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PubMed1990

[Computer-assisted information processing in nephrology exemplified by the Nephrology-Dialysis Data System].

The data system nephrology/dialysis (DSND) may improve the documentation and information processes used in chronic hemodialysis. DNSD is efficient if the data input is done carefully. It is possible to display large numbers of laboratory and dialysis data arranged alpha-numerically or graphically. Data over a period of 5 weeks or 14 consecutive examinations are recorded. An advantage is the possibility to print letters, labels and dialysis protocols. For scientific questions the points of class wideness for laboratory results, weight changes or medication are possible. Furthermore, the use of DSND may be valuable for use in a kidney transplantation information system.

Germany↗
PubMed2001

Nephrology nurse-patient relationships in the outpatient dialysis setting.

A qualitative examination of the beliefs and experiences of nephrology nurses was conducted by interviewing 22 nurses in dialysis units. The interviews were transcribed and content analysis of the transcripts was conducted. Seven propositions are reported: (a) The relationship between nephrology nurses and nephrology patients, in some ways, is similar to a psychotherapeutic patient/therapist relationship; (b) End-of-life decisions are conducted within the matrixes of ongoing relationships; (c) What draws nurses to nephrology practice is different from what keeps them in nephrology practice; (d) Nephrology nurses are engaged in ongoing learning at both a technical and interpersonal level; (e) Both internal and external support systems aid the mental health of nephrology nurses; (f) Nephrology nurses see their professional experiences as unique; and (g) Nephrology nurses see themselves as different from their colleagues. These findings, if supported by further research, have important implications for recruiting, training, and supporting nephrology nurses.

Ambulatory Care↗
PubMedDate not supplied

The history of nephrology in Poland.

Modern nephrology developed in Poland mostly from the internal medicine department chaired in Warsaw by the great internist prof. Witold Orłowski (1874-1966). Three of his pupils Tadeusz Orłowski, Jan Roguski and Jakub Penson independently established the foundations of clinical nephrology and renal replacement therapy in different parts of Poland. T. Orłowski and his team worked in Warsaw, where despite developing clinical nephrology and dialysis also performed the first successful renal transplantation in Poland in 1966. Thereafter in 1975 the Institute of Transplantology in Warsaw was established and for several years was the leading research and education center in nephrology and transplantology. J. Penson established a sound clinical nephrology program in Gdańsk, where later physiological and biochemical aspects of the kidney were studied by his successors -- A. Manitius and B. Rutkowski in collaboration with S. Angielski and his biochemical team. They were instrumental in establishing a successful program leading to the development of dialysis in Poland during the last twenty years. J. Roguski in Poznań continued the research on water-electrolyte balance, metabolic and endocrine disturbances in renal patients and immunology of glomerular diseases. The first HD treatment was performed in Poznań in 1958 by the group of J. Roguski and coworkers chaired by K. Baczyk. Subsequently, several strong academic centers were established throughout Poland. F. Kokot in Katowice being himself leader of the Polish nephrology for many years created a very active centre well known for its pioneer publications on water- electrolyte, acid- base and endocrine disorders in different stages of chronic kidney disease. F. Kokot and his successor A. Wiecek are also very active and well recognized on an international scale. In Wrocław a nephrological center was established by Z. Wiktor and later his coworkers Z. Szewczyk and recently M. Klinger. Other valuable academic nephrological centers were created in Kraków (Z. Hanicki, W. Sułowicz), Lublin (Z. Twardowski, A. Ksiazek), Łódź (Z. Orłowski, W. Chrzanowski), Bydgoszcz (A. Nartowicz, J. Manitius) and later Białystok (M. Myśliwiec), and others. Simultaneously strong academic units were formed in the military hospitals-Łódź (K. Trznadel, M. Luciak) and Warsaw (Z. Wańkowicz). The last center was for many years widely known for their studies concerning PD treatment. Pediatric nephrology developed in parallel with adult centers mainly in Warsaw (T. Wyszńska, M. Sieniawska, R. Grenda), Wrocław (Z. Morawska, D. Zwoliska) and Gdańsk (M. Uszycka-Karcz, A Zurowska). Several Polish nephrologists were and still are involved in the activity of European and international nephrological societies.

History, 19th Century↗
PubMed2004

The number, quality, and coverage of randomized controlled trials in nephrology.

Randomized controlled trials (RCT) are the optimal study design to answer intervention questions. The authors evaluated the number, quality, and coverage of RCT in nephrology. MEDLINE was searched using the relevant medical subject headings for nephrology and 12 major specialties in internal medicine, limited by "randomized controlled trial" as a publication type. A random selection of 160 RCT in nephrology (40 for each decade) published since 1966 and an additional 270 RCT from ongoing or published Cochrane systematic reviews in various areas of nephrology, dialysis, and transplantation were evaluated for quality of reporting using standard criteria. The number of RCT published in nephrology from 1966 to 2002 (2779) is fewer than all other specialties of internal medicine (range: 5335 in hematology to 27109 in cardiology) with the proportion of all citations which are RCT being the third lowest (1.15%). There has been an increase in both indices from 1966 to 1996, but not at a greater rate than other specialties, and there has been no increase over the past 5 yr. Some areas of nephrology, in particular glomerulonephritis, are clear outliers with very low numbers of RCT to guide clinical decision-making. Overall the quality of RCT reporting in nephrology is low and has not improved over the past 30 yr with unclear allocation concealment (89%), lack of reported blinding of outcome assessors (92%), and failure to perform "intention-to-treat analysis" (50%) particularly frequent. The challenges of improving the quality and quantity of trials in nephrology are substantial, but they can be overcome by using standard guidelines and checklists for trial reporting, greater attention to the trial methods and not just the results, involving experts in trial design and reporting, multicenter collaboration, and larger and simpler trials.

Humans↗