Journal of Yeungnam Medical Science

Original articles

The relationship between disability and clinical outcomes in maintenance dialysis patients: Seok Hui Kang, Jun Young Do, Jun Chul Kim; Yeungnam Univ J Med. 2021;38(2):127-135. Published online October 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00346

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Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods
This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results
The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion
Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Citations

Citations to this article as recorded by

The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis
Nilofar Pasyar, Mostafa Jowkar, Masoume Rambod
BMC Nephrology.2023;[Epub] CrossRef
Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
Seung Min Chung, Jun Sung Moon, Min Cheol Chang
Frontiers in Medicine.2021;[Epub] CrossRef

Improvement of catheter-related outcomes after application of tunneled cuffed hemodialysis catheter insertion without fluoroscopy: Seok Hui Kang, Jun Young Do; Yeungnam Univ J Med. 2020;37(3):186-193. Published online March 17, 2020; DOI: https://doi.org/10.12701/yujm.2019.00465

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Abstract PDF

Background
Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion.
Methods
We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed.
Results
Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload.
Conclusion
Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.

Citations

Citations to this article as recorded by

Validating the anatomical landmark technique for bedside tunneled central venous catheter placement in the medical intensive care unit
Hanny Sawaf, James Lane, Roman Shingarev, Matthew Siuba, Alvin G Kwon, Tarik Hanane, Tushar J Vachharajani
The Journal of Vascular Access.2024;[Epub] CrossRef

Case Report

Complete atrioventricular block during tunneled cuffed hemodialysis catheter insertion in a patient with pre-existing left bundle branch block.: Eun Woo Choi, Ji Yoon Jung, Jun Huck Su, Sae Huyn Park, Kyu Hyang Cho, Kyung Woo Yoon, Jong Won Park, Jun Young Do, Seok Hui Kang; Yeungnam Univ J Med. 2015;32(2):152-154. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.152

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Abstract PDF: Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.

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