Introduction
Over the past 25–30 years, there has been a steady increase in the number of patients with CKD in the world. This increase is considered to be connected majorly to an improvement in the detection of directly independent nephropathies. Additionally, higher life expectancy of the population, as well as an increase in the prevalence of cardiac pathology, diabetes mellitus, metabolic syndrome and other conditions, also contribute to the expansion of kidney diseases. Lately, peritoneal dialysis (PD) has become one of the main treatment methods in the urology practice – mostly due to the higher safety and efficiency of it. However, studies show that the mortality rates of the patients who receive PD have a direct correlation to the choice of catheter used for the procedure.
Significance to Nursing
Comparison of hemodialysis and PD reveals several medical and social benefits of PD. Among the clinical advantages, most researchers prioritize the longer – in comparison with hemodialysis – preservation of residual renal function in patients with CKD. Moreover, the absence of serious hemodynamic changes in PD conditions is also a serious argument in favor of choosing it as a treatment method in patients with severe cardiac pathology. Thus, it is of crucial importance for the nurses to learn how to choose the correct catheter to ensure the safety and the best quality of life of the patients.
Literature Overview
Critical studies have explored different aspects of CKD treatment, including the effects the peritoneal dialysis has on both the efficiency and comfortability of it. Several researches highlight the importance of prevention measures for kidney diseases, as the penetration of any kind, including the peritoneal dialysis, ultimately results in the degradation of patient’s overall health. In addition, findings indicate an increased risk of mortality from coronavirus in CKD patients (Gansevoort & Hilbrands, 2020). Comparative studies of mortality rates associated with catheter choice for peritoneal dialysis reveal the factors that might affect the doctor’s perspective when choosing the correct catheter.
Research Design and Methodology: Sampling Procedure
The research is a longitudinal study of the patients with chronic kidney disease. These patients receive peritoneal dialysis as a part of treatment for a long period of time. An age- and gender-diverse sampling pool is required to properly measure the impact of the catheter choice on PD patients’ quality of life.
Research Design and Methodology: Data Collection Procedures
During the stage of data collection, several methods were used. The patients who gave consent to participate in the research were interviewed with the EQ-5D questionnaires. Test-retest procedure and alternative-form testing ensured the quality and reliability of the data. To objectively evaluate patient’s current condition, electronic health records were also employed, providing the research with medical data such as lab test results and medication prescriptions. Detailed information about the use of various types of catheters will also be scrutinized (Shimizu et al., 2020).
Research Design and Methodology: Data Analysis Overview
Regressive analysis method would be the most suitable for this research, as it measures the association between variables, especially the numerical ones (Hocher & Adamski, 2017). Moreover, this method of analysis implies the use of a variety of specific tools, ranging from least squares to polynomial regression, which allows an in-depth study of the subject. The relationship between independent and dependent variables is examined closely through the regression analysis, thus providing the base for prediction and correlation studies.
Ethical Considerations
Patients should be aware of the multiple responsibilities that participation in this research requires. Therefore, it is important to acquire informed consent from them, as it allows the patients to recognize and understand different aspects of the research. Additionally, through informed consent, patients can learn risks and benefits associated with their participation.
Conclusion
Due to the improvement of early recognition and treatment methods for the CKD, as well as the introduction of new protocols for the dialysis therapy into clinical practice, the disease’s frequency has decreased in recent years. However, to date, the mortality rates associated with the choice of catheter continue to pose a certain problem when employing PD, affecting the technical survival of this method in patients with CKD. Numerous studies show that the use of PD in patients with CKD can significantly increase the effectiveness of the treatment. However, it is also noted, that the indications and contraindications reflected in the current clinical recommendations should be taken into account when choosing a catheter type for PD. Additionally, the initiation of treatment on time, as well as adherence to the protocols for the prevention and treatment of its complications, also proved to be of crucial importance to the treatment success. Still, further study of the subject is highly recommended.
References
Gansevoort, R. T., & Hilbrands, L. B. (2020). CKD is a key risk factor for COVID-19 mortality. Nature Reviews Nephrology, 16(12), 705-706. Web.
Hocher, B., & Adamski, J. (2017). Metabolomics for clinical use and research in chronic kidney disease. Nature Reviews Nephrology, 13(5), 269-284.
Kim, D. H., Park, J. I., Lee, J. P., Kim, Y.-L., Kang, S.-W., Yang, C. W., Kim, N.-H., Kim, Y. S., & Lim, C. S. (2019). The effects of vascular access types on the survival and quality of life and depression in the incident hemodialysis patients. Renal Failure, 42(1), 30–39.
Ng, J. K. C., & Li, P. K. T. (2018). Chronic kidney disease epidemic: how do we deal with it?. Nephrology, 23, 116-120.
Vonesh, E. F., Snyder, J. O. N. J., Foley, R. N., & Collins, A. J. (2004). The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis. Kidney International, 66(6), 2389–2401.
Shimizu, Y., Nakata, J., Yanagisawa, N., Shirotani, Y., Fukuzaki, H., Nohara, N., & Suzuki, Y. (2020). Emergent initiation of dialysis is related to an increase in both mortality and medical costs. Scientific Reports, 10(1), 1-8.