1
|
Hu N, Wang A, Chang T. Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Front Psychol 2023; 14:1062337. [PMID: 36910788 PMCID: PMC9998938 DOI: 10.3389/fpsyg.2023.1062337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/08/2023] [Indexed: 03/14/2023] Open
Abstract
Background No research has yet been done on social support's influence on the association between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Accordingly, it remains unclear how medical personnel can assist patients in successfully adjusting to the early postoperative period and improving their health. Objective This study sought to explore the influence of illness perception and social support on the psychosocial adaptation of young and middle-aged recipients of kidney transplants in China during the early postoperative period. Methods This study adopted a cross-sectional design. The study included 236 young and middle-aged kidney transplant recipients from a tertiary hospital in China. Demographic and disease-related data were collected. Additionally, the Psychosocial Adjustment to Illness Scale-Self-Report, the Brief Illness Perception Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to assess participants' psychosocial adaptation, illness perception, and social support, respectively. The model was examined using descriptive analysis, Pearson's correlation analysis, hierarchical multiple regression analysis, and the PROCESS Macro in SPSS 26.0. Results A total of 176 (74.56%) participants reported an average psychosocial adaptation score >50, which is relatively negative. Marital status, education level, residence, per capita monthly income (in Chinese yuan), medical insurance, work status, post-transplant time, body mass index, creatinine status, and complications were all related to psychosocial adaptation (p < 0.05). The more negative their illness perception and the worse their social support, the worse the psychosocial adaptation of young and middle-aged kidney transplant recipients. Further, the effect of illness perception on psychosocial adaptation was partially mediated by social support (36.56%). Conclusion In general, the psychosocial adaption level of young and middle-aged kidney transplant recipients was negative during the early postoperative period. Healthcare teams should assist patients in building a positive illness perception shortly following kidney transplantation, while also providing psychological care and support to help them cope with the onset of psychosocial issues.
Collapse
Affiliation(s)
- Na Hu
- Transplantation Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Tiantian Chang
- Transplantation Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
2
|
Toure AO, Balde MD, Diallo A, Camara S, Soumah AM, Sall AO, Kourouma K, Camara BS, Bocoum FY, Kouanda S. The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso). BMC Nephrol 2022; 23:222. [PMID: 35739468 PMCID: PMC9219226 DOI: 10.1186/s12882-022-02847-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic renal failure can lead to dialysis and/or a kidney transplant in the final stage. The number of patients under dialysis has increased considerably in the world and particularly in sub-Saharan Africa. Dialysis is a very expensive care. This is the reason why this study on the costs of dialysis management was initiated in Burkina Faso. The objective of the study is to determine the direct medical and non-medical costs of managing chronic renal failure among dialysis patients in Ouagadougou in 2020. Methods An analytical cross-sectional study was conducted. Data were collected in the hemodialysis department of three public university hospitals in Ouagadougou, Burkina Faso. All dialysis patients with chronic renal failure were included in the study. Linear regression was used to investigate the determinants of the direct medical and non-medical cost of hemodialysis. Results A total of 290 patients participated in this study, including children, adults, and the elderly with extremes of 12 and 82 years. Almost half of the patients (47.5%) had no income. The average monthly total direct cost across all patients was 75842 CFA or US$134.41.The average direct medical cost was 51315 CFA or US$90.94 and the average direct non-medical cost was 24 527 CFA or US$43.47. Most of the patients (45.2%) funded their hemodialysis by their own source. The multivariate analysis showed that the presence of an accompanying person during treatment, residing in a rural area, ambulatory care, use of personal cars, and treatment at the dialysis center of Yalgado Teaching Hospital were associated with higher direct costs. Conclusion The average cost of dialysis services borne by the patient and his family is very high in Burkina Faso, since it is 2.1 times higher than the country's minimum interprofessional wage (34664 CFA or US$61.4). It appears that the precariousness of the means of subsistence increases strongly with the onset of chronic renal failure requiring dialysis. Thus, to alleviate the expenses borne by dialysis patients, it would be important to extend the government subsidy scheme to the cost of drugs and to promote health insurance to ensure equitable care for these patients.
Collapse
Affiliation(s)
- Amadou Oury Toure
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea.
| | - Mamadou Dioulde Balde
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Aissatou Diallo
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Sadan Camara
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Anne Marie Soumah
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Alpha Oumar Sall
- Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI), Conakry, Guinea
| | - Karifa Kourouma
- National Center for Training and Research in Rural Health in Maferinyah Guinea /Centre national de formation et de recherche en santé rurale à Maferinyah Guinée, Maferinyah, Guinea
| | - Bienvenu Salim Camara
- National Center for Training and Research in Rural Health in Maferinyah Guinea /Centre national de formation et de recherche en santé rurale à Maferinyah Guinée, Maferinyah, Guinea
| | - Fadima Yaya Bocoum
- Institut de Recherche en Sciences de la Santé (IRSS) Burkina Faso, Ouagadougou, Burkina Faso.,African Institute of Public Health (IASP) Burkina Faso/Institut Africaine de Santé Publique Burkina Faso, Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS) Burkina Faso, Ouagadougou, Burkina Faso.,African Institute of Public Health (IASP) Burkina Faso/Institut Africaine de Santé Publique Burkina Faso, Ouagadougou, Burkina Faso
| |
Collapse
|
3
|
Zhang D, Du X, Zhang X, Li K, Kong F, Cheng G, Zhao S. In vitro induction and in vivo engraftment of kidney organoids derived from human pluripotent stem cells. Exp Ther Med 2020; 20:1307-1314. [PMID: 32742364 PMCID: PMC7388233 DOI: 10.3892/etm.2020.8844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 01/10/2020] [Indexed: 11/06/2022] Open
Abstract
The shortage of transplantable organs impedes the development of tissue-engineered alternatives. Producing tissues similar to immature kidneys from pluripotent stem cells is possible in vitro, but the size of the organoids is limited. Furthermore, in vivo implantation is necessary for organoid development and functional maturation. In the present study, the induction procedure was optimized and kidney organoids derived from induced pluripotent stem cells in vitro were produced. The kidney organoids were examined by immunofluorescence and quantitative PCR. Then, a unilateral nephrectomy model was established that was beneficial to the compensatory proliferation of the other kidney. Finally, these organoids were implanted below the kidney capsules of immunodeficient mouse hosts that had been nephrectomized unilaterally. This implantation resulted in the enlargement of the organoids and the production of vascular cells. Although signs of organoid maturation were lacking in short-term culture in vivo, the present study provided a method for studying kidney organoid development in vivo.
Collapse
Affiliation(s)
- Denglu Zhang
- Central Laboratory, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P.R. China.,Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Xiaohang Du
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| | - Xufeng Zhang
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China.,Department of Kidney Transplantation, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Kailin Li
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China.,Central Research Laboratory, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China.,Shandong University-Karolinska Institute Collaborative Laboratory for Stem Cell Research, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Feng Kong
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China.,Central Research Laboratory, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China.,Shandong University-Karolinska Institute Collaborative Laboratory for Stem Cell Research, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Guanghui Cheng
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China.,Central Research Laboratory, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China.,Shandong University-Karolinska Institute Collaborative Laboratory for Stem Cell Research, The Second Hospital, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Shengtian Zhao
- Key Laboratory for Kidney Regeneration of Shandong Province affiliated to The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
| |
Collapse
|
4
|
Rotella AAF, Nascimento RAD, Camargo MFCD, Nogueira PCK. EMOTIONAL REPERCUSSIONS AND QUALITY OF LIFE IN CHILDREN AND ADOLESCENTS UNDERGOING HEMODIALYSIS OR AFTER KIDNEY TRANSPLANTATION. ACTA ACUST UNITED AC 2019; 38:e2018221. [PMID: 31778416 PMCID: PMC6909242 DOI: 10.1590/1984-0462/2020/38/2018221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/07/2018] [Indexed: 11/21/2022]
Abstract
Objective: To investigate the emotional repercussions and quality of life (QOL) associated with end-stage kidney disease (ESKD) in children and adolescents undergoing hemodialysis or a kidney transplant (TX). Methods: We conducted a quantitative-qualitative study. 48 children and adolescents with ESKD were interviewed; half of them underwent hemodialysis treatment, and the other half had a kidney transplantation. Their respective 48 caregivers also participated in the study. The questionnaire involved both the Pediatric Quality of Life Inventory and a thematic story-drawing tool. An analysis of the QOL questionnaire’s results was done by comparing the sum of points between groups and the theme-based story-drawing consisted of interpreting the data contained in the material using Freudian and Lacanian theories. Results: In the QOL questionnaires, the total score was higher in the transplanted patients and in their caregivers, suggesting a perception of better QOL after kidney transplantation. In the specific aspects of the questionnaire, physical capacity was considered superior by children who underwent transplants and their caregivers. There were no differences between the groups in the emotional, social and school aspects. However, the caregivers of the patients who had a transplant perceived a significant difference in QOL in the school aspect. In the thematic story-drawings, emotional suffering in the two analyzed groups was evidenced regardless of the treatment. Conclusions: Despite the questionnaire results suggesting that transplantation does improve some aspects of QOL, there were no differences observed between kidney replacement therapies regarding the emotional repercussion of chronic kidney disease.
Collapse
|
5
|
Nédélec M, Glémain P, Rigaud J, Karam G, Thuret R, Badet L, Kleinclauss F, Timsit MO, Branchereau J. [Renal transplantation on vascular prosthesis]. Prog Urol 2019; 29:603-611. [PMID: 31447181 DOI: 10.1016/j.purol.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/29/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION In front of a very calcified aortoiliac axis, renal transplantation with implantation of the artery on vascular prosthesis can be proposed. This rare intervention is considered difficult and morbid. The main objective of this work was to evaluate the overall and specific survival of the transplant in this situation. The secondary objective was the study of the complications and the evolution of the transplant's renal function. MATERIAL AND METHODS From a multicenter retrospective data collection of the DIVAT cohort (6 centers) added with data from 4 other transplant centers, we studied transplants with prosthetic arterial anastomosis. RESULTS Thirty four patients was included. The median duration of follow-up was 2.5 years. 4 patients died in the month following transplantation, 16 were hemodialysis and 9 were transfused. The median survival of the transplant was 212 days. Functional arrests of the transplant were mostly associated with nephrological degradation and return to dialysis (about 80%) while 10% were related to a death of the recipient directly attributable to renal transplantation. The surgical complications of the transplantation were marked by one arterial stenosis, one fistula and 4 urinary stenoses. CONCLUSION Thus, renal transplantation with arterial anastomosis on vascular prosthesis, on selected patients, offers an alternative to dialysis. A national compendium of transplanted patients on vascular prosthesis would allow a long-term follow-up of transplant's survival and define selection criteria prior to this kind of surgery. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- M Nédélec
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France
| | - P Glémain
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France
| | - J Rigaud
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France
| | - G Karam
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France
| | - R Thuret
- Service d'urologie, CHU de Montpellier, 371, avenue du Doyen-Gaston Giraud, 34295 Montpellier cedex 5, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France
| | - L Badet
- Service d'urologie, hôpital Edouard-Herriot, hospices civils de Lyon, 69437 Lyon cedex 03, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France
| | - F Kleinclauss
- Service d'urologie, CHRU de Besançon, 25030 Besançon cedex, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France
| | - M O Timsit
- Service d'urologie, hôpital Européen Georges-Pompidou (HEGP), AP-HP, 75015 Paris, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France
| | - J Branchereau
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, 44093 Nantes, France; Centre de Recherche en Transplantation et Immunologie UMR 1064, Inserm, Université de Nantes, 44093 Nantes, France; Comité de transplantation et d'insuffisance rénale chronique (CTIRC), 75017 Paris, France.
| |
Collapse
|