Chinese Journal of Blood Purification

Clinical observation of dialysate containing balanced amino acids used in maintenance hemodialysis patients

2008, 7 (4): 179-182.

Abstract ( 609 )

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Objective: To investigate the effects of dialysis with balancing amino acid dialysate in chronic hemodialysis patients. Methods: Twenty-nine chronic hemodialysis patients were dialysis treated with balancing amino acid dialysate for one month. Serum free amino acid, plasma proteins, some markers of inflammation, BUN, Cr, electrolytes were measured before and after treatment. Results: After dialysis with balancing amino acid dialysate for one month, the levels of most kinds free amino acids and the level of total amino acid elevated to normal, and the levels of BUN, SCr and UA elevated. Neither the concentrations of electrolytes, calcium and P , nor the levels of plasma total protein, ALB PreA asn Trf had any significant changes. The serum levels of β2-MG和SCRP decreased significantly, compared with baseline levels (P<0.05). Conclusion: The dialysis with balancing amino acids might prevent the loss of amino acids, improve the metabolic disorder, and inflammatory status in the chronic hemodialysis patients.

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The relationship of Cystatin C with cardiac function

MA Jing;XIE Ru-juan

2008, 7 (4): 183-187.

Abstract ( 976 )

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Objective To clarify the association of Cystatin C with cardica dysfunction and biochemical indicator in predialysis patients with chronic kidney disease(CKD). Methods Whole blood concentration of Cystatin C was detected by latex particle enhancement turbidity method in a cohort of 198 non-dialysis CKD patients and 25 hypertensive controls. The relationship of Cystatin C with echocardiographic parametter,biochemical indicator and history of cardiovascular disease in CKD patients was examinned. Result Cystatin C level was significantly higher in CKD patients than that in control subjects. Spearman correlation showed that the Cystatin C level was positively correlated with left ventricular end diastolic dimension(LVDd)、left ventricular end systolic dimension(LVDs)、left ventricular mass index(LVMI); Cystatin C concentration was negatively correlated with ejection fraction， and correlation of Cystatin C and each parameter in cardiac dysfunction washigher than creatinine. multiple regression analysis Revealed that congestive heart failure was an inde- nt danger factor to Cystatin C level.LVMI, history of cardiovascular disease, glomerular filtration rate, albumn were independent determinals of Cystatin C . Conclusion Cystatin C level is significantly correlated with cardiac function and may be a sensitive marker for the evaluation of cardiac function in non-dialysis CKD patients.

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Effect of continuous quality improvement on central venous catheter-related bloodstream infections in hemodialysis patients

WANG Lei;MENG Xian-hua;TAN Min;YANG Jing-hua;FAN Xiao-zhi;SHAO Lin;CAI Mei-shun;WANG Mei.

2008, 7 (4): 188-191.

Abstract ( 709 )

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Objective　To analyze the incidence for central venous catheter-related bloodstream infections (CRBSI) in hemodialysis patients and improve catheter-related bloodstream infections management using continuous quality improvement (CQI). Methods Analyzing the incidence of central venous catheter-related bloodstream infections (CRBSI) in 68 hemodialysis patients pre-CQI and using CQI to prophylaxis CRBSI. The CQI team was driven by a four-step process called PDCA cycle: plan, do, check and act. Compared the incidence for CRBSI in 76 hemodialysis patients with central venous catheter post-CQI Results　 For untunneled CVCs, The incidence of the total CRBSI is 8.1episodes /1000 catheter-days pre-CQI, and which reduced to 2.6 episodes/1000 catheter-days during the same period post-CQI(decreased 68%).For tunneled CVCs, the incidence of CRBSI dropped from 2.6 episodes /1000 catheter-days pre-CQI to 0.7 episodes /1000 catheter-days post-CQI. Conclusion　Continuous quality improvement program can improve the management of CRBSI in hemodialysis patients.

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Comparison between membrane coated activated charcoal and HA230 absorption resin for the clearance of profenofos in hemoperfusion

CHEN Yan-jun;JIN Yong-jiu;ZHAO Yan-xia;CAO Hua-wei;ZHANG Xue-mei;YAN Hui-fang.

2008, 7 (4): 192-194.

Abstract ( 228 )

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Objective To compare the clearance efficiencies of blood profenofos by hemoperfusion with membrane coated activated charcoal and HA230 absorption resin. Method Profenofos standard solutions were mixed with blood samples from healthy subjects, and the profenofos in blood samples was adsorbed by hemoperfusion through a column containing membrane coated activated charcoal or HA230 absorption resin. The remaining profenofos in blood was then extracted by ethylacetate and determined by capillary gas chromatography. Result The lowest limit for blood methamidophos measurement by this method was 0.8ng. The recovery rate to low, middle and high concentrations of blood profenofos was 95.1%～101.2%, with the relative standard deviation of 1.11%～10.97%. By hemoperfusion using membrane coated activated charcoal column and HA230 absorption resin column, the clearance efficiencies were 78.2%～85.8% and 84.5%～93.8%, respectively. Conclusion Blood profenofos can be cleared efficiently and rapidly by hemoperfusion with membrane coated activated charcoal or HA230 absorption resin.

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Apoptosis of peripheral blood mononuclear cells as an index to evaluate biocompatibility of hemodialysis membranes

LUO Yang;BIAN Wei-jing.

2008, 7 (4): 195-197.

Abstract ( 598 )

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Objective To study whether the apoptosis of peripheral blood mononuclear cells (PMBC) can be used as an index to evaluate the biocmpatibility of hemodialysis membranes. Methods PMBC of hemodialysis patients were stimulated in vitro with different biocompatibility membranes for 0 to 72 hours, then Flow cytometry and ELISA analysis were applied to evaluate the apoptosis and the synthesis of interleukin-1 and tumor necrosis factor- of PMBC. Results Bad biocompatibility membrane such as CA membrane can cause much heavier apoptosis of PMBC than good biocompatibility membrane can do, the absorbent density (OD) which represents the degree of PMBC apoptosis in CA group was significant higher than that in PS group and control group. In CA group, OD in 48 hr was significantly higher than that in 24hr and it had no significant different with OD in 72 hr (P>0.05). Our data also showed that the apoptosis of PMBC had a significant positive correlation with the production of interleukin-1 and tumor necrosis factor- during which they were stimulated. Conclusion It is advisable to use the apoptosis of PMBC as an index to evaluate biocmpatibility of hemodialysis membranes.

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Effect of norcantharidin on expression of connective tissue growth factor and nuclear factor-闎p65 in kidney of protein-overloaded nephropathy rats

YE Kun;LIU Fu-you;LI Ying

2008, 7 (4): 198-202.

Abstract ( 638 )

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Objective To detect expression of connective tissue growth factor (CTGF) and nuclear factor-κB (NF-κB)p65 in renal tissues，and investigate the mechanism of Norcantharidin (NCTD) on renal interstitial fibrosis prevention. Methods uninephrectomized SD rats were received intraperitoneally injections of bovine serum albumin (BSA). The nephropathy rats were randomly divided into model group (BSA group, intraperitoneally injections of BSA 5g·kg-1·d-1) and NCTD group (intraperitoneally injections of BSA 5g·kg-1·d-1and NCTD 0.1mg·kg-1·d-1). An additional set of uninephrectomized rats were only given saline as control group. At week 9, the rats were sacrificed and the remnant kidney was collected. Renal pathological change was observed by light microscopy and electron microscopy. Expression of CTGF mRNA and NF-κBp65 mRNA in renal tissue was semi-quantitative analyzed by RT-PCR. CTGF protein expression was detected by western blot. NF-κBp65 protein expression was detected by immunohistochemistry. Result ⑴By light microscope, in BSA group it was showed that glomerular sclerosis existed and lots of inflammatory cell infiltrated in renal interstitium with segmental interstitial fibrosis. By electron microscope, obvious electron dense deposits existed and foot process fusion was seen extensively in BSA group. After intervention of NCTD, tubulointerstitial lesion（TIL）score significantly decreaded (P＜0.05). ⑵Compared with BSA group, expression of CTGF mRNA and NF-κBp65 mRNA in NCTD group were down-regulated (P＜0.01). ⑶Compared with BSA group, protein expressions of CTGF in NCTD was down-regulated (P＜0.05) by western blot. ⑷Compared with BSA group, deposited area and positive cell population of NF-κBp65 decreased (P＜0.05). Conclusion NCTD could effectively prevent renal tubulointerstitial fibrosis by significantly down-regulating expressions of CTGF and NF-κBp65.

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Inhibition of CTGF expression in mouse peritoneal mesothelial cells by nano-carrier PAMAM mediated pCTGF-shRNA

YI Bin;LIU Fu-you;LIU Hong;PENG You-ming;LIU Ying-hong.

2008, 7 (4): 203-206.

Abstract ( 605 )

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Objectives To investigate the effects of nano-carrier G9 PAMAM mediated plasmid containing the CTGF-shRNA (pCTGF-shRNA) on the expression of CTGF in mouse peritoneal mesothelial cells. Methods The plasmids named pCTGF1-shRNA、pCTGF2-shRNA and negative control pHK-shRNA were designed and formed. Transfection of plasmids to MPMCs (3rd generation, induced by 4.25% glucose) was performed using G9 PAMAM. The expression of CTGF mRNA was detected by RT-PCR. The protein level of CTGF was determined by Western Blot. Results With the treatment of 4.25% glucose, the expression of CTGF in MPMCs were significantly up-regulated. Introduction of pCTGF1-shRNA and pCTGF2- shRNA resulted in significant reduction of CTGF expression (P<0.05) with pCTGF2-shRNA more effective. But the introduction of pHK-shRNA did not lead to significant reduction in CTGF expression（P>0.05）. Conclusions Nano-carrier G9 PAMAM has the ability to efficiently transfect pCTGF-shRNA into primary MPMCs and has prominent inhibition effects on increased expression of CTGF induced by high glucose. PAMAM vector mediated pCTGF-shRNA can be used as a very efficient strategy in gene therapy of peritoneal fibrosis

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