Nephrology Nursing Journal最新文献

Nephrology nurses working in hemodialysis units face unique challenges managing multiple patients - an experience often contributing to higher levels of burnout and stress, and potentially lower job satisfaction and retention rates, exacerbating the existing nursing shortage in dialysis settings. Targeted strategies are essential to improve job satisfaction. In this study, we explored the relationship between emotional intelligence and job satisfaction among nephrology nurses working in acute and chronic hemodialysis settings. A quantitative, non-experimental, descriptive, correlational design was used. There was a statistically significant positive correlation between emotional intelligence and job satisfaction, suggesting that heightened levels of emotional intelligence are associated with increased job satisfaction among nurses. Recommendations for enhancing emotional intelligence are discussed.

Chronic kidney disease (CKD) affects 10% of the global population, with increasing prevalence driven by diabetes, hypertension, and aging populations. CKD often progresses asymptomatically, frequently undetected until advanced stages, and may require costly treatments, such as dialysis or transplantation. CKD imposes a substantial financial burden on health care systems, with management costs rising sharply as the disease progresses, underscoring the need for early, cost-effective interventions. The Kidney Health Score (KHS) was developed to assess six essential risk factors - blood pressure, body mass index (BMI), waist circumference, blood glucose (HbA1c), estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (uACR). Identifying these risk factors enables health care professionals to manage modifiable risks and improve CKD outcomes. This article provides evidence-based insights into the relevance of each factor to kidney health.

Citrate anticoagulation offers a targeted and effective method for preventing clotting in extracorporeal blood circuits during dialysis. This article reviews the mechanisms, benefits, risks, and best practices associated with citrate anticoagulation, emphasizing its growing role within critical care and dialysis.

Patients in need of a kidney transplant have the option of receiving a kidney from a living donor or a deceased donor. Patients in the United States who do not have an available living donor typically wait on the deceased donor waiting list for an average of three to five years, although some patients may wait longer. The waiting list is very complex and intended to allocate kidneys in a fair and equitable manner. The deceased donor waiting list is currently managed by the United Network for Organ Sharing, but a recent change will soon distribute its current functions to multiple different organizations with a goal to improve transplantation rates. This article discusses how to help patients navigate the complexity of the kidney transplant waitlist.

Intradialytic hypotension (IDH) is a common occurrence in hemodialysis. IDH occurs when there is a drop in blood pressure along with hypotensive symptoms. There are various causes of IDH, and it is important to consider proper management of this condition. One strategy is to administer vasoconstrictor medication before the hemodialysis session to decrease the risk of IDH. A vasoconstrictor medication used for IDH is midodrine. Midodrine is an oral alpha-1 adrenergic receptor agonist. Evidence on its long-term efficacy and safety data is lacking. This article describes important information on midodrine for nephrology practitioners.

Whether pediatric dialysis is morally obligatory is an ethical issue. The study's aim was to understand neonatal and pediatric intensive care unit (ICU) nurses' beliefs regarding the ethical use of pediatric dialysis. A single center study was conducted using theoretical and case-based surveys. Sixty-three (63) registered nurses completed at least part of the survey. The most important factors influencing nurses' beliefs on the appropriateness of dialysis were patient quality of life, prognosis, and severity of comorbidities. Nurses with experience vs. nurses without experience caring for patients on dialysis ranked family wishes as more important (p < 0.05) and were more likely to express their beliefs when they disagreed with the decision (p < 0.005). The data suggest that beliefs of nurses vary based on demographic and situational factors. Consideration of these factors may improve care team communication.

Patients with acute kidney injury often require dialysis (AKI-D) in the outpatient setting following hospitalization. Management of the patient with AKI-D should focus on preventing further insult to the damaged kidney and recovery of kidney function. Clinical attention should include continuity of care, education, infection control, medication management, and fluid management.

More and more nursing homes are admitting residents receiving dialysis. In 2023, the Centers for Medicare and Medicare Services released guidance addressing the qualifications of those caring for these residents and further clarified the survey process. The American Nephrology Nurses Association Board of Directors created the Home Dialysis for Nursing Home Residents Task Force to review the revised guidance, investigate strategies and opportunities for nephrology registered nurses in home dialysis therapy in this setting, and consider the potential implications related to alternative home dialysis settings. This article discusses their process, findings, and outcomes.