Chinese Journal of Blood Purification

12 May 2010, Volume 9 Issue 5 Previous Issue    Next Issue

专题

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Will the therapy for renal osteodystrophy exacerbate vascular calcification? ZHANG Ling 2010, 9 (5):  233-235.  Abstract ( 457 )   HTML ( 0 )   PDF (204KB) ( 240 )   Metrics

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Will the therapy for renal osteodystrophy exacerbate vascular calcification? ZHANG Ling 2010, 9 (5):  233-238.  Abstract ( 377 )   HTML ( 1 )   PDF (201KB) ( 191 )   Metrics

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The pathogenesis of vascular calcification in chronic renal diseases RUI Hong-liang;ZHANG Ling 2010, 9 (5):  239-241.  Abstract ( 416 )   HTML ( 0 )   PDF (197KB) ( 196 )   Metrics

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Fibroblast growth factor 23 and disturbances of bone and mineral metabolismin patients with chronic renal disease GAN Liang-ying;WANG Mei 2010, 9 (5):  245-246.  Abstract ( 460 )   HTML ( 0 )   PDF (195KB) ( 218 )   Metrics

临床研究

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Impact of coronary artery calcification score measured with electron beam computed tomography on cardiovascular disease and its mortality in hemodialysis patients LI Wen-ge;BIAN Wei-jing;ZHANG Ling;FU Fang-ting;LV Bin 2010, 9 (5):  247-250.  Abstract ( 595 )   HTML ( 0 )   PDF (227KB) ( 201 )   【Abstract】 Objective To investigate correlation of coronary artery calcification score (CACS) with morbidity and mortality of cardiovascular disease (CVD) in hemodialysis patients. Methods Twenty-two patients undergoing maintain hemodialysis (MHD) were enrolled. CACS was determined by electron beam computed tomography (EBCT) in 2002. At 2009-12-31, the relationship of CACS to morbidity and mortality of CVD was analyzed retrospectively. Results In 2002, there were twenty-one patients (95.5%) with coronary artery calcification (CACS＞0). The mean CACS was 1935.54 (0~9833). During a Follow-up period of 7 years, CVD occurred in 17 cases (81.0%) of 21 Patients, and there were 14 deaths (66.7%), of which all was from disease correlated with CVD. Patients with CACS=100 had significantly higher morbidity and mortality of CVD than patients with CACS＜100. High level of hs-CRP and low Alb in group of CACS=100 than CACS<100(P＜0.05). Kaplan-Meier curve demonstrated the average survival time in group of CACS＜100 was longer than group of CACS=100（222.7 vs 111.3M,P=0.042）. Conclusions CACS is correlated with morbidity and mortality of CVD in hemodialysis patients. Microinflammation and malnutrition are important factors. The survival time in group of CACS＜100 was longer than group of CACS≥100. Metrics

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Effect of early intervention in calcium and phosphorus metabolism on vascular calcification in patients with chronic kidney disease LUO Fu-zhang;DENG Jie-yao;HONG Guo-bao;CHEN Jian-zhi;LI Xuan;CAO Xiuhuai 2010, 9 (5):  251-254.  Abstract ( 588 )   HTML ( 0 )   PDF (280KB) ( 186 )   【Abstract】 Objective To investigate the effects of early improving disorder of calcium and phosphorus metabolism on vascular calcification（VC） in stage 3 of chronic kidney disease (CKD). Methods 106 patients at stage 3, 4 and 5 of non-dialysis patients of CKD were divided into intervention group or control group randomly. Patients of intervention group were administered phosphate binding drugs or 1,25 dihydroxy vitamin D to ensure that their serum level calcium, intact phosphate or parathyroid hormone (iPTH) keep at the suitable extent of the K/DOQI guideline. The trial would be concluded if patients progressed to end-stage renal disease（ESRD）and needed hemodialysis or other replacement treatment. Segments of radial arteries were obtained during the operation of A-V fistula and observed by Alizarin red stain and immunohistochemical staining. Results 49 patients progressed to ESRD and needed replacement therapy finally. All subjects received A-V fistula operation in which some segments of radial arteries were obtained. Cases and severity of VC in intervention group were signi?cantly reduced compared with controls（P<0.05）. Osteopontin (OPN)抯 level was significantly increased and -smooth muscle actin(-SMA)抯 level was significantly decreased in VS cases compared with controls. Conclusion The intervention of calcium and phosphorus metabolism disorder earlier can effectively ameliorate VS in stage 3 or 4 CKD patients. Changes of OPN and -SMA are earlier than definite calcification. VC was positively correlated to OPN, and was negatively correlated to -SMA. OPN and -SMA may be earlier markers of VC in CKD patients. Metrics

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The analysis about the results of bone density in elderly patients on maintenance hemodialysis LI Quan-rui;ZHANG Pei;JIA Qiang 2010, 9 (5):  255-257.  Abstract ( 540 )   HTML ( 0 )   PDF (174KB) ( 200 )   【Abstract】Objective To explored the bone mineral loss or osteoporosis in elderly population on maintenance hemodialysis (MHD). Methods 56 aged patients on MHD in the blood purification center of Nephrology department of Xuanwu Hospital Capital Medical University were recruited as test group, 52 young patients on MHD and 43 elderly patients with dialysis-independent end stage renal disease (ESRD) were selected as control groups. The patients age, sex, height, body weight, bone fracture events, and so on were recorded. Mineral density of spinal bone (L1～L4) and femoral bone were measured by dual energy X ray absorptiometry. SPSS software was used for statistical analysis. Results The frequency of femoral osteoporosis in elderly dialysis group was higher than those in non-dialysis aged group and the young dialysis group (P<0.05), while there were no significant differences in frequency of lumbar osteoporosis across groups (P＞0.05).The old women of lumbar osteoporosis in elderly men with high significant difference (P<0.05).Conclusion Elderly patients on maintenance hemodialysis are more likely to suffer from femoral osteoporosis Metrics

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The effect of dialysate containing vitamin C on secondary hyperparathyroidism XIE Hong-chang;ZHAO Xian-guo;WANG Xin-fang 2010, 9 (5):  258-260.  Abstract ( 955 )   HTML ( 0 )   PDF (201KB) ( 203 )   【Abstract】 Objective Comprehend the action of vitC-containing dialysate on secondary hyperparathyroidism of maintenance hemodialysis Patients. Methods Eighty-two stable maintenance hemodialysis patients were enrolled in the research, fell into two groups randomly. Then we used routine dialysate and vitC-containing dialysate respectively to do hemodialysis,the Period was three months. We examine the contents of iPTH、Ca、P、CaX、ALP 、VitC pre-and post-treatment before hemodialysis.Results The plasma level of iPTH、ALP rose slightly,Ca、P、CaX had no obviously change,VitC descended after hemodialysis with routine dialysate,the difference was statistically significant;but the level of plasma iPTH、ALP were significantly lower than before, the difference was statistically significant, Ca 、P、CaX had no obviously change,VitC rose slightly after hemodialysis with vitC-containing dialysate.Conclusions A lot of vitC can be lost during the hemodialysis with routine dialysate; VitC can reduce the plasma level of iPTH、ALP and prevent the secondary hyperparathyroidism. Metrics

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Therapeutic effect of two inoculation methods for hepatitis B vaccination in hemodialysis patients SU Wei;ZHANG Huan-qiao;SHANG You-quan;ZHANG Yan-zhi. 2010, 9 (5):  261-264.  Abstract ( 1116 )   HTML ( 0 )   PDF (250KB) ( 258 )   【Abstract】Objective Effective immunoprotection has great benefits for hemodialysis(HD) patients who have the high risk of infection with hepatitis B virus (HBV).However, the lower response to hepatitis B vaccination is observed in HD patients. The aim of this study was to research the effects of vaccination by two ways. Methods 50 chronic HD patients with normal aminotransferase levels, seronegative for HBsAg, anti-HBc, and anti-HBs antibodies were divided into two groups.:patients of group A (32 HD patients) received 4 doses of 20ug recombinant hepatitis B vaccine by i.m route in the deltoid region at 0, 1, 6 and 9 months,;patients of group B (18 chronic HD patients)received 6 doses of 5ug recombinant hepatitis B vaccine at 2 every two weeks by i.d route on the volar surface of the forearm. Protective seroconversion is indicated by the serum levels of hepatitis B surface antibody (anti-HBs) equal to or higher than 10 mIU/ml. Serum anti-HBs were tested 1-3 months after completion of vaccination.The differences of protective antibody seroconversion rate between the two groups were analyzed. Results 25 patients in group A have had the protective antibody (protective seroconversion rate was 78.12%) while 16 patients in group B have had the protective antibody (protective seroconversion rate was 88.89%),there are difference between the two groups.The level of antibody titers in group A is higher than group B,there is significant difference between two groups .There are no differences among two groups for the sex, age, course, creatinine level, albumin level, hemoglobin level(P>0.05). Conclusion Compared with the traditional methods of hepatitis B vaccination, Long course of intramuscular injection as well as repeated low-dose intradermal injection of recombinant hepatitis B vaccine may produce a higher percentage of protective antibodies,while the latter was more higher. The level of antibody titers in group of long period、routine doses with i.m route is higher than in group of multiple low doses with i.d route .The sample is small in this study,,it need further study . Metrics

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Effects of urokinase 24 hours dwelling-lock thrombolysis treatment on thrombosis in double lumen catheter indwelling in internal jugular vein for dialysis XUE Zhi-qiang;ZENG Shi-yang 2010, 9 (5):  265-268.  Abstract ( 620 )   HTML ( 0 )   PDF (275KB) ( 201 )   【Abstract】 Objective This single-center, open-label control clinical study was performed to test the effect of a dose (20000 IU/mL) urokinase 24 hours dwelling-lock thrombolysis technique to clear double lumen central venous catheters for dialysis and reestablish patency when occluded by thrombus. Safeties and efficacies of the new technique were compared with those of regimen recommended by K/DOQI guideline. Methods Adult dialysis patients with nontunneled double lumen central venous catheters occlusion were treated with 20000 IU/mL intracatheter urokinase 24 hours dwelling-lock thrombolysis technique(treatment group) or 5000 IU/mL urokinase instillations thrombolysis regimen recommended by K/DOQI guideline(control group). Lumen patency, side effects and cathether thrombus reoccurrence were assessed and compared between the two groups after the treatment. Results A total of 88 cases of non-tunneled double lumen central venous catheters occlusion were enrolled in the study during Aug 2003 and Dec 2008. 45 were in treatment group and 43 in control group. Overall, 20000 IU/mL urokinase 24 hours dwelling-lock thrombolysis technique successfully restored total catheter patency (all treated lumens) to 88.2% of catheter ocllusions (45 of 51). Patency was restored in 90.2% of devices (46 of 51) in 5000 IU/mL urokinase instillations group. Patency was restored equally in both group and no side effects were recorded in both treatments. Catheter occlusions reoccurrences were also equal in both groups. Conclusion The use of a new 20000 IU/mL intracatheter urokinase 24 hours dwelling-lock thrombolysis technique is simple, safe and effective for the restoration of patency to occluded dialysis nontunneled double lumen central venous catheters. Metrics

论文

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Analysis of hemoglobin level in hemodialysis patients in 2007 Beijing HUANG Wen;CHEN Shen;ZHANG Guojuan 2010, 9 (5):  285-287.  Abstract ( 409 )   HTML ( 0 )   PDF (189KB) ( 210 )   【Abstract】Objective To analyze the hemoglobin level of hemodialysis patients from Beijing Hemodialysis Qulity Control Improvement Center in 2007, and to investigate it抯 relationship with patients gender, age, and primary disease. Methods Based on the cross-sectional data provided by Beijing Hemodialysis Qulity Control Improvement Center（BJHDQCIC） in 2007, the hemoglobin level of prevalent and incident hemodialysis patients in Being were analysed. The relationship of hemoglobin level with patients gender, age and primary disease was further investigated. Results The overall up-to-standard rate of the hamoglobin in Beijing hemodialysis patients was no more than 50% in both prevalent and incident patients. Gender was one of factors that affected the up-to-standard rate of the hemoglobin in the prevalent patients, but not in the incident patients. Age didn抰 affect hemoglobin in either prevalent or incident patients. As to the up-to-standard rate of patients with different primary diseases, the patients with urinary system tumor had significantly higher up-to-standard rate and patients with hemolytic uremic syndrome had significantly lower up-to-standard rate than the overall up-to-standard rate respectively, but they both had relatively fewer cases. Conclusion The up-to-standard rate of the hemoglobin in Beijing hemodialysis patients were lower than other countries in both incident and prevalent hemodialysis patients. Gender was one of factors that affected the up-to-standard rate of the hemoglobin. Metrics