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Quality of life of patients after kidney transplantation
Nováková, Monika ; Jirkovský, Daniel (advisor) ; Haluzíková, Jana (referee)
Bachelor thesis "Quality of life in patients after kidney transplant" deals with issue of patient´s quality of livfe before and after transplantation. The objective of this thesis was to map quality of life before and after kidney transplantation in several dimensions - physical functioning, physical limitation, general health, vitality, social functioning, emotional issues and mental health. In theoretial section is presented overview of kidney diseasees, proces of transplantation and quality of life. In empirical section are presented methods of data collection, realisation of survey and results of this investigation. Chosen Method was standardized questionaire SF-36 supplemented with soci-demographic and health related information questionaire devised by autor. It was distributed among patients of nefrological ambulantory practice in IKEM which underwent kidney transplantation. Results: Quality of life of patients after udergoing tranplantation of kidney was better then before transplantationin these areas: perception of one`s own health, walking up the stirs one and more floors, walking hundred meters, managing worload, lesser difficulities in activities of daily living. Pain was lesser obstacle in managing work. Positive shift occured in feeling of pep, nervousness, depression, calm and peace,...
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Nursing care of a patient with a hemodialysis catheter in a chronic dialysis program
Horniková, Renata ; Hromádková, Jaroslava (advisor) ; Jirkovský, Daniel (referee)
This bachelor's thesis is focused on the treatment of hemodialysis catheters. A hemodialysis catheter is an integral part of every elimination method, and without a functional hemodialysis catheter, hemodialysis is not possible. The aim of the bachelor's thesis was to find out whether and how care for hemodialysis catheters differs at individual workplaces. The theoretical part of the thesis presents knowledge about the anatomy and physiology of the kidneys, pathophysiology of the kidneys, elimination methods, vascular approaches and specifically describes hemodialysis catheters and their nursing care. The empirical part of the work presents the results of our own questionnaire survey, which took place at selected workplaces of the Motol University Hospital and at selected Fresenius Medical Care centers. The target group of respondents were nurses working at these workplaces. At the end of the investigation, 75 duly completed questionnaires were included in the statistical data processing. The obtained data are presented in pie and bar graphs and tables, and these data are subsequently compared with hypotheses oriented to the type of workplace and the level of education of the respondents. The results of the questionnaire survey revealed that there were statistically significant differences,...
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The needs of patients in the dialysis program and the role of the nurse in this issue
CHYTRÁČKOVÁ, Aneta
This bachelor's thesis focuses on the needs of patients in a dialysis program and the role of the nurse in this issue. Two objectives were established for this bachelor's thesis: To map the needs of patients in a dialysis program, and to determine the role of the nurse in patients undergoing dialysis. The work is divided into a theoretical and empirical part. In the theoretical part, the anatomy of the kidneys is briefly described, as well as the reasons for kidney failure. Subsequently, various elimination methods are described and explained, along with nutritional and exercise measures. The transplantation procedure is also briefly described. Attention is paid to the needs of patients, nursing care, and education. The empirical part was processed using qualitative research through semi-structured interviews focused on patients undergoing dialysis and nurses working in the dialysis center. The research sample consisted of 13 patients and 9 nurses. To achieve the set objectives, five research questions were created: What are the bio-psycho-social-spiritual needs of patients in a dialysis program? How does dialysis treatment affect patients' lives? What is the level of patient education before starting dialysis treatment? What is the role of the nurse in satisfying the needs of patients in a dialysis program? What is the role of the nurse in providing information to patients in a dialysis program? Our research has shown that dialysis generally has a negative impact on the quality of life of most of our respondents. Respondents are most negatively affected by thirst, the time demands of dialysis, poor sleep quality, changes in social needs, and overall fatigue after dialysis. Additionally, our research has shown that nurses in the dialysis center primarily fill the role of provider of nursing care, educator, and advisor who also provides emotional support. The results of the research serve as informational material for patients in the predialysis program and as potential recommendations for nurses working in dialysis centers.
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The patient healing hemodialysis at home by the paramedic´s perspective
KŘIVÁNEK, Martin
This bachelor's thesis focuses on the issue of domestic haemodialysis with special attention to the role of paramedics in dealing with acute problems associated with this procedure. The work is intended as theoretical, without the author´s own research. It aims at reviewing treatment options for kidney failure, describing the principle of home haemodialysis, its benefits and disadvantages for patients and their families. Special attention is paid both to potential risks brought about by this method of dialysing blood and to ways of addressing the complications from the perspective of pre-hospital care. To achieve its goals, the work outlines and compares current attitudes towards these issues both in this country and abroad. Its introductory part summarizes the structure and functions of kidneys, the most frequent causes of renal diseases as well as their possible therapies. Further on, it introduces in greater details both general and specific procedures applied by emergency medical squads in case of complications during domestic haemodialysis. The main scientific contribution of the work consists in the very synthesis of the present knowledge and methods of treatment and - at the same time - in defining the so far unresolved issues. The part of the thesis devoted to home haemodialysis, which still represents a relatively rarely used method, underlines particularly the fact that emergency medical procedures responding to specific complications connected with this treatment have not been sufficiently defined yet. The thesis therefore comes to the conclusion that paramedics facing acute problems associated with domestic haemodialysis have to rely mainly on general procedures determined for providing pre-hospital care. That is why this field still remains open for further theoretical research. Detailed potential practical steps aimed specifically at complications during home haemodialysis are in demand as well.
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The effect of dialysis on activities of daily live
Kolaříková, Jaroslava ; Nikodemová, Hana (advisor) ; Jirkovský, Daniel (referee)
The aim of this bachelor's thesis entitled "The effect of dialysis on activities of daily life" is to provide a brief overview of relevant basic knowledge of hemodialysis and peritoneal dialysis using existing and already published litarature and try to determine the influence of the dialysis on activities of daily life. The thesis is devided into theoretical and empirical part. The theoretical part is focused on kidney disease, hemodialysis and peritoneal dialysis, principles of dialysis therapy, their differences, complications, dietary measures and approaches to dialysis. Further attention is paid to the comparison of the advantages and disadvantages of both methods of dialysis among themselves. Part of the work deals with human needs and activities of daily life. The empirical part consists of an exploratory survey, which was given to patients in dialysis centers Fresenius Medical Care Prague 5 - Motol, Prague 10 - Vinohrady, Prague 4 - Krc, Prague 9 - Vysočany, Slaný, Louny, Chomutov, Most and dialysis center department of Internal Medicine Strahov Všeobecná fakultní nemocnice in Prague. The obtained data are presented in tabular and in graphic reports. Keywords hemodialysis, peritoneal dialysis, renal failure, activities of daily life, disease impact
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Role of the FTO gene in the genetic determination of common multifactorial diseases
Dlouhá, Dana ; Hubáček, Jaroslav (advisor) ; Černá, Marie (referee) ; Rossmeislová, Lenka (referee)
Obesity is a risk factor for development of cardiovascular disease, diabetes type 2 and some cancers. Newly detected genetic risk factor for body weight is the FTO gene ("fat mass and obesity associated"). The aim of this thesis was determine 1) whether the presence of risk alleles correlate with BMI in Czech population and to determine 2) whether there is an association between variants in the FTO gene and risk of myocardial infarction/ acute coronary syndrome (MI/ ACS), 3) renal failure (ESRD), or 4) incidence of colorectal cancer (CRC). We analyzed polymorphisms rs17817449 (first intron) and rs17818902 (3rd intron) using by PCR-RFLP and then also RT PCR. We found an association of the first intron variant (but not the 3rd one) and BMI in Czech control population. We have detected an association of 1st intron SNP and BMI changes during the intervention study in obese children, but not in obese females. We found a correlation between the risk allele and increased risk of ACS (OR 1.49) in patients with MI. In patients with ESRD was detected association between the risk allele and the risk of disease (OR 1.37). We didn't confirmed the association between rs17817449 and the development of CRC. Representative selected groups of the Czech populations "MONICA" and "HAPPIE" were used as controls. One...
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Infectious complications in chronic renal failure
Kielberger, Lukáš ; Eiselt, Jaromír (advisor) ; Dusilová Sulková, Sylvie (referee) ; Matoušovic, Karel (referee)
INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complications in chronic kidney disease population is presented. The other part of this work presents results of our research dealing with pharmacoeconomical aspects of cytomegalovirus infection and finally our results in the field of influenza vaccination. The Aim of the first presented work was to evaluate the cost impact of four different strategies for prevention of cytomegalovirus infection after renal transplantation. We provide post hoc analysis of 2 randomized studies performed in our department and calculating direct CMV-related expenses using valacyclovir prophylaxis, ganciclovir prophylaxis, preemptive vlaganciclovir treatment and deferred therapy. To simulate ihe impact of varying prices of prharmacotherapy or diagnostic procedures, a sensitivity analysis was performed. With respect to our results, valacyclovir...
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Role of the FTO gene in the genetic determination of common multifactorial diseases
Dlouhá, Dana
Obesity is a risk factor for development of cardiovascular disease, diabetes type 2 and some cancers. Newly detected genetic risk factor for body weight is the FTO gene ("fat mass and obesity associated"). The aim of this thesis was determine 1) whether the presence of risk alleles correlate with BMI in Czech population and to determine 2) whether there is an association between variants in the FTO gene and risk of myocardial infarction/ acute coronary syndrome (MI/ ACS), 3) renal failure (ESRD), or 4) incidence of colorectal cancer (CRC). We analyzed polymorphisms rs17817449 (first intron) and rs17818902 (3rd intron) using by PCR-RFLP and then also RT PCR. We found an association of the first intron variant (but not the 3rd one) and BMI in Czech control population. We have detected an association of 1st intron SNP and BMI changes during the intervention study in obese children, but not in obese females. We found a correlation between the risk allele and increased risk of ACS (OR 1.49) in patients with MI. In patients with ESRD was detected association between the risk allele and the risk of disease (OR 1.37). We didn't confirmed the association between rs17817449 and the development of CRC. Representative selected groups of the Czech populations "MONICA" and "HAPPIE" were used as controls. One...
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Nutrition of dialysis patient
BOHÁČOVÁ, Kristýna
Bachelor thesis "The Diet of Dialyzed Patients" deals with the nutrition of patients, who regularly receive the dialysis treatment. The aim of this work is to map the awareness of a diet regime and patients' compliance with it. The theoretical part describes the anatomy and physiology of kidneys, then it mentions the kidney failure and the elimination methods. Most of the space in this part is given to the nutrition, where the basic nutrients, vitamins and minerals are described. Their amount is specific for the dialyzed patients. The end of this part is aimed at suitable and unsuitable foodstuffs for dialyzed patients. The practical part uses the quantitative method of structured questionnaire, which contains 34 questions. 30 respondents, who regularly receive the dialysis treatment, participated in it. The results of the research showed that 17 out of 30 patients adhere to the diet measures for dialyzed patients. 57% is not a satisfying result given the availability of the education nowadays. The reason for this result might be that the respondents were not informed about the diet regime from a nutritional therapist. The work suggests the presence of a nutritional therapist for regular check-ups and so-called big blood samples that are done once a month to check the amount of minerals and other substances. Nutritional therapist could then decide, which substances are abundant or deficient, and they could then suggest an adjustment of the patient's diet.
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