Chinese Journal of Blood Purification

12 November 2009, Volume 8 Issue 11 Previous Issue    Next Issue

专题

Select

Prevention and management of hepatitis C virus infection for hemodialysis patients must be emphasized WANG Niansong;YAO Xingmei;SHENG Xiaohua 2009, 8 (11):  581-583.  Abstract ( 465 )   HTML ( 0 )   PDF (212KB) ( 172 )   Metrics

Select

Present situation of hepatitis B vaccine inoculation in uremic patients treated with hemodialysis ZHOU Yi;YUAN Wei-jie 2009, 8 (11):  584-587.  Abstract ( 474 )   HTML ( 0 )   PDF (266KB) ( 199 )   Metrics

Select

Hepatitis B virus infection and maintenance hemodialysis patients DUAN Shao-bin;LIU Fu-you;CHEN Jun 2009, 8 (11):  587-589.  Abstract ( 435 )   HTML ( 0 )   PDF (214KB) ( 186 )   Metrics

Select

Transmission pathway of hepatitis C infection in maintenance hemodialysis patients HENG Xiao-hua;WANG Nian-song 2009, 8 (11):  590-592.  Abstract ( 482 )   HTML ( 0 )   PDF (218KB) ( 176 )   Metrics

论著

Select

Hepatitis C virus infection in uremic patients on maintenance hemodialysis: a follow-up study for 126 months WANG Nian-song;SHENG Xiao-hua;ZHAGN Xiao-guang;YAN Yan;YU Gang;CUI Yong-ping;TANG Ling-quan. 2009, 8 (11):  593-596.  Abstract ( 569 )   HTML ( 0 )   PDF (248KB) ( 206 )   【Abstract】 Objection To delineate the incidence and risk factors for sero-conversion to positive anti-HCV antibody in maintenance hemodialysis (HD) patients. Methods From June 1998 to December 2008, 2080 HD patients in our hemodialysis unit were followed up, and anti-HCV antibody assay by ELISA was performed every 6 months in the same laboratory. Results From results of the 22 assays at an interval of 6 months for every patient, the sequential prevalence rate of anti-HCV antibody was 54.7%, 53.8%, 52.6%, 53.0 %, 51.2%, 45.9%, 45.5%, 48.2%, 35.6%, 33.7%, 33.7%, 31.7%, 30.4%, 28.4%, 27.2%, 24.5%, 20.8%, 19.4%, 16.6%, 14.4%, 15.3% and 15.2%. During the follow-up period for 126 months, anti-HCV antibody became positive in 225 patients, of whom 58 had not been treated with transfusion. Sero-conversion to positive anti-HCV antibody was found in 49 (4.5%) of the 1086 patients followed up for 1-12 months, in 29 (6.9%) of the 421 patients followed up for 13-24 months, in 35 (11.9%) of the 196 patients followed up for 25-48 months, in 32 (28.1%) of the 114 patients followed up for 49-60 months, in 27 (35.1%) of the 77 patients followed up for 61-72 months, in 22 (38.6%) of the 57 patients followed up for 73-84 months, in 15 (46.9%) of the 32 patients followed up for 85-96 months, in 9 (56.3%) of the 16 patients followed up for 97-108 months, and in 6 (54.5%) of the 11 patients followed up for 109-126 months. Conclusion Hemodialysis may be responsible for the HCV transmission either due to the common use of a dialysis machine or to the unawareness of isolation procedures for HCV-infected patients. Therefore, sterilization manipulations and strict isolation for HCV-infected patients are of great importance for the prevention of HCV transmission among hemodialysis patients. Metrics

Select

The influence of hepatitis C virus infection on atherosclerosis and left ventricular hypertrophy in maintenance hemodialysis patients LI Hai-ming;CHEN Jing;YIN Ying;KUANG Ding-wei;LONG Quan;GU Yong 2009, 8 (11):  597-600.  Abstract ( 591 )   HTML ( 0 )   PDF (242KB) ( 184 )   【Abstract】 Objective To observe the correlation of hepatitis C virus (HCV) infection with inflammation-related factors, atherosclerosis and left ventricular hypertrophy in maintenance hemodialysis (MHD) patients. Methods In a cohort of 40 MHD patients, anti-HCV antibody was found in 20 patients, and negative anti-HCV antibody was found in the remaining 20 patients. Serum albumin, hemoglobin, blood lipids and C-reactive protein were examined by routine methods. The intima thickness (IMT) of carotid artery was measured by high resolution B-mode ultrasonography. Left ventricular diameter (LVD), left atrial diameter (LAD), left ventricular mass index (LVMI), left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST), and left ventricular ejection fraction (LVEF) were measured by ultrasonic cardiography. Results IMT (1.25±0.36mm vs. 0.96±0.27mm，P＜0.05) and CRP (5.56±2.34mg/L vs. 2.25±1.34mg/L, P＜0.001) were significantly higher in anti-HCV antibody positive patients than in negative patients, while cholesterol, albumin, pre-albumin, hemoglobin and body weight index were lower in anti-HCV antibody positive patients than in negative patients. No differences were found in LVD, LAD, LVPWT, IVST, LVEF and LVMI between anti-HCV antibody positive and negative patients. Conclusion In MHD patients, HCV infection is correlated with atherosclerosis. Since MHD patients are usually complicated with several uremia-related risk factors for cardiovascular diseases, the effect of HCV infection on left ventricular hypertrophy may be underestimated in this study. Metrics

Select

Serum hepatitis B virus surface antigen in maintenance hemodialysis patients: its risk factors and its effect on liver function CHEN Sheng;YU Qing;ZHANG Zheng;SHANG Ming-hua;BAO Jin-fang;YUAN Wei-jie 2009, 8 (11):  601-604.  Abstract ( 568 )   HTML ( 0 )   PDF (314KB) ( 197 )   【Abstract】 Objective To study the prevalence of hepatitis B virus (HBV) infection, liver function changes by the infection, and the risk factors of the infection in maintenance hemodialysis (MHD) patients. Methods We retrospectively analyzed 301 MHD patients treated for more than 6 months in Shanghai First People’s Hospital Affiliated to Jiaotong University from December 2008 to March 2009. Their hemodialysis period lasted 6-372 months (64.13±61.00 months). The indicators for HBV infection were examined every half a year for all patients. We divided the patients into HBsAg positive and HBsAg negative groups. Before the beginning of hemodialysis, we assayed HBV by the second generation enzyme linked immunosorbent assay (ELISA), liver functions by an automatic biochemical analyzer, and blood routine tests by a blood cell analyzer. Results In the 301 cases, serum HBsAg was found in 20 cases (6.64%); but the infection rate increases to 42.52% if patients with one or more than one HBV infection markers (HBVM) were included. Five HBsAg positive patients (25.00%) and 6 HBsAg negative patients (2.14%) had the history of blood transfusion. Logistic analysis showed that blood transfusion was significantly correlated with patients with serum HBsAg (r=16.597, P=0.000). In HBsAg positive patients, one had liver cirrhosis, and one turned to be negative later. Positive HBsAg did not affect liver function and the quality of dialysis in MHD patients. Conclusions In this cohort of MHD patients, the rate of positive serum HBsAg was 6.64%. Blood transfusion increased the rate of HBV infection. HBV infection had less effect on liver function and complications in these patients. Regular detection of HBV infection and strict isolation measures are essential for the prevention of HBV infection in MHD patients. Metrics

Select

Immune response and the factors influencing the response after vaccination with recombinant hepatitis surface antigen in adult hemodialysis patients CAO Li-ou;QIAN Jia-qi;YAN Yu-cheng;NI Zhao-hui;LIN Xing-hui;PANG Hui-hua. 2009, 8 (11):  605-607.  Abstract ( 954 )   HTML ( 0 )   PDF (199KB) ( 201 )   【Abstract】 Objective To evaluate the safety and efficacy of the recombinant HBV vaccine made in China in adult hemodialysis patients, and the factors influencing the response to the vaccination. Method We assigned 29 patients (aged 53.1±13.3 years) who had received hemodialysis for more than one month, without previous HBV vaccination, but with negative serum HBV and HCV antibodies and normal liver function, to be vaccinated intradermally with 10μg HBV vaccine 3 times at 0, 1st and 6th months. Anti-HBV antibodies were measured after the last vaccination for 3 months. The medical staffs working in the hemodialysis center with negative serum HBV and HBC antibodies were also vaccinated using the same vaccination schedule as the controls. Result The vaccine was well tolerated. Lower fever (＜38℃) was found in one patient and one control, but without other untoward reactions. All patients completed the 3 vaccinations and serum anti-HBV antibody assays. Positive response to the vaccine was found in 51.7% patients and 70% controls. After 5 years, 11 patients with response to the vaccine were still alive, of whom 9 remained serum positive HBV antibodies, and 2 turned to be negative (one became negative after 2 years, and one after 3 years). Conclusion Lower response to the vaccination exhibited in hemodialysis patients due to their impaired immunological function. In this study, no significant differences in age, sex, primary diseases, body weight, hematocrit, serum calcium and phosphorus, iPTH and dialysis efficacy, but significant differences in serum albumin and pre-albumin (P＜0.05) were found between patients responding to the vaccination and those without response to the vaccination, suggesting that nutrition status of hemodialysis patients may affect the response to the vaccination. Metrics

Select

The effect of different schedule for intravenous iron administration on anemia and oxidative stress response in maintenance hemodialysis patients LOU Yi-meng;WANG Zong-qian;LIAN Yan;HU Shu-juan 2009, 8 (11):  608-611.  Abstract ( 863 )   HTML ( 0 )   PDF (263KB) ( 238 )   【Abstract】 Objective To observe the effect of different schedules for intravenous iron administration on uremic anemia, microinflammation and oxidative stress response in maintenance hemodialysis (MHD) patients, in order to find out a convenient, safe and efficient iron administration for these patients. Methods We prospectively studied 70 MHD patients treated in the Fourth China Medical University Hospital during the period of 2006 to 2007. They were randomly assigned into 5 groups to observe their hematological changes of hemoglobin (Hb), hematocrit (Hct), serum iron (SI) and serum ferritin (SF), as well as the microinflammation and oxidative stress parameters of serum C reactive protein (CRP), malondialdehyde (MDA) and superoxide dismutase (SOD) before and after the treatment. The side effects of iron therapy were also recorded. Results After the iron treatment for 8 weeks, Hb, Hct and SF increased significantly in the intravenous iron administration groups (P＜0.01), but had no differences among the intravenous iron administration groups of 100mg for one dose, 200mg for 5 times, and 500mg for 2 times (P＞0.05). MHD patients had lower serum SOD activity and higher serum CRP and MDA concentrations, as compared with those of healthy controls (P＜0.01). Serum SOD activity decreased and serum CRP and MDA concentrations increased in the intravenous iron administration groups after the treatment for 8 weeks (P＜0.05). However, these parameters showed no differences in the 3 intravenous administration groups of various doses. Conclusion The 3 methods of intravenous sucrose iron administration are equally effective to improve anemia, iron deficiency, microinflammation and oxidative status without considerable side effects in MHD patients. The method of intravenous 500mg sucrose iron for 2 times is relatively convenient. Metrics

Select

Clinical analysis of cephalosporins induced encephalopathy in renal failure patients PAN Ming-ming;LIU Jian-hua;ZHANG Hong;ZHANG Lei;ZHANG Li-yuan;CAO Wei. 2009, 8 (11):  612-614.  Abstract ( 880 )   HTML ( 0 )   PDF (225KB) ( 211 )   【Abstract】 Objective To discuss the appropriate administration of cephalosporins in renal failure patients. Methods We retrospectively analyzed 30 renal failure patients developing encephalopathic syndrome and electroencephalogram changes during the cephalosporins treatment (daily dose of 2-3g). Results In the 30 patients, 29 completely recovered from encephalopathy syndrome after discontinuing of the drug for 2-5 days, and one patient died. Twenty-two patients were treated with hemodialysis, 2 with peritoneal dialysis, and 5 patients used antiepileptic drugs. Electroencephalogram showed background of generalized slow waves with continuous bursts of moderate to high amplitude, or sharp and slow wave activity in 23 of the 27 patients. Conclusions Regular dose of cephalosporins treatment may have neurotoxicity in renal failure patients, probably resulting from blood-brain barrier change, low drug clearance and higher blood drug concentration. Therefore, we should adjust the dosage of cephalosporins based on creatinine clearance rate, and discontinue the drugs once unexplained encephalopathy appears. Metrics

Select

The influence of anti-HBc antibody on patients after renal transplantation MU Xing-yu;QIN Yan;FAN Yu;ZHANG Fang;WANG Zhong 2009, 8 (11):  615-617.  Abstract ( 559 )   HTML ( 0 )   PDF (173KB) ( 193 )   【Abstract】 Objective To study the influence of anti-hepatitis B core antigen antibody (HBcAb) on renal transplantation patients. Methods Patients were divided into 3 groups based on the markers for hepatitis B virus infection: Group A (HBsAg+ and HBcAb+), Group B (HBsAg- and HBcAb+), and Group C (HBsAg- and HBcAb-). Liver damage and kidney function were analyzed among the 3 groups after renal transplantation. Results The incidence of liver damage was 52.0% in group A, 36.8% in group B, and 8.69% in group C. Significant differences were found among the 3 groups. Conclusions Liver damage is frequently seen in patients with positive HBcAb after transplantation. Metrics

血液净化中心管理与技术

Select

Multi-center investigations on life quality in hemodialysis patients in Urumchi area ZHANG Yu;SONG Hong-ping;YANG Wen-jun;WU Li-jun;LIU Jian 2009, 8 (11):  631-634.  Abstract ( 510 )   HTML ( 0 )   PDF (257KB) ( 178 )   【Abstract】 Objective This study was designed to evaluate the life quality (LQ) and the factors affecting LQ in hemodialysis (HD) patients in Urumqi, and to provide useful information for clinical and other related services for counseling. Methods We recruited 169 HD patients from dialysis units in the 3 hospitals in Urumqi. Marital status, employment and recreational activities were questioned, and Quality of life scale in Short Form-36 (SF-36) was used to measure the health-related LQ. Results (a) The overall SF-36 scores were (50.10±20.87) in HD patients. (b) The body pain score was higher in males than in females. The overall score of LQ and other parameters by SF-36 were indifferent between Han and minority nationalities patients, but were lower in HD patients with diabetic nephropathy than those without diabetic nephropathy, as well as in jobless HD patients than those with employment. (c) Age of the patients was negatively correlated with the overall score by SF-36, physical functioning, physiological activity and vitality, but was positively correlated with emotional functioning and mental health. Education and employment were positively correlated with social status and mental health of the patients. (d) Factors affecting the LQ score by SF-36 included age, education employment, and diabetes. Conclusion The LQ scores in HD patients in Urumqi were comparable to those in patients in Guangzhou and Wuhan cities, but were inferior to those in HD patients in western countries and Japan. Many factors influence the LQ scores in HD patients. Subsequently, multidisciplinary efforts including medical management, services from government and social security department are indispensable to promote LQ in HD patients. Metrics