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Chinese Journal of Blood Purification

    25 October 2009, Volume 8 Issue 10 Previous Issue    Next Issue
    专题
    Novel knowledge about asthenic osteopathy in dialysis patients
    NI Zhao-hui;ZHOU Wen-yan
    2009, 8 (10):  523-525. 
    Abstract ( 444 )   HTML ( 0 )   PDF (207KB) ( 233 )  
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    Research progress in fibroblastic growth factor 23 and calcium/phosphate metabolic disturbances in hemodialysis patients
    WANG Li;DING Han-lu
    2009, 8 (10):  526-528. 
    Abstract ( 486 )   HTML ( 0 )   PDF (198KB) ( 188 )  
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    Calcium/phosphate metabolic disturbances and vascular calcification diseasesin dialysis patients
    CHEN Men-hua
    2009, 8 (10):  529-532. 
    Abstract ( 445 )   HTML ( 0 )   PDF (275KB) ( 208 )  
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    Control of hyperphosphatemia in maintenance hemodialysis patients
    ZHANG Jin-hong;HUAN Hong-ti
    2009, 8 (10):  533-535. 
    Abstract ( 425 )   HTML ( 0 )   PDF (197KB) ( 251 )  
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    论著
    Correlation analysis between peripheral arterial disorders in lower extremities and calcium/phosphorus metabolic disturbances among patients with maintenance hemodialysis
    FU Wen-cheng;PEN Wen;WANG Hao;LIU Yu-jun;WANG Yun-man
    2009, 8 (10):  536-540. 
    Abstract ( 630 )   HTML ( 0 )   PDF (318KB) ( 176 )  
    【Abstract】Objective To investigate the prevalence of peripheral arterial disease (PAD) in lower extremities and the condition of calcium/phosphorus metabolism among patients undergoing maintenance hemodialysis (MHD), and to further elucidate the impact of calcium/phosphorus metabolism disturbances on PAD in these patients Methods For the diagnosis of PAD in HMD patients, we used color Doppler ultrasonography technique to examine the arterial intima, lumen diameter, plaque, peak of systolic velocity, end diastolic velocity, mean velocity, pulse index and resistant index in arteries of lower extremities and carotid arteries in 73 MHD patients and 60 healthy individuals. The prevalence of PAD and its risk factors were then studied in association with their clinical history and biochemical parameters. Results Based on Doppler ultrasonography, PAD were found in 50.68% (37 cases) MHD patients, in whom PAD was located in one lower extremity in 12 cases and in two lower extremities in 25 cases. PAD was found in 11.67% healthy controls (P<0.001, as compared with that in HMD patients). Univariate logistic regression analysis showed that PAD in lower extremities in MHD patients was closely associated with serum phosphorus, calcium-phosphorus product, C reactive protein, calcification in carotid arteries, and serum lipoprotein A, albumin and parathyroid hormone. Multivariate logistic regression analysis demonstrated that serum albumin, parathyroid hormone and lipoprotein A levels were independent risk factors causing PAD in lower extremities in HMD patients. Conclusion PAD in lower extremities is frequently encountered among MHD patients. PAD is closely related to calcium/phosphorus metabolic disturbances, micro-inflammation and malnutrition of the patients.
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    Clinical observation of DNA immunoadsorption for the treatment of lupus nephritis
    ZHAO Shuz-hen;LIU Guang-zhen
    2009, 8 (10):  541-544. 
    Abstract ( 573 )   HTML ( 0 )   PDF (242KB) ( 223 )  
    【Abstract】Purpose To observe clinical effect of DNA immunoadsorption for the treatment of lupus nephritis. Methods We selected 32 patients with active lupus nephritis, and divided them equally into conventional treatment group and immunoadsorption group. For conventional treatment group, glucocorticoids (prednisolone) and immunosuppressive drugs (cyclophosphamide) were used; for immunoadsorption group, blood DNA immunoadsorption therapy was performed once half a month for 6 times in addition to the conventional therapy. Blood samples were collected before and after immunoadsorption to evaluate its clearance to antinuclear antibody (ANA) and anti-double-stranded DNA antibody (anti-ds-DNA), and its effect on blood routine examinations, erythrocyte sedimentation rate, immunoglubulins, complements and renal function. Clinical presentations were also recorded. Results In immunoadsorption group after the treatment, symptoms and signs improved significantly, ANA and anti-ds-DNA decreased remarkably (for ANA, from 1:2000 to 1:300, P<0.001; for anti-ds-DNA, from 36.5±10.4 to 19.4±10.3 IU/ml), immunoglobulins also decreased significantly (P<0.05), but blood routine examinations, erythrocyte sedimentation rate and complements remained unchanged. Conclusions DNA immunoadsorption is effective for the treatment of lupus nephritis. It improves clinical symptoms with less side-effects, and may become a new approach for the treatment of lupus nephritis.
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    Influential factor analysis of thrombosis in internal arteriovenous fistula in maintenance hemodialysis patients
    MA Zu-deng;CHEN Di-ling;YANG Zheng-lin;ZHAN Yi-min
    2009, 8 (10):  544-546. 
    Abstract ( 536 )   HTML ( 0 )   PDF (175KB) ( 216 )  
    【Abstract】Objective To investigate the influential factors relating to thrombosis in internal arteriovenous fistula in maintenance hemodialysis patients. Methods One hundred and seventy six cases with artificial arteriovenous fistulae for the first time were included in this study. Serum albumin, C-reactive protein, urea nitrogen, β-microglobulin and iPTH, plasma fibrinogen, and hemoglobin were assayed twice every year. In 122 cases with vascular access failure due to thrombosis in their internal arteriovenous fistulae, COX regression analysis and multivariate linear regression analysis were used to evaluate the correlation of these factors with the life span of arteriovenous fistulae. Result Diabetes, serum albumin, serum C-reactive protein and plasma fibrinogen correlated with the thrombosis in internal arteriovenous fistulae; Serum C-reactive protein linearly correlated with serum albumin and plasma fibrinogen. Conclusion Diabetes, serum albumin, serum C-reactive protein, and plasma fibrinogen were the risk factors relating to thrombosis in internal arteriovenous fistula. Serum albumin was a protective factor. Increase of serum C-reactive protein induced the lower level of serum albumin and the higher level of plasma fibrinogen.
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    Observation of serum protein loss in uremia patients treated with high-flux and reprocessable dialyzer
    ZHANG Qi-meng;LI Jie;A Si-ya;LIANG Fu;JI Fu-ying;SU Xiang-biao
    2009, 8 (10):  547-549. 
    Abstract ( 629 )   HTML ( 0 )   PDF (181KB) ( 189 )  
    【Abstract】 Objective To observe serum protein loss in uremia patients treated with conventional hemodialysis (HD), hemodiafiltration (HDF) and high-flux dialysis reprocessing (HFDR). Methods We recruited 52 uremia patients treated with maintenance hemodialysis in Beijing Zhong Guan Cun Hospital, and randomly divided them into HD group (n=20), HDF group (n=20) and HFDR group (n=12). We prospectively observed protein content in discharged fluid in the 3 groups, and serum albumin change after HD and HFDR for half a year and one year. Results (a) Protein concentration in discharged fluid was lower in HD group (1.14±0.52 mg/dl) than in HFDR group (1.37±0.45 mg/dl, P<0.05), and the concentration in HFDR group was significantly lower than that in HDF group (3.39±1.60mg/dl, P<0.01). (b) Protein concentration in discharged fluid did not change significantly if the high-flux dialyzer was reused for less than 20 times after reprocessing by the automatic dialyzer reprocessing machine (P>0.05). (c) After the treatment for half a year and one year, no significant differences in serum albumin was found between HD group (half a year, 37.97±2.54 mg/dl; one year, 36.69±1.84 mg/dl) and HFDR group (half a year, 37.83±2.13 mg/dl; one year, 37.26±2.46mg/dl, P>0.05). Conclusions Conventional HD therapy causes less protein loss. HFDR may not result in excess protein loss and decrease of serum albumin, if the dialyzer was reused within permissible times. HDF causes more protein loss.
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    Effect of Valsartan supplementation on micro-inflammation inmaintenance hemodialysis patients
    Zhong Hong Su Rong Xu Yan
    2009, 8 (10):  550-551. 
    Abstract ( 463 )   HTML ( 0 )   PDF (193KB) ( 173 )  
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    基础研究
    Effect of hyperphosphate on calcification of vascular smooth muscle cells and the intervention effect of osteoprotegerin
    WANG Hong-rui;YU Qing;HAO Jing;YUAN Wei-jie.
    2009, 8 (10):  552-556. 
    Abstract ( 918 )   HTML ( 0 )   PDF (313KB) ( 209 )  
    【Abstract】Objective To study the effect of hyperphosphate on calcification and osteoprotegerin (OPG) mRNA expression in rat vascular smooth muscle cells (RVSMCs), and the protection effect of OPG on RVSMCs calcification induced by hyperphosphate. Methods RVSMCs were cultured in normal phosphate medium, high phosphate medium, caspase inhibitor Z-VAD-FMK containing medium or OPG containing medium. Calcium content was quantified by the o-cresolphthalein complexone method, and protein content by the BCA method. RVSMCs calcification was visualized by Von Kossa staining. OPG mRNA was measured by semi-quantitative RT-PCR, and cell apoptosis was assayed by flow cytometry. Result (a) At the culture for 3, 6 and 9 days, RVSMCs calcification occurred more frequently in cells cultured in high phosphate medium than those in normal phosphate medium (P<0.05); (b) At the culture for 6 days, calcium deposition in RVSMCs was significantly inhibited in the cells cultured in 1.0μM/L and 2.0μM/L Z-VAD-FMK containing media (P<0.05), and in those cultured in 10μg/L and 100μg/L OPG containing media (P<0.05); (c) OPG mRNA increased in cells cultured in high phosphate medium, compared to those in normal phosphate medium; (d) Apoptosis and calcification of RVSMCs occurred fрĀ_Ā꿾㣰豀꘾y in those cultured in high phosphate medium. OPG significantly inhibited apoptosis in RVSMCs. Conclusion Hyperphosphate induces calcification of RVSMCs possibly through the induction of cell apoptosis. OPG protects RVSMCs from phosphate-induced calcification through inhibiting cell apoptosis.
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    血液净化中心管理与技术
    Etiology analysis of incident hemodialysis patients in Beijing in 2007
    CHEN Hong;ZHOU Chun-hua
    2009, 8 (10):  572-575. 
    Abstract ( 1136 )   HTML ( 0 )   PDF (246KB) ( 220 )  
    【Abstract】 Objective To investigate age, sex and primary disease of incident hemodialysis patients with end stage renal disease (ESRD) in Beijing in 2007. Methods Based on the information from the database issued by Beijing Hemodialysis Quality Control Improvement Center (BJHDQCIC), we analyzed age, sex and primary disease in 1732 ESRD patients newly treated with hemodialysis in Beijing in 2007.  Results In 2007 in Beijing, 1732 cases began to treated with hemodialysis. The male/female ratio was 1.35:1, and 73.6% patients were in the age range of 41~80 years. The most frequent primary diseases were primary glomerulonephritis 27.97%, diabetic nephropathy 23.19%, and hypertensive nephropathy 13.21%. Conclusion In this study, the major primary disease leading to ESRD and hemodialysis was primary glomerulonephritis. In the recent 5 years, however, the ratio of primary glomerulonephritis in the hemodialysis patients is decreasing, and that of diabetic nephropathy is increasing.
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