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Relationship between pH and strong ion difference (SID) in predialysis patients with chronic kidney disease and in patients on chronic haemodialysis
Havlín, Jan ; Matoušovic, Karel (advisor) ; Žabka, Jiří (referee) ; Zadražil, Josef (referee)
SUMMARY: Metabolic acidosis (MAC) is a constant symptom of chronic kidney diesease (CKD) in advanced stages. The Siggaard-Andersen analysis is a traditional method of acid-base balance (ABB) assessment, assessing the metabolic component by means of the base excess and the anion gap (AG). Modern methods of ABB assessment draw upon the theory proposed by Stewart, which is based on the electric neutrality principle. Stewart distinguishes three independent variables determining plasmatic pH: pCO2, strong ion difference (SID) and 3) the total charge of non-volatile weak acids [Atot-]. The aim of this study was to assess the relationship between pH and plasma ion changes associated with ABB disorders in patients with chronic kidney disease using both methods of analysis, and subsequently compare both approaches. The cohort of patients consisted of three groups: 1) the "CKD" group, 60 patients with CKD stage 3 to 4 according to the KDOQI; 2) the "HD" group, 68 patients on chronic hemodiafiltration using dialysate bicarbonate concentration of 32 mmol/L; 3) a control group, 19 healthy volunteers. In all patients we measured parameters necessary for both approaches, in the HD group before and after dialysis treatment. We have found that MAC was present in two thirds of patients in the CKD group. A decrease of...
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Care of peritoneally dialysed patient with acute peritonitis
Slováková, Kateřina ; Žabka, Jiří (advisor) ; Lachmanová, Jana (referee)
The Thesis is concerned with the topic of acute peritonitis with patients cured by peritoneal dialysis. Theoretical part of this thesis is focused on anatomy and physiology of peritoaeum and peritoneal cavity, it describes briefly the method of peritoneal dialysis and the last section is focused on acute peritonitis from medical and nursing point of view. The empirical part of the present thesis deals with the problem of adherence to preventative measures that can prevent acute peritonitis from its emergence. To collect relevant data for the empirical part, the methods of qualitative research were used, particularly the method of impersonal and structural observation and the method of categorized interview. The final aim of this thesis was to create educational brochure on the basis of knowledge acquired from our respondents about an adherence to preventative measures. This brochure is focused mainly on the topic of acute peritonitis and its preventative measures.
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