ELECTRONIC
APPLICATION OF BARTOCAR IN CHRONIC RENAL FAILURE PATIENTS: A LITERATURE REVIEW
Amalia Arifatul Diktina1,
Fitri Arofiati2
Universitas
Muhammadiyah Yogyakarta1,2
[email protected]1, [email protected]2
Received:
17-06-2022�������������������� ��������������� Accepted: 27-06-2022���������������������� ��������������� Published: 22-07-2022������
ABSTRACT
Chronic
Renal Failure (CRF) is a slow, progressive and irreversible decline in renal
function can lead to the inability of the kidneys to dispose of residual waste
products and unable to maintain fluid and electrolyte balance. Hemodialysis
treatment measures performed on CRF patients in order to survive. Fluid
monitoring in CRF patients using telemonitoring (remote monitoring equipment),
the application contains fluid control and diet to facilitate patients at home.
To find out the nutritional monitoring of Chronic Renal Failure patients using
the electronic application of bartocar (nutritional fluid monitoring sheet). In
this literature review were use 3 data bases namely proquest, pubmed and google
scholar, he last 5 years from 2016-2020. Inclusion criteria: Quantitative,
qualitative and mix method research design, have communication tools such as
mobile phones/computers, Based via online (smartphones and websites), Chronic
renal failure undergoing hemodialysis, Free, the last 5 years 2016-2020.
Exclusion criteria: Paid journals, Patients undergoing hemodialysis. From the
results of the journal search obtained 35,944 English journals discussed only
10 journals discussed different topics.�
Electronic bartocar (fluid monitoring sheet) in patients very helpful to
facilitate diet, restriction of incoming and outgoing fluids and nutrients.
This mHealth app is designed to help with early diagnosis of CRF and
self-monitoring. This app can be accessed via online, android 4.0/ios mobile
web application and website app. Bartocar serves to help monitoring fluids and
nutrients in chronic renal failure patients at home.
Keyword: Bartocar
Chronic Renal Failure, Electronic Application, Nutrients Fluids.
Corresponding Author: Amalia Arifatul Diktina
E-mail: [email protected]
INTRODUCTION
Chronic Kidney Failure (CKD) is a slow, progressive
and irreversible decline in kidney function that can lead to the inability of
the kidneys to get rid of waste products and unable to maintain fluid and
electrolyte balance (Bettoni et al., 2017). The results of basic health research in 2013 and
2018 show that the prevalence of chronic kidney failure in Indonesia 15 years
based on a doctor's diagnosis in 2013 was 0.2% and there was an increase in
2018 of 0.38%. For the province of Central Java, chronic kidney failure appears
to be lower than the national prevalence. In 2015 deaths caused by chronic
kidney failure reached 1,243 people (Organization, 2017).
According to the (World Health Organization 2017),
reports that those suffering from chronic kidney failure have increased by 50%
from the previous year, globally the incidence of chronic kidney failure is
more than 500 million people and who have to live life depending on dialysis (hemodialysis)
as many as 1.5 million people. The causes of chronic kidney failure according
to the United States Renal Data System (USRDS) in 2014, the first order is
diabetes mellitus by 34%, hypertension by 21%, glomerulonephritis by 17%,
pyelonephritis by 3.4%, polycystic kidney by 3.4% and others by 21%.
Hemodialysis is a kidney replacement therapy using a semi-permeable membrane
that functions as a nephron so that it can remove metabolic waste from the body
and correct fluid and electrolyte balance disorders in patients with chronic
kidney failure (Mailani, 2015).
The development of the times, now chronic kidney
failure patients can control fluids and nutrition by using online (websites,
mobile phone applications) When the patient undergoes treatment at home
electronic bartocar makes it easier to limit fluids and nutrients in the body.
Facilitates the control of liquids and food through online (Olivares-Gandy et al.,
2019). Make it easier to control nutrients from and control fluids in the
hospital by using electronic services bartocar in patients with chronic kidney
failure. In addition, it easier for patients to consult with nutritionists
about fluids and food diets and facilitates treatment in undergoing remote
monitoring in the consultation. On the site there are nutritionists and
laboratories by including patient profiles, medical records, and the hospital
being treated during hemodialysis. With the remote monitoring tool by using
online makes it easier for patients by consulting with doctors and nurses even
though the patient is at home (Liu et al., 2017). With telemonitoring (remote monitoring equipment)
patients rarely come to the hospital for treatment and only hospitalized to
perform hemodialysis, the application there is fluid control and diet to
facilitate patients at home.
The purpose of this research is to fluid monitoring in
CRF patients using telemonitoring (remote monitoring equipment), the
application contains fluid control and diet to facilitate patients at home. To
find out the nutritional monitoring of Chronic Renal Failure patients using the
electronic application of bartocar (nutritional fluid monitoring sheet).
METHOD
The database in
writing this literature review uses 3 databases namely proquest, pubmed and
google sholar". Keywords in writing this literature review with online
card hemodialysis keywords, acute kidney failure and fluid and nutrition
monitoring, the last 5 years from 2016-2020. The search results of the journal
were obtained by 35,944 English-language journals. However, as per the title or
discussed in the literature review, only 10 other journals covered different
topics. Using English keywords and synonyms. In the literature review there are
2 criteria, namely inclusion and exclusion criteria. Inclusion criteria: design
used in quantitative, qualitative and mixed methods research, has a
mobile/computer communication device, access through the website, patients with
chronic kidney failure, hemodialysis, journals that are accessed for free,
journals accessed in the last 5 years 2016 -2020. Exclusion criteria: journals
with paid access, patients who did not undergo hemodialysis, patients who did
not have mobile phones/computers, journals accessed for more than 5 years. For
literature review researchers, they use a quality assessment tool from the
Joanna Briggs Institute with the following link https://joannabriggs.org/critical-appraisal-tools.
�
RESULTS AND DISCUSSION
The
study investigated 35,900 journals. There are thee journals in the literature
review, of the 35,900 journals need full text journal screening. And after
screening the journal in full text produces 10 journals that will be written in
the review literature. By using a bartocar (remote fluid monitoring sheet) in
patients with chronic kidney failure, it is easier for doctors, care and
nutritionists to monitor nutrition, diet and fluid limits both in and out of
the body. A complete description of the results of the literature review is
explained as follows.
A total of 9 articles were reviewed,
discussing monitoring fluid limits in chronic kidney failure patients that can
be accessed via smartphone. After reviewing the article, the authors identified
that monitoring fluid restriction in chronic kidney failure patients can be
accessed via smartphone. Based on the 9 articles analyzed, it produced 6 main
themes. The resulting theme represents Mobile for Management of Chronic Kidney
Care and End-Stage Kidney Disease: Systematic Search in the App Store and
Evaluation in table 1. Themes are found to have a relationship between one
theme and another.
Table
1. Characteristics of the included literature
Name & Year |
Tittle |
Metode |
Result |
|
(Siddique
et al., 2019) |
Mobile App for Chronic
Kidney Care Management and End-Stage Kidney Disease: Systematic Search on the
App Store and Evaluation |
Desaign research using Random sampling Characteristics of CKD patient respondents The study was conducted in the United
States. |
The MARS total score had excellent internal
consistency (Cronbach alpha=.90) and a moderate level of interrater
reliability (2-way mixed ICC 0.65). Overall, 11 out of the 12 reviewed apps
met the minimum acceptable score of 3.0 in MARS rating. The 3 apps with the
highest combined scores were My Kidneys, My Health Handbook (MARS=4.68); My
Food Coach (MARS=4.48); and National Kidney Foundation Malaysia (MARS=4.20).
The study identified 2 general weaknesses in the existing apps: the apps fell
short of accommodating advanced interactive features such as providing
motivational feedback and promoting family member and caregiver
participations in the app utilization. |
|
(Sobrinho
et al., 2018) |
Design and evaluation of
mobile apps to help self-monitor chronic kidney disease in developing
countries |
Elicited requirements were translated into a native
mHealth app targeting the Android platform. Afterward, the Cohen�s Kappa
coefficient statistics was applied to evaluate the agreement between the app
and three nephrologists who analyzed test results collected from 60 medical
records. Finally, eight users tested the app and were interviewed about
usability and user perceptions. |
A mHealth app was designed to assist the CKD early
diagnosis and self-monitoring considering quality attributes such as safety,
effectiveness, and usability. A global Kappa value of 0.7119 showed a
substantial degree of agreement between the app and three nephrologists. Results
of face-to-face interviews with target users indicated a good user
satisfaction. However, the task of CKD self-monitoring proved difficult
because most of the users did not fully understand the meaning of specific
biomarkers |
|
(Welch et
al., 2013) |
Using a Mobile App to Self-Monitor Diet and Fluid Intake among Adults Who Receives Hemodialysis |
This study uses Case control. Characteristics of
respondents� HD patient >3 months,
age >18 years, Willing to follow your own diet and fluid
restriction The study was conducted at a hospital in the United
States. Needing It took a very long time to see results with 6 weeks of
intervention. |
Results from
this pilot study suggest the intervention is feasible and acceptable,
although few significant effects on outcomes were found in this small sample.
The DIMA has potential to facilitate dietary and fluid self-monitoring but
requires additional refinement and further testing |
|
(Chen et
al., 2016) |
Effect
of Journal Dietary Intake Application on Chronic Health Outcomes Stage of Kidney Disease
3B-5 |
Characteristics of respondents Aged >50 years,
Patients are able to use computers, smartphones and the e significant results
that is 12 weeks. |
Thirteen of 20
participants completed the dietary protein restriction intervention, and
their health outcomes were measured according to changes in blood urea
nitrogen, serum creatinine, albumin, and glycated hemoglobin compared with
those who dropped out. The empirical results support the first hypothesis and
show that using the food journaling app can significantly increase the
dietary compliance, but the results regarding the second hypothesis were not
significant. |
|
(Kosa et
al., 2019) |
Nutrition
Mobile App for CKD Patients: A Review Methodical |
The characteristics, user satisfaction with,
usability/feasibility, and effectiveness in changing dietary behavior of the
mobile application were summarized using descriptive statistics and in a
narrative manner |
Thirteen
full-text studies were included, of which 11 were single center, with a mean
sample size of 23. Of the 7 studies that measured usability/feasibility, all
found at least some aspects of the application feasible/useful. Of the 5
studies that reported an evaluation of changes in behavior/diet related to
self-management, all reported some positive change. |
|
(Olivares-Gandy
et al., 2019) |
A telemonitoring
system for nutritional intake in patients with chronic kidney disease
receiving peritoneal dialysis therapy |
In this study, we present the analysis, design, and
development of a telemonitoring system for the nutritional intake of patients
with CKD receiving PD therapy. The proposed system consists of a mobile web
application addressed to the nutrition specialist and a native Android
application aimed at patients undergoing PD. |
Furthermore, the system allows the patient to record
the intake data daily, receive updates on diets generated by the nutritionist
and communicate with the nutritionist through a consultation module. Finally,
we performed a usability assessment of our system based on a laboratory study
with two users: a nutritionist and a patient undergoing peritoneal dialysis
treatment. Based on the obtained results, our telemonitoring system shows a
favorable opinion in terms of usability from the perspectives of the patient
and nutritionist. |
|
(Okoyo
Opiyo et al., 2020) |
Perception of
Adherence to Dietary Prescriptions for Adults with Chronic Kidney Disease on
Hemodialysis: A Qualitative Study |
This study used Purposive sampling. Characteristics of respondents of patients aged
>18 years, CKD patients undergoing HD The research was conducted in the hemodialysis room. |
Most of them
make un-informed dietary decisions that lead to consumption of unhealthy
foods with negative outcomes such as metabolic waste accumulation in the
patients' bodies negating the effects of dialysis and undermining the efforts
of healthcare system in management of patients with chronic kidney disease. |
|
(Mart�nez
Garc�a et al., 2018) |
Telemonitoring system for
patients with kidney disease chronic undergoing
peritoneal dialysis: Assessment of usability based on case studies |
This study used Purposive sampling. Characteristics of respondents of patients aged
>50 years and above, CKD patients undergoing HD The study was conducted in Mexico in a hospital. |
Based on the obtained
results, the evaluated telemonitoring system holds wide acceptance,
satisfaction, and applicability from patients' and doctors' perspectives. It
is also noted that the evaluated system considers and satisfies the
requirements and suitable parameters that should be monitored in PD treatment
according to studies presented in the literature. |
|
(Liu et
al., 2017) |
Remote Monitoring
System for Chronic Patients in Hemodialysis Home: Field Trials of Copresence
Enhanced Design |
This study used Purposive sampling. Characteristics of respondents of patients aged
>18 years, CKD patients, hemodialysis patients This study was conducted in the hemodialysis room. |
Health care professionals were able to prioritize
the review of the entries based on the emotional status and also felt assured
to see patients' change in mood. There were 989 entries sent with short
notes. Entries with negative emotions had a higher percentage of
supplementary notes entered compared to the entries with positive and neutral
emotions. The qualitative data further showed that the HHD system was able to
improve patients' feelings of being connected with their health care
professionals and thus enhance their self-care on HHD. The health care
professionals felt better assured with patients' status with the use of the
system and reported improved productivity and satisfaction with the
copresence enhancement mechanism. The survey on the system usability
indicated a high level of satisfaction among patients and nurses. |
|
Discussion
1.
Hemodialysis
Hemodialysis
is a kidney replacement therapy using a semi-permeable membrane that functions
as a nephron so that it can remove metabolic waste from the body and correct
fluid and electrolyte balance disorders in patients with chronic kidney failure
(Mailani, 2015). According to (Bawazier et al., 2018), hemodialysis is a
process of separation/filtering to clean the blood through semipermeability
carried out by patients with chronic kidney failure whose kidney function is no
longer good/decreased. Patients with chronic renal failure with a total
Gromerulus Filtration Rate (GFR) <15 mL/min, using a Creatinine Clearance
Test (TKK) <5 mL/min even though there are no symptoms. At TKK/GFR 5
mL/minute, the renal excretory function is minimal, resulting in the
accumulation of toxic substances in the blood and has experienced dangerous
complications if dialysis is not performed immediately (Jangkup et al., 2015).
The function of hemodialysis in patients
with chronic kidney failure is to maintain survival while changing the
patient's lifestyle. Chronic kidney failure patients who have undergone
hemodialysis are prone to stress related to fluid restriction, dietary compliance,
physical limitations, complications, drug side effects and hemodialysis
dependence will reduce the patient's quality of life (Mailani, 2015).
2.
Bartocar
(remote fluid monitoring sheet)
The
increasingly advanced development of era 4.0 makes it easier for patients and
staff, both doctors, nurses and nutritionists, to create new health plans using
online access, such as the bartocar (fluid monitor) specially designed for CKD
patients to facilitate diet, nutrition and fluid programs that enter and go
out. Some researchers bartocar (fluid monitoring sheet) that, bartocar (fluid
monitoring sheet) is an application designed to help CKD / ESRD patients who
are under strict diet and medication control and tend to have limited resources
and capacities ( Siddique , et al. 2019)
According
to research (Sobrinho et al., 2018), that the mHealth
app is designed to help early diagnosis of CKD and self-monitoring. According to
(Siddique et al., 2019), this application is
useful for CKD patients to control diet and fluid restrictions from within the
body.
According
to (Okoyo Opiyo et al., 2020), this application
has many benefits ranging from, ease of implementing a prescribed diet, dietary
adherence, a specified dialysis schedule, nutritional information, transition
to a new diet, health complications and disease severity. According to (Welch et al., 2013), the Dietary Intake
Monitoring (DIMA) application has the potential to facilitate self-monitoring
of food and fluids but requires additional refinement and further testing.
According
to (Olivares-Gandy, et al. 2019), the mHealth application is designed to help
early diagnosis of CKD and self-monitoring. This application can be accessed
via online, android 4.0/ios mobile web application (Mart�nez Garc�a et al., 2018). The benefits of
bartocar (fluid monitoring sheet) are that it makes it easier for patients to
implement diet and dietary adherence, provide nutritional information, know the
severity of the disease, reduce complications and hemodialysis as scheduled (Okoyo Opiyo et al., 2020). According to (Olivares-Gandy et al., 2019), telemonitoring
systems (remote monitoring) show a favorable opinion in terms of usefulness
from the perspective of patients and nutritionists.
To
get optimal results mHealth applications by using a telemonitoring system
(remote monitoring) takes a very long time. According to research that using
the mHealth application to produce significant/expected results takes
approximately 6 weeks (Welch, et al. 2016), 12 weeks (Chen, Wu and Chou 2016)
and even 5 months per patient (Mart�nez Garc�a et al., 2018). At the time of
monitoring the patient's diet and fluid limits, it can be done at home, in the
hospital and in the hemodialysis room by using a smartphone/ computer and
accessing the mHealth application (Mart�nez Garc�a et al., 2018).
The results using the significant
mHealth found in the Dietary Intake Monitoring App (DIMA) have the potential to
facilitate self-monitoring of food and fluids but require additional refinement
and further to (Welch et al., 2013). According to
research (Mart�nez Garc�a et al., 2018), empirical results
support the first hypothesis and show that the use of a food journal
application can significantly improve dietary adherence, but the results
regarding the second hypothesis are not significant. According to a study (Kosa et al., 2019), that the mHealth
app was able to evaluate behavioral/dietary changes related to self-management,
all of them reported positive changes in CKD patients.
CONCLUSION
Chronic renal failure is a slow, progressive
and irreversible decline in kidney function that can lead to the inability to
get rid of waste products and unable to maintain fluid and electrolyte balance.
Treatment in patients with kidney failure is to perform hemodialysis and kidney
transplantation, in order to prolong life. In patients with chronic kidney
failure will experience excessive excess production in the body. Increasingly
advanced in the era of sophisticated nurses, doctors and nutritionists make
innovations in the form of fluid control of chronic kidney failure patients
using online (remote) to make it easier for patients and health workers to
control nutrition and diet. By using innovation via online here, the tool used
is a bartocar (body fluid monitor). Bartocar here serves to help monitor fluids
and nutrition in patients who fail at home, the bartocar can be accessed using
the mHealth application which can be operated on Android 4.0 and iOS mobile
phones and can be via the website. To obtain optimal results in monitoring
fluid and diet of patients with chronic kidney failure using a bartocar (fluid
monitoring sheet) it takes a very long time, namely 6 weeks, 12 weeks and even
5 months/patient.
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