evaluated the functional capacity measured by the Glittre-ADL test (TGlittre) in patients with nondialysis-dependent chronic kidney disease (NDD-CKD) and analyzed the test’s associations with muscle strength, physical activity level (PAL), and quality of life. Methods: Thirty patients with NDD-CKD underwent the following evaluations: the TGlittre; the International Physical Activity Questionnaire (IPAQ); the Short Form-36 (SF-36); and handgrip strength (HGS). The absolute value and percentage of the theoretical TGlittre time were 4.3 (3.3–5.2) min and 143.3 ± 32.7%, respectively. The main difficulties in completing the TGlittre were squatting to perform shelving and manual tasks, which were reported by 20% and 16.7% of participants, respectively. The TGlittre time correlated negatively with HGS (r = −0.513, p = 0.003). The TGlittre time was significantly different between the PALs considered “sedentary”, “irregularly active”, and “active” (p = 0.038). There were no significant correlations between TGlittre time and the SF-36 dimensions. Patients with NDD-CKD had a reduced functional capacity to exercise with difficulties performing squatting and manual tasks. There was a relationship between TGlittre time and both HGS and PAL. Thus, the incorporation of the TGlittre in the evaluation of these patients may improve the risk stratification and individualization of therapeutic care. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)
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10 pages, 829 KiB  
Article
A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients
by Michael Corr, Carolyn Hunter, Daniel Conroy, Damian McGrogan, Damian Fogarty and Stephen O’Neill
Healthcare 2023, 11(11), 1654; https://doi.org/10.3390/healthcare11111654 - 05 Jun 2023
Viewed by 1287
Abstract
Introduction: Rates of peritoneal dialysis (PD) have been traditionally low in Northern Ireland. With rising numbers of patients reaching end-stage kidney disease, PD is a more cost-effective treatment than haemodialysis and aligns with international goals to increase home-based dialysis options. The aim of [...] Read more.
Introduction: Rates of peritoneal dialysis (PD) have been traditionally low in Northern Ireland. With rising numbers of patients reaching end-stage kidney disease, PD is a more cost-effective treatment than haemodialysis and aligns with international goals to increase home-based dialysis options. The aim of our study was to highlight how a service reconfiguration bundle expanded access to PD in Northern Ireland. Methods: The service reconfiguration bundle consisted of the appointment of a surgical lead, a dedicated interventional radiologist for fluoroscopically guided PD catheter insertion, and a nephrology-led ultrasound-guided PD catheter insertion service in an area of particular need. All patients in Northern Ireland who had a PD catheter inserted in the year following service reconfigurations were included and prospectively followed up for one-year. Patient demographics, PD catheter insertion technique, setting of procedure, and outcome data were summarised. Results: The number of patients receiving PD catheter insertion doubled to 66 in the year following service reconfigurations. The range of approaches to PD catheter insertion (laparoscopic n = 41, percutaneous n = 24 and open n = 1) allowed a wide range of patients to benefit from PD. Six patients had emergency PD catheter insertion, with four receiving urgent or early start PD. Nearly half (48%, 29/60) of the PD catheters inserted electively were in smaller elective hubs rather than the regional unit. A total of 97% of patients successfully started PD. Patients who experienced percutaneous PD catheter insertion were older [median age 76 (range 37–88) vs. 56 (range 18–84), p < 0.0001] and had less previous abdominal surgery than patients who experienced laparoscopic PD catheter insertion (25%, 6/24 vs. 54%, 22/41, p = 0.05). Discussion: Through a service reconfiguration bundle, we were able to double our annual incident PD population. This study highlights how flexible models of service delivery introduced as a bundle can quickly deliver expanded access to PD and home therapy. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)
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10 pages, 274 KiB  
Article
Effect of Uncertainty in Illness and Fatigue on Health-Related Quality of Life of Patients on Dialysis: A Cross-Sectional Correlation Study
by Ok-Hee Cho, Insook Hong and Hyekyung Kim
Healthcare 2022, 10(10), 2043; https://doi.org/10.3390/healthcare10102043 - 16 Oct 2022
Cited by 2 | Viewed by 1344
Abstract
This study aimed to determine the effect of uncertainty in illness and fatigue on the health-related quality of life of patients on dialysis. A community-based cross-sectional study was conducted among patients on hemodialysis (n = 80) and peritoneal dialysis (n = [...] Read more.
This study aimed to determine the effect of uncertainty in illness and fatigue on the health-related quality of life of patients on dialysis. A community-based cross-sectional study was conducted among patients on hemodialysis (n = 80) and peritoneal dialysis (n = 81) in Korea. Data were collated using self-reported structured questionnaires. Multiple regression analysis was used to identify those factors affecting the physical and mental health-related quality of life of patients. Patients on peritoneal dialysis reported higher levels of fatigue (p < 0.001). Factors affecting the physical health-related quality of life of patients on dialysis were fatigue (p < 0.001), employment (p = 0.001), and exercise (p = 0.016), thus explaining the observed variance of 37%. Factors affecting mental health-related quality of life were fatigue (p < 0.001), uncertainty (p = 0.004), educational level (p = 0.005), and smoking (p = 0.035). To improve the health-related quality of life of patients on dialysis, clinicians should assess their fatigue levels and plan multidisciplinary interventions to manage it. In addition, education level and employment status should be considered, and tailored interventions should be provided to acquire positive coping strategies and health promotion behaviors to counter disease uncertainty. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)

Review

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20 pages, 450 KiB  
Review
The Educational Needs of Adolescent and Young Adult Renal Transplant Recipients—A Scoping Review
by Michael Corr, Clare McKeaveney, Fina Wurm, Aisling E. Courtney and Helen Noble
Healthcare 2023, 11(4), 566; https://doi.org/10.3390/healthcare11040566 - 14 Feb 2023
Viewed by 1515
Abstract
Renal transplantation is the gold-standard treatment for adolescents and young adults with end-stage renal disease. Despite enjoying excellent short-term outcomes, they suffer the worst rates of premature transplant function loss. Health behaviors: such as lack of adherence to immunosuppressive medications, are felt to [...] Read more.
Renal transplantation is the gold-standard treatment for adolescents and young adults with end-stage renal disease. Despite enjoying excellent short-term outcomes, they suffer the worst rates of premature transplant function loss. Health behaviors: such as lack of adherence to immunosuppressive medications, are felt to be the major contributory factor. Understanding the educational needs of young renal transplant recipients allows healthcare practitioners to better support patients in managing their chronic disease. The aim of this scoping review was to understand what is known about their educational needs. A scoping review methodology was followed. Following an online search, study titles, and abstracts were screened for eligibility, followed by full-text assessment and data extraction. Data were qualitatively analyzed using thematic analysis. A total of 29 studies were included in the scoping review. In young people who struggled with self-management, three themes were identified (1) the Needs of the disrupted youth, (2) the Needs of the disorganized youth (3) the Needs of the distressed youth. There was a paucity of research to identify the protective factors that enable young recipients to successfully manage their health. This review outlines current knowledge of the patient education needs of young transplant recipients. It also highlights remaining research gaps that will need to be addressed with future research. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)
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21 pages, 469 KiB  
Review
Piperacillin–Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?
by Abdullah Tarık Aslan and Murat Akova
Healthcare 2022, 10(8), 1582; https://doi.org/10.3390/healthcare10081582 - 20 Aug 2022
Cited by 1 | Viewed by 2107
Abstract
Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are [...] Read more.
Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are still unclear. One major limitation of the existing studies is the utilization of serum creatinine to quantify AKI since serum creatinine is not a sufficiently sensitive and specific biomarker to truly define the causal relationship between TZP–VAN exposure and nephrotoxicity. Even so, some preventive measures can be taken to reduce the risk of AKI when TZP–VAN is preferred. These measures include limiting the administration of TZP–VAN to 72 h, choosing FEP–VAN in place of TZP–VAN in appropriate cases, monitoring the VAN area under the curve level rather than the VAN trough level, avoiding exposure to other nephrotoxic agents, and minimizing the prescription of TZP–VAN for patients with a high risk of AKI. More data are needed to comment on the beneficial impact of the extended-infusion regimen of TZP on nephrotoxicity. Additionally, TZP and teicoplanin can be reasonable alternatives to TZP–VAN for the purpose of lowering AKI risk. However, the data are scarce to advocate this practice convincingly. Full article
(This article belongs to the Special Issue Management of the Patient with Kidney Disease)
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