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Accelerated Peritoneal Dialysis Training in Urgen-Start Peritoneal Dialysis Patients During the COVID-19 Pandemic

Yıl 2023, Cilt: 18 Sayı: 3, 115 - 123, 30.09.2023
https://doi.org/10.47565/ndthdt.2023.74

Öz

Aim: In this study, our goal was to initiate peritoneal dialysis earlier through an accelerated training process, conducted with strict control measures, during the COVID-19 pandemic.

Materials and Methods: This observational, cross-sectional study was conducted at the Peritoneal Dialysis Unit of Kırıkkale University Faculty of Medicine, Department of Nephrology, with a total of eight participants, including six patients and two of their relatives. The peritoneal dialysis training protocol recommended by the International Society of Peritoneal Dialysis guidelines was provided to the enrolled patients and their relatives within four days. The training encompassed peritoneal dialysis concepts, aseptic techniques, hand hygiene, mask usage, fluid exchange procedures, actions in case of possible contamination, catheter exit site maintenance, peritonitis, leakage, exit site or tunnel infection recognition and treatment, record-keeping, material procurement, principles of control, home visits, vacation planning, and adaptation to social life. Before commencing treatment, participants underwent both theoretical and practical assessments. Achieving a score of 80% or higher in the theoretical test and successfully completing seven stages in the practical test was considered "adequate" for education.

Results: Of the patients, three (37.5%) were female, and five (62.5%) were male, with an average age of 60.5±15.8 years. Participants received an average of 440.6±116.8 minutes of training. The shortest mean training duration was 8.8±5.8 minutes for record-keeping, while the longest mean training duration was 220±53.5 minutes for exchange procedures. Treatment commenced between the 48th - 72nd hours with 500 mL to 750 mL of peritoneal dialysis solution. Gradually, at the 96th hour, the exchange volume increased to 1000-1250 mL, followed by 1500-1750 mL in the second week, and reaching 2000 mL in the third week. During follow-up, one patient developed peritonitis, while no non-peritonitis complications occurred in any patient.

Conclusion: Urgent-start peritoneal dialysis treatment can be initiated promptly through intensified patient/caregiver education during the pandemic period.

Proje Numarası

Yok

Kaynakça

  • 1. who.int [Internet]. WHO Coronavirus (COVID-19) Dashboard; September 2023 [cited 2023 Sep 26]. Available from: https://COVıD19.who.int/
  • 2. Ozturk S, Turgutalp K, Arici M, Odabas AR, Altiparmak MR, Aydin Z et al. Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey. Nephrol Dial Transplant. 2020 Dec 4;35(12):2083-95. doi: 10.1093/ndt/gfaa271.
  • 3. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19 Kidney Int. 2020;97(5): 829-38. doi: 10.1016/j.kint.2020.03.005.
  • 4. Ferrey AJ, Choi G, Hanna RM, Chang Y, Tantisattamo E, Ivaturi K, et al. A case of novel coronavirus disease 19 in a chronic hemodialysis patient presenting with gastroenteritis and developing severe pulmonary disease. Am J Nephrol. 2020;51(5):337-42. doi: 10.1159/000507417.
  • 5. Wilkie M, Davies S. Peritoneal dialysis in the time of COVID-19. Peritoneal Dialysis International. 2020;40(4):357-358. https://doi.org/10.1177/0896860820921657.
  • 6. Sadioğlu RE, Aktar M, Çelik GB, Açıkgöz E, Eren ŞA, Ateş K. COVID-19 Pandemisi Sırasında Uzaktan Kontrollü Aletli Periton Diyalizi ile Sürekli Ayaktan Periton Diyalizi Uygulayan Hastaların Karşılaştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2021;74(2):190-9. doi: 10.4274/atfm.galenos.2021.94830
  • 7. El Shamy O, Patel N, Abdelbaset MH, Chenet L, Tokita J, Lookstein R. et al. Acute start peritoneal dialysis during the COVID-19 pandemic: Outcomes and experiences. J Am Soc Nephrol. 2020;31(8):1680-2. doi: 10.1681/ASN.2020050599.
  • 8. Htay H, Wong PMPK, Choo RR, Dawood US, Foo MWY, Jayaballa M, Lee G, Lee MB, Liu YLA, Low S, Ng AKH, Oei EL, See YP, Tagore R, Tai Y, Liew A. Strategies for management of peritoneal dialysis patients in Singapore during COVID-19 pandemic. Ann Acad Med Singap. 2020;49(12):1025-8. doi: 10.47102/annals-acadmedsg.2020250.
  • 9. Figueiredo AE, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C. et al. A syllabus for teaching peritoneal dialysis to patients and caregivers. P Perit Dial Int. 2016;36(6):592-605. doi: 10.3747/pdi.2015.00277.
  • 10. ispd.org [Internet]. International Society for Peritoneal Dialysis (ISPD). Strategies regarding COVID-19 in PD patients;2020 [cited 2022 July 6]. Available from: https://ispd.org/strategies COVıD19/
  • 11. Kliger AS, Silberzweig J. Mitigating Risk of COVID-19 in Dialysis Facilities. Clin J Am Soc Nephrol. 2020;15(5):707-9. doi: 10.2215/CJN.03340320.
  • 12. Chen TH, Wen YH, Chen CF, Tan AC, Chen YT, Chen FY. et al. The advantages of peritoneal dialysis over hemodialysis during the COVID-19 pandemic. Semin Dial. 2020;33(5):369-71. doi: 10.1111/sdi.12903.
  • 13. Altmann C, Ahuja N, Kiekhaefer CM, Andres Hernando A, Okamura K, Bhargava R. et al. Early peritoneal dialysis reduces lung inflammation in mice with ischemic acute kidney injury. Kidney Int. 2017;92(2):365-76. doi: 10.1016/j.kint.2017.01.020.
  • 14. Rajora N, Shastri S, Pirwani G, Saxena R. How to build a successful urgent-start peritoneal dialysis program. Kidney360. 2020;1(10):1165-77. doi: 10.34067/KID.0002392020.
  • 15. Oeltmann JE, Vohra D, Matulewicz HH, DeLuca N, Smith JP, Couzens C, Lash RR, Harvey B, Boyette M, Edwards A, Talboy PM, Dubose O, Regan P, Loosier P. et al. Isolation and quarantine for coronavirus disease 2019 in the United States, 2020-2022. Clin Infect Dis. 2023;77(2):212-9. doi: 10.1093/cid/ciad163.
  • 16. Rabindranath KS, Adams J, Ali TZ, MacLeod AM, Vale L, Cody J. et al. Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. Cochrane Database Syst Rev. 2007;2007(2):CD006515. doi: 10.1002/14651858.CD006515.
  • 17. Ye H, Yang X, Yi C, Guo Q, Li Y, Yang Q,. et al. Urgent-start peritoneal dialysis for patients with end stage renal disease: a 10-year retrospective study. BMC Nephrol. 2019;20(1):238. doi: 10.1186/s12882-019-1408-9.

COVID-19 Pandemi Döneminde Acil Başlangıçlı Periton Diyalizi Hastalarında Hızlandırılmış Periton Diyalizi Eğitimi / Accelerated Peritoneal Dialysis Training in Urgen-Start Peritoneal Dialysis Patients During the COVID-19 Pandemic

Yıl 2023, Cilt: 18 Sayı: 3, 115 - 123, 30.09.2023
https://doi.org/10.47565/ndthdt.2023.74

Öz

Amaç: Bu çalışmada COVID-19 pandemisi döneminde, hızlandırılmış bir eğitim ve kontrollü olarak yürütülmüş bir süreç ile daha erken dönemde periton diyalizinin başlatılmasını amaçladık.

Gereç ve Yöntem: Bu çalışma Kırıkkale Üniversitesi Tıp Fakültesi, Nefroloji Bilim Dalı, periton diyalizi ünitesinde takip edilen altısı hasta, ikisi hasta yakını toplam sekiz katılımcının alındığı gözlemsel, kesitsel bir çalışmadır. Çalışmaya alınan hasta/hasta yakınlarına International Society of Peritoneal Dialysis kılavuzunun önerdiği periton diyaliz eğitim protokolü dört gün içerisinde aktarıldı. Eğitim içeriği; periton diyaliz kavramı, aseptik teknik, el yıkama, maske kullanımı, sıvı değişim işlemi, olası kontaminasyonda yapılacaklar, kateter çıkış yeri bakımı, peritonit, sızıntı, çıkış yeri veya tünel enfeksiyonu komplikasyonların tanınması ve tedavisi, kayıt tutma, malzeme temini, kontrol esasları, ev ziyareti, tatil programı ve sosyal yaşama adaptasyon konularından oluşturuldu. Katılımcılara tedaviye başlamadan önce ve sonra teorik ve uygulama testi uygulandı. Son testte; hasta ve hasta yakınları tarafından teorik testte %80 ve üzerinde başarı, uygulama testinde yedi aşamanın tamamlanmış olması eğitim açısından “yeterli” olarak tanımlandı.

Sonuçlar: Hastaların üçü (%37,5) kadın, beşi (%62,5)’i erkek olup ortalama yaşları 60,5±15,8 yıldı. Katılımcılara ortalama 440,6±116,8 dakika eğitim verildi. En kısa ortalama eğitim süresi 8,8±5,8 dakika ile kayıt tutma iken, en uzun ortalama eğitim süresi 220±53,5 dakika ile sıvı değişim prosedürleriydi. Tedaviye 48-72. saatte 500 mL-750 mL periton diyaliz solüsyonu ile başlandı. Kademeli artış ile 96. saatte 1000-1250 mL, ikinci haftada 1500-1750 mL, üçüncü haftada ise 2000 mL değişim volümüne ulaşıldı. Takiplerde bir hastada peritonit gelişirken, hiçbir hastada peritonit dışı komplikasyon gelişmedi.

Sonuç: Pandemi döneminde yoğunlaştırılmış hasta/hasta yakını eğitimiyle acil başlangıçlı periton diyaliz tedavisi kısa sürede başlanabilir.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Kaynakça

  • 1. who.int [Internet]. WHO Coronavirus (COVID-19) Dashboard; September 2023 [cited 2023 Sep 26]. Available from: https://COVıD19.who.int/
  • 2. Ozturk S, Turgutalp K, Arici M, Odabas AR, Altiparmak MR, Aydin Z et al. Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey. Nephrol Dial Transplant. 2020 Dec 4;35(12):2083-95. doi: 10.1093/ndt/gfaa271.
  • 3. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19 Kidney Int. 2020;97(5): 829-38. doi: 10.1016/j.kint.2020.03.005.
  • 4. Ferrey AJ, Choi G, Hanna RM, Chang Y, Tantisattamo E, Ivaturi K, et al. A case of novel coronavirus disease 19 in a chronic hemodialysis patient presenting with gastroenteritis and developing severe pulmonary disease. Am J Nephrol. 2020;51(5):337-42. doi: 10.1159/000507417.
  • 5. Wilkie M, Davies S. Peritoneal dialysis in the time of COVID-19. Peritoneal Dialysis International. 2020;40(4):357-358. https://doi.org/10.1177/0896860820921657.
  • 6. Sadioğlu RE, Aktar M, Çelik GB, Açıkgöz E, Eren ŞA, Ateş K. COVID-19 Pandemisi Sırasında Uzaktan Kontrollü Aletli Periton Diyalizi ile Sürekli Ayaktan Periton Diyalizi Uygulayan Hastaların Karşılaştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2021;74(2):190-9. doi: 10.4274/atfm.galenos.2021.94830
  • 7. El Shamy O, Patel N, Abdelbaset MH, Chenet L, Tokita J, Lookstein R. et al. Acute start peritoneal dialysis during the COVID-19 pandemic: Outcomes and experiences. J Am Soc Nephrol. 2020;31(8):1680-2. doi: 10.1681/ASN.2020050599.
  • 8. Htay H, Wong PMPK, Choo RR, Dawood US, Foo MWY, Jayaballa M, Lee G, Lee MB, Liu YLA, Low S, Ng AKH, Oei EL, See YP, Tagore R, Tai Y, Liew A. Strategies for management of peritoneal dialysis patients in Singapore during COVID-19 pandemic. Ann Acad Med Singap. 2020;49(12):1025-8. doi: 10.47102/annals-acadmedsg.2020250.
  • 9. Figueiredo AE, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C. et al. A syllabus for teaching peritoneal dialysis to patients and caregivers. P Perit Dial Int. 2016;36(6):592-605. doi: 10.3747/pdi.2015.00277.
  • 10. ispd.org [Internet]. International Society for Peritoneal Dialysis (ISPD). Strategies regarding COVID-19 in PD patients;2020 [cited 2022 July 6]. Available from: https://ispd.org/strategies COVıD19/
  • 11. Kliger AS, Silberzweig J. Mitigating Risk of COVID-19 in Dialysis Facilities. Clin J Am Soc Nephrol. 2020;15(5):707-9. doi: 10.2215/CJN.03340320.
  • 12. Chen TH, Wen YH, Chen CF, Tan AC, Chen YT, Chen FY. et al. The advantages of peritoneal dialysis over hemodialysis during the COVID-19 pandemic. Semin Dial. 2020;33(5):369-71. doi: 10.1111/sdi.12903.
  • 13. Altmann C, Ahuja N, Kiekhaefer CM, Andres Hernando A, Okamura K, Bhargava R. et al. Early peritoneal dialysis reduces lung inflammation in mice with ischemic acute kidney injury. Kidney Int. 2017;92(2):365-76. doi: 10.1016/j.kint.2017.01.020.
  • 14. Rajora N, Shastri S, Pirwani G, Saxena R. How to build a successful urgent-start peritoneal dialysis program. Kidney360. 2020;1(10):1165-77. doi: 10.34067/KID.0002392020.
  • 15. Oeltmann JE, Vohra D, Matulewicz HH, DeLuca N, Smith JP, Couzens C, Lash RR, Harvey B, Boyette M, Edwards A, Talboy PM, Dubose O, Regan P, Loosier P. et al. Isolation and quarantine for coronavirus disease 2019 in the United States, 2020-2022. Clin Infect Dis. 2023;77(2):212-9. doi: 10.1093/cid/ciad163.
  • 16. Rabindranath KS, Adams J, Ali TZ, MacLeod AM, Vale L, Cody J. et al. Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end-stage renal disease. Cochrane Database Syst Rev. 2007;2007(2):CD006515. doi: 10.1002/14651858.CD006515.
  • 17. Ye H, Yang X, Yi C, Guo Q, Li Y, Yang Q,. et al. Urgent-start peritoneal dialysis for patients with end stage renal disease: a 10-year retrospective study. BMC Nephrol. 2019;20(1):238. doi: 10.1186/s12882-019-1408-9.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik
Bölüm Makale
Yazarlar

Meltem İçen 0000-0002-5590-941X

İbrahim Doğan 0000-0001-8489-4985

Emel Uçar 0000-0002-4224-3014

Alper Kırkpantur 0000-0002-0713-1957

Proje Numarası Yok
Yayımlanma Tarihi 30 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 18 Sayı: 3

Kaynak Göster

Vancouver İçen M, Doğan İ, Uçar E, Kırkpantur A. COVID-19 Pandemi Döneminde Acil Başlangıçlı Periton Diyalizi Hastalarında Hızlandırılmış Periton Diyalizi Eğitimi / Accelerated Peritoneal Dialysis Training in Urgen-Start Peritoneal Dialysis Patients During the COVID-19 Pandemic. NefroHemDergi. 2023;18(3):115-23.

Nefroloji Hemşireliği Dergisi/ Journal of Nephrology Nursing Creative Commons Lisansı Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.