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      Incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients

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          Abstract

          Introduction: Chronic kidney disease (CKD) is a rising problem across the world, including Iran. Most of the patients will require hemodialysis for survival. Despite the great progress has been made in the hemodialysis equipment, but it is still associated with complications. Nausea and vomiting are common complication of during hemodialysis, which leads to unpleasant feeling in patients.

          Objectives: This study aimed to determine incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients.

          Patients and Methods: This is a descriptive and analytical study on 60 hemodialysis patients of dialysis wards in Semnan University of Medical Sciences. Verbal Numeric Rating Scale (VNRS) and Korttila vomiting severity scale were used to measure the severity of nausea and vomiting during hemodialysis respectively.

          Results: In this study, the incidence of nausea and vomiting during hemodialysis were 28.3% and 11.7%, respectively. Meanwhile, the mean severity of nausea was 1.15 and the mean rank of vomiting was 2.08.

          Conclusion: The results of the study showed a relatively high incidence of nausea and vomiting in patients undergoing hemodialysis, hence nurses must consider these problems by suitable measures to prevent the occurrence of the these unpleasant feelings in the patients during hemodialysis.

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          Intradialytic complications during hemodialysis.

          Andrew Davenport (2006)
          With the advent of developments and advances in hemodialysis machine technology, dialysate water purification, and dialyzers, the clinical spectrum of intradialytic complications has changed over the decades. In the pioneering days of hemodialysis, patients could develop allergic reactions to dialyzer membranes, sterilizing and reprocessing agents, coupled with machines that could not accurately control ultrafiltration rates, and chemically and bacterially contaminated dialysate. Whereas today, although cardiovascular problems remain the most common intradialytic complication, these are mainly due to the time restraints of trying to cope with excessive dialytic weight gains and achieve target dry weight on a thrice weekly schedule, coupled with an aging elderly dialysis population with increasing co-morbidity.
          Article 0 comments Cited 47 times – based on 0 reviews     Review now
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            Characteristics of hypotension-prone haemodialysis patients: is there a critical relative blood volume?

            Thomas Kuenzi, Claudia Barth, Jutta Passlick-Deetjen … (2003)
            Intradialytic morbid events (IME, mostly hypotension) mainly due to ultrafiltration-induced hypovolaemia still are the most frequent complication during haemodialysis (HD). This study was performed to test the hypothesis that there is an individual critical relative blood volume (RBV(crit)) in IME-prone HD patients. In this prospective international multicentre study, 60 IME-prone patients from nine dialysis centres were observed during up to 21 standard HD sessions without trial-specific intervention. The RBV was monitored continuously by an ultrasonic method (BVM; blood volume monitor). Also, the ultrafiltration rate was registered continuously. Blood pressure was measured at regular intervals, and more frequently during IME. All IME and specific therapeutic interventions were noted. In total, 537 IME, some with more than one symptom, were documented during 585 HD sessions. The occurrence of IME increased up to 10-fold from the start to the end of the HD session. RBV(crit) showed a wide inter-individual range, varying from 71 to 98%. However, the intra-individual RBV limit was relatively stable, with an SD of <5% in three-quarters of the patients. In patients with congestive heart failure, cardiac arrhythmia, advanced age, low ultrafiltration volume and low diastolic blood pressure, higher values of RBV(crit) were observed. While all correlations between RBV(crit) and patient characteristics alone were found to be of weak or medium strength, the combination of diastolic blood pressure, ultrafiltration volume and age resulted in a strong correlation with RBV(crit): the linear equation with these parameters allows an estimation of RBV(crit) in patients not yet monitored with a BVM. An individual RBV limit exists for nearly all patients. In most IME-prone patients, these RBV values were stable with only narrow variability, thus making it a useful indicator to mark the individual window of haemodynamic instabilities.
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              Relationship between hematocrit and renal function in men and women.

              Roman G Kuperman, D Bates, Sharon G Curhan … (2001)
              Anemia is a known complication of renal insufficiency, but the relationship between level of renal function and magnitude of reduction in hematocrit is not well defined. Men have higher hematocrit and absolute glomerular filtration rate (GFR) than women; however, it is unknown whether the level of clearance associated with decreased hematocrit is the same in men and women. We conducted a cross-sectional study of 12,055 adult ambulatory patients. General linear models were used to analyze the relationship between hematocrit and Cockcroft-Gault equation estimated creatinine clearance (C(Cr); mL/min) and Modification of Diet in Renal Disease (MDRD) formula estimated the GFR indexed to body surface area (mL/min/1.73 m(2)). The hematocrit decreased progressively below estimated C(Cr) 60 mL/min in men and 40 mL/min in women. Compared with subjects with C(Cr)> 80 mL/min, men with C(Cr) 60 to 50 mL/min, 50 to 40 mL/min, 40 to 30 mL/min, 30 to 20 mL/min, and 80 mL/min/1.73 m(2), men with GFR 50 to 40 mL/min/1.73 m(2), 40 to 30 mL/min/1.73 m(2), 30 to 20 mL/min/1.73 m(2), and < or =20 mL/min/1.73 m(2) had mean hematocrits that were lower by 2.0, 4.4, 5.3, and 9.4%; the corresponding reductions in women with GFR 50 to 40 mL/min/1.73 m(2), 40 to 30 mL/min/1.73 m(2), 30 to 20 mL/min/1.73 m(2) and < or =20 mL/min/1.73 m(2) were 0.6, 1.6, 3.8, and 5.3% (all P < 0.05). A decrease in hematocrit is apparent even among patients with mild to moderate renal insufficiency. At any given level of renal function below estimated C(Cr) 60 mL/min, men have a larger decrease in hematocrit than women.
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Renal Inj Prev
                Journal ID (iso-abbrev): J Renal Inj Prev
                Journal ID (publisher-id): J Renal Inj Prev
                Journal ID (publisher-id): JRIP
                Title: Journal of Renal Injury Prevention
                Publisher: Nickan Research Institute
                ISSN (Electronic): 2345-2781
                Publication date Collection: 2017
                Publication date (Electronic): 03 September 2016
                Volume: 6
                Issue: 1
                Pages: 49-55
                Affiliations
                1Nursing Care Research Center, Department of Medical-Surgical Nursing, Faculty of Nursing and Allied Health, Semnan University of Medical Sciences, Semnan, Iran.
                2Student Research Committee, Faculty of Nursing, Semnan University of Medical Sciences, Semnan, Iran
                3Social Determinants of Health Research Center, Department of Social Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
                4Department of Allied Health, Faculty of Nursing and Allied Health, Semnan University of Medical Sciences, Semnan, Iran
                Author notes
                [* ] Corresponding author: Ali Asghar Ghods, aaghods@ 123456yahoo.com
                Article
                DOI: 10.15171/jrip.2017.09
                PMC ID: 5414519
                PubMed ID: 28487872
                SO-VID: cf286354-9b50-4173-b306-2083a0ab3066
                Copyright © Copyright © 2017 The Author(s); Published by Nickan Research Institute
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 19 June 2016
                Date accepted : 31 August 2016
                Page count
                Tables: 4, References: 30, Pages: 7
                Categories
                Subject: Original Article

                Keywords: chronic kidney disease,hemodialysis,nausea,vomiting
                Data availability:
                Keywords: chronic kidney disease, hemodialysis, nausea, vomiting

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