Journal of Yeungnam Medical Science

Original articles

Nephrology
The impact of quality of life measured by WHOQOL-BREF on mortality in maintenance hemodialysis patients: a single center retrospective cross-sectional study: Seong Gyu Kim, In Hee Lee; J Yeungnam Med Sci. 2023;40(1):49-57. Published online April 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00080

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Background
Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool.
Methods
This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results.
Results
The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively.
Conclusion
QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.

Citations

Citations to this article as recorded by

Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things
Xiaoping Chen, Fei He, Yan Jiang, Xuezhen Chen, Yubing Yan
DIGITAL HEALTH.2024;[Epub] CrossRef
Effects of Urban Forest Therapy on Depression, Anxiety, and Sleep Quality in People Experiencing Cancer
Youngsin Jeon, Ye-Seul Kim, Ga Yeon Kim, Poung-Sik Yeon
Journal of People, Plants, and Environment.2024; 27(4): 303. CrossRef

Nephrology
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

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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.2025; 26(3): 815. CrossRef
Feasibility and Safety of bedside placement of tunneled dialysis catheters: A systematic review and meta-analysis of prevalence
Ayman Bsat, Moussa Hojeij, Bassel Hafez, Sami Nabhani, Marwan Bahmad, Yasmine Kotob, Rakan Nassereldine
The Journal of Vascular Access.2025; 26(6): 2011. CrossRef
Comparison of catheter outcomes according to dialysis modality and clinical factors in patients with femoral dialysis catheters
A-Young Kim, Kyu Hyang Cho, Jong Won Park, Jun Young Do, Seok Hui Kang
BMC Nephrology.2025;[Epub] CrossRef

Original Article

Nephrology
Follow-up of thyroid ultrasonography in patients with hemodialysis: Hyun Jung Kim, Bo Ra Kim, Yeong Mi Seo, Yoon Young Cho, Jong Ha Baek, Kyong Young Kim, Soo Kyung Kim, Seung Hoon Woo, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm; Yeungnam Univ J Med. 2017;34(1):69-74. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.69

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Abstract PDF

BACKGROUND
Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

Citations

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Parathyroid carcinoma as an overlooked etiology of osteoporosis in postmenopausal women: a case report
Jing Su, Shiqiong Lei, Meiyuan Jin, Hongzhi Hu, Wenshan He
Frontiers in Endocrinology.2026;[Epub] CrossRef

Case Reports

Nephrology
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.

Cardiology and Cardiovascular Medicine
Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm.: Soon Young Kim, Tae Jun Kim, Seong Kyun Na, Seung Ah Park, Dong Min Jung, Yong Kyun Kim, Sang Ho Jo; Yeungnam Univ J Med. 2014;31(1):17-20. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.17

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Abstract PDF: Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

Nephrology
Two Cases of Spinal Epidural Abscess in Hemodialysis Patients.: Young Hwan Kim, Jin Taek Yoo, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Mun Jang, Jung Choi; Yeungnam Univ J Med. 2013;30(1):36-38. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.36

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Abstract PDF: While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

Original Article

Nephrology
Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study.: Dong Oh Kang, Du Ha Lee, Hyun Seo Kim, Hyun Su Kim, Sung Rok Kim, Jong Seon Park; Yeungnam Univ J Med. 1999;16(2):309-317. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.309

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Abstract PDF: BACKGROUND
Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function, we performed M-mode and Doppler echocardiopraphic studies before and after hemodialysis. METHODS: The study population consisted of 30 patients(15 patients were male, mean age 45+/-10 years) with CRF on maintenance henodialysis. They have normal left ventricular systolic function(Fractional shortening > 30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction(EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxaion time(IVRT), deceleration time(DT), and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance(IMP) was calculated from each of the Doppler velocity indices. RESULTS: The weight reduction after hemodialysis was 2.1+/-1.0kg(p<0.0001). After hemodialysiss, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant in IVRT and IMP(p<0.05, p<0.0001) were noted. CONCLUSTION: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And and increased IMP suggests that diastolic function may be aggravated after gemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

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