Hong Kong Journal of Nephrology最新文献

{"title":"Unaffordability of renal replacement therapy in Nigeria","authors":"Samuel Ajayi ,&nbsp;Yemi Raji ,&nbsp;Temitope Bello ,&nbsp;Lanre Jinadu ,&nbsp;Babatunde Salako","doi":"10.1016/j.hkjn.2015.11.002","DOIUrl":"10.1016/j.hkjn.2015.11.002","url":null,"abstract":"<div><p>With the increase in epidemic proportions of diabetes worldwide, the number of patients who will require renal replacement therapy (RRT) will be a great challenge to the health infrastructures of developing countries such as Nigeria. Because those mostly affected are in the economically productive age group, a vicious circle is established whereby those who keep the economy going are the same people affected. Secondary and tertiary care of chronic kidney disease involving RRT would exact disproportionate toll on the income of patients in the developing world where patients pay out of pocket for their own care. Whilst there is an increase in the number of facilities offering RRT, there is no commensurate sustainability of care either by the patients themselves or even by the government. The level of unemployment is increasing. Kidney transplantation is out of reach in addition to the cost of post-transplant care, which includes hospitalization and immunosuppressive medications. Most of the end-stage kidney disease patients who enlisted in our dialysis program were unable to get or sustain adequate hemodialysis. The data also showed that more men were dialyzed at our facilities over the period under review and the age distribution has not changed much over the decade. From this dismal picture in the last decade emerges a series of questions as to why this is so and what must be done to increase access to RRT. Prudent fund management and cost containment, local manufacture of dialysis materials and nongovernmental sources of funding are means of driving down the cost of dialysis. In countries where drugs and equipment for health services are locally manufactured, such as India and other countries, the cost of health care is more affordable than in countries such as Nigeria where these are imported.</p><p>在全世界，糖尿病的盛行率與日俱增，然而對於發展中國家如尼日利亞，基礎醫療架構並不足以應付患者對腎置換療法 (RRT) 的需求。本地民眾必須自費支付自身的醫療費用，但其收入水平遠不足以負擔慢性腎病二級與三級照護所需的 RRT。即使目前 RRT 設施已有所增加，但無論是患者或政府均難以維持治療的長期實施。此外，腎臟移植所需的資源在本地更是相當之有限。在被我們納入透析計劃的末期腎病 (ESKD) 患者間，大多數並未能接受足夠或持續的透析治療。過去十年間，在我們設施內接受透析的病人中，年齡分佈大致穩定，且男性佔較多數。目前，我們正研究如何能促進 RRT 普及實施的方案。透過謹慎的理財與成本控制、透析物料的本土生產、及非政府資金的運用，透析的相關費用可望得以降低。目前，發展中國家如尼日利亞的藥物與醫療器材大多仰賴進口，因此相關物資的本土生產是降低醫療成本的可行方案。</p></div>","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"18 ","pages":"Pages 15-19"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2015.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77445097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impairment in hemodialysis patients: What can slow this decline?","authors":"Mitesh Patel,&nbsp;Indranil Dasgupta,&nbsp;George Tadros,&nbsp;Jyoti Baharani","doi":"10.1016/j.hkjn.2015.08.003","DOIUrl":"10.1016/j.hkjn.2015.08.003","url":null,"abstract":"<div><p>With over 70% of hemodialysis (HD) patients, aged ≥55 years, having moderate to severe chronic cognitive impairment (CI), in an increasingly aging population, the need to stop this cognitive decline is paramount. CI amongst HD patients raises patient safety concerns, while limiting their ability to understand information such as medical advice and their decision-making ability. Unfortunately, the data available on assessment of cognition in HD patients and interventions utilized remain extremely limited. This paper discusses assessment of cognition, the theories of CI in HD patients, and current literature on cognitive interventions in chronic disease, with many not applicable to the HD population. An encouraging psychological intervention called cognitive stimulation therapy helps improve cognition as well as social skills in CI. This is the first review article discussing the possibility of cognition stimulation during HD which has not been investigated previously. With cognitive stimulation therapy showing improvements in cognition at 6-month follow-up, as well as being recommended by the National Institute for Health and Care Excellence for use in dementia, we suggest the need to study whether this therapy has any effect on cognition in HD patients both in short term, with respect to daily activities and decision making, and in long term, with respect to the possibility of reducing the risk of dementia.</p><p>在 55 歲或以上的血液透析 (HD) 病人間, 逾 70% 有中至重度的慢性認知障礙 (CI), 在目前老年化的人口中, 這是必須要解決的問題。在接受 HD 後, CI 可引發病人安全的隱憂, 同時亦限制患者接受資訊如醫囑、及決策的能力。然而, 至今關於 HD 病人認知功能與改善方案的數據仍非常有限。本文探討了認知功能的評估方法、及 CI 發生於 HD 的相關理論, 亦回顧了目前有關慢性病中認知功能改善方案的文獻, 雖然很多並不特定於 HD 病人群。我們注意到一種稱為認知刺激療法 (cognitive stimulation therapy, CST) 的心理治療方案, 可望改善 CI 患者的認知功能和社交技能。本文將首度就這種療法對 HD 病人的效應作出探討。事實上, CST 經證實可於 6 個月期間達到認知功能的改善, 亦是英國 NICE (National Institute for Health and Care Excellence) 建議的失智症療法, 我們認為有需要研究 CST 對 HD 病人認知功能的影響, 不論是在短期 (日常活動及決策能力)、或長期層面 (失智症的預防)。</p></div>","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"18 ","pages":"Pages 4-10"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2015.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74824474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment status in peritoneal-dialysis patients","authors":"Man Ching Law,&nbsp;Kai Ming Chow,&nbsp;Janny Suk Fun Fung,&nbsp;Cheuk Chun Szeto,&nbsp;Philip Kam Tao Li","doi":"10.1016/j.hkjn.2015.10.002","DOIUrl":"10.1016/j.hkjn.2015.10.002","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>The employment status of peritoneal-dialysis patients could have been related to selection bias. This study examined the employment rate and associated factors in a population with peritoneal-dialysis-first policy.</p></div><div><h3>Methods</h3><p>We performed a single-center cross-sectional survey on the employment status of prevalent peritoneal-dialysis patients between January and September 2013 in Hong Kong.</p></div><div><h3>Results</h3><p>The survey included 383 prevalent peritoneal-dialysis patients, with 128 of them in the labor force. Among the patients in the labor force, the employment rates were 65.8% and 18.9% for automated peritoneal-dialysis patients and continuous-ambulatory-peritoneal-dialysis patients, respectively, whereas 39.1% of patients in the labor force had expressed that they were able to work, but were unemployed. In adjusted analysis, the use of automated peritoneal dialysis (adjusted odds ratio of 7.93; 95% confidence interval 2.92–21.74) was independently associated with employment, whereas older age was associated with lower likelihood of employment (adjusted odds ratio of 0.53 for each 10 years old; 95% confidence interval 0.38–0.72).</p></div><div><h3>Conclusion</h3><p>The employment rate in peritoneal-dialysis patients is very low when compared to that in the general population. Patients on automated peritoneal dialysis were more likely to be employed.</p></div><div><h3><strong>背景</strong></h3><p>腹膜透析患者就業狀況的研究，有可能會受到選擇性偏倚的影響。這項調查 是在一個採納了 é腹膜透析第一û 政策的地區，進行就業率及其相關因素的研究。</p></div><div><h3><strong>方法</strong></h3><p>在2013年1月至9月期間，我們在香港一個腹膜透析中心對現存的腹膜透析患者的就業狀況進行了一次橫斷面調查。</p></div><div><h3><strong>結果</strong></h3><p>本次調查包括383名現存的腹膜透析患者，其中有128人被納入勞動力人口。在勞動力人口的患者中，自動腹膜透析的使用者就業率為65.8 %，連續性家居腹膜透析的使用者就業率為18.9 % 。另一方面，39.1%的勞動力人口患者，表示他們有能力工作，但並未受僱用。在調整後的分析，使用自動腹膜透析與就業率有獨立關聯，另外，較年長的患者與較低就業率有關聯。</p></div><div><h3><strong>結論</strong></h3><p>相比一般香港人，腹膜透析患者的就業率非常低。自動腹膜透析的患用者較易就業。</p></div>","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"18 ","pages":"Pages 11-14"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2015.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86282088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Analysis of 25-Hydroxy Vitamin D3 Levels and IgA Nephropathy","authors":"L. Pan, Zhihong Ban, Y. Liao","doi":"10.1016/J.HKJN.2015.08.108","DOIUrl":"https://doi.org/10.1016/J.HKJN.2015.08.108","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85625636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Long-term Label Retaining Cells in Regeneration Process of Ischemia-Reperfusion Injured Mouse Kidney","authors":"Lian Zengyan","doi":"10.1016/j.hkjn.2015.09.073","DOIUrl":"https://doi.org/10.1016/j.hkjn.2015.09.073","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72621847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonapnea Sleep Disorders and the Risk of Acute Kidney Injury: A Population-based Retrospective Cohort Study","authors":"H. Y. Lin, Kai-Ting Chang, Yu-Han Chang, C. Hung, H. Chen, Shang-Jyh Hwang","doi":"10.1016/J.HKJN.2015.08.070","DOIUrl":"https://doi.org/10.1016/J.HKJN.2015.08.070","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73497395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Deficiency of GPR124 Exacerbates Podocyte Injury in Diabetic Nephropathy","authors":"Xiaojie Wang,&nbsp;Yiqi Duan,&nbsp;Fan Yi","doi":"10.1016/j.hkjn.2015.08.012","DOIUrl":"https://doi.org/10.1016/j.hkjn.2015.08.012","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"17 2","pages":"Page S3"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2015.08.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90005237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of steroid therapy in immunoglobulin A-dominant poststaphylococcal glomerulonephritis","authors":"Mahesh Eswarappa,&nbsp;Vijay Varma,&nbsp;K.C. Gurudev","doi":"10.1016/j.hkjn.2015.03.002","DOIUrl":"10.1016/j.hkjn.2015.03.002","url":null,"abstract":"<div><p>Staphylococcal immunoglobulin A (IgA)-dominant infection-related glomerulonephritis (IgA-IRGN) is an emerging clinical entity seen in immunocompromised hosts. Antibiotics are the mainstay of treatment and the role of steroids is controversial. We present a review of literature and our recommendations on the use of steroids in the management of IgA-IRGN.</p><p>近年來，葡萄球菌感染相關的 IgA 型腎小球腎炎 (IgA-IRGN) 逐漸被世人認識，通常發生於免疫機能不全的病人，治療以抗生素療法為主，類固醇的角色則仍然存有爭議。以下我們將回顧 IgA-IRGN 的相關文獻，並對此病的臨床處置作出建議。</p></div>","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"17 2","pages":"Pages 46-49"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2015.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74617463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcription Factor SRF Promotes Renal Fibrosis in Diabetic Nephropathy","authors":"Lijie He, Shiren Sun, Jinping Hu, Ning Feng, T. Shi","doi":"10.1016/j.hkjn.2015.08.029","DOIUrl":"https://doi.org/10.1016/j.hkjn.2015.08.029","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73740732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Rhododendron Molle G. Don on Renal Interstitial Fibrosis in UUO Model","authors":"J. Xiong, S. Jin, Chun Zhang","doi":"10.1016/J.HKJN.2015.09.109","DOIUrl":"https://doi.org/10.1016/J.HKJN.2015.09.109","url":null,"abstract":"","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73999016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}