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Chinese Journal of Blood Purification

Chinese Journal of Blood Purification

    12 September 2012, Volume 11 Issue 9 Previous Issue    Next Issue
    Re-appreciation of the treatment target for nephrogenic anemia
    PU Lei, WANG Li
    2012, 11 (9):  465-467. 
    Abstract ( 175 )   HTML ( 0 )   PDF (130KB) ( 260 )  
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    Prospective view of the novel erythropoietic stimulants for the treatment of
            nephrogenic anemia
    QI Chao-jun, NI Zhao-hui
    2012, 11 (9):  468-471. 
    Abstract ( 165 )   HTML ( 0 )   PDF (151KB) ( 249 )  
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    New strategy for the standardized treatment of nephrogenic anemia
    WANG Ya-ping
    2012, 11 (9):  472-475. 
    Abstract ( 172 )   HTML ( 1 )   PDF (174KB) ( 624 )  
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    Comparison of sustained low-efficient hemodiafiltration and continuous veno-venous hemofiltration for the treatment of acute kidney injury patients following wasp stings
    HEN Jian-ming, WAN Yun, CHEN Bo, TIAN Shao-jiang, WANG Li-ping, LI Jun-feng
    2012, 11 (9):  476-479.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 316 )   HTML ( 1 )   PDF (203KB) ( 236 )  
    【Abstract】 Objective To evaluate the effect of sustained low-efficient hemodiafiltration (SLEDF) on acute kidney injury (AKI) patients following wasp stings. Methods Clinical data of the 31 patients with phase III AKI following wasp stings were retrospectively analyzed. These patients were treated with SLEDF (SLEDF group, n=17) or continuous veno-venous hemofiltration (CVVH) (CVVH group, n=14). General conditions of the patients, mortality, time to reach polyuria stage, time to recover from higher serum creatinine, score of acute physiology and chronic health evaluation (APACHE II), serum level of creatinine at the 3rd and 7th day after treatment, adverse effects of SLEDF and CVVH, and expenses for blood purification were compared between the two groups. Results There were no significant differences in general conditions of the patients, mortality (11.7% vs 7.1%), time to reach polyuria stage (22.2±3.2 days vs. 20.2±4.1 days), time to recover from higher serum creatinine (39.3±7.9 days vs. 34.1±7.7 days), and adverse effects between the two groups. There were also no significant differences in APACHE II scores and serum creatinine levels before treatment, at 3rd day and 7th day between the two groups. Blood purification expense was lower in SLEDF group than in CVVH group (P＜0.01).  Conclusion SLEDF and CVVH have similar effects in outcomes, recovery of renal function, relief of early disease symptoms, and stabilization of hemodynamics in acute kidney injury (AKI) patients following wasp stings. However, the expense is lower in SLEDF than in CVVH.
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    Effects of saccharum iron on restless legs syndrome in maintenance hemodialysis patients
    WU Bi-bo, ZHANG Li-ming, TANG Qi, JIA Jie-shuang, LU Yi-zhou
    2012, 11 (9):  480-484.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 185 )   HTML ( 0 )   PDF (244KB) ( 136 )  
    【Abstract】 Objective To observe the effects of saccharum iron on restless legs syndrome (RLS) in maintenance hemodialysis (MHD) patients. Methods We recruited 40 patients who underwent hemodialysis for at least three months before the study and with restless legs syndrome (RLS). RLS was diagnosed according to the criteria from the International Restless Legs Syndrome Study Group (IRLSSG). These patients were randomly divided into two groups, treatment group (20 cases) and control group (20 cases). In the treatment group, 100mg of saccharum iron were infused to the patient during the dialysis treatment once a week with a total dose of 1000 mg, while in the control group no iron preparations were used. Hemoglobin (Hb), serum Fe (Fe), serum ferritin (SF), transferrin saturation (TSAT) and RLS rating scale were determined every four weeks during the treatment. Side-effects of the drug were also recorded.  Results At the initiation of the investigation, there were no significant differences in Hb, Fe, SF, TSAT and RLS rating scale between the two groups. After the treatment for 10 weeks, Fe, SF and TSAT increased significantly compared with those before treatment (P＜0.05 or P＜0.01) in the treatment group, but changed insignificantly in the control group (P＞0.05). RLS rating scale was 16.29±10.08 and 15.79±10.42 before the treatment (P＞0.05), 14.02±9.18 and 16.03±10.4 after the treatment for 4 weeks (P<0.05), 10.94±9.03 and 15.12±9.34 after the treatment for 8 weeks (P＜0.01), and 10.02±8.14 and 14.97±10.13 after the treatment for 10 weeks (P＜0.01) in the treatment group and control group, respectively. No significant side-effects were found in the treatment group. Conclusion   Intravenous supplement of saccharum iron appears to be associated with the improvement of RLS in MHD patients.
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    Clinical study on placement of indwelling hemodialysis catheter through stenotic or occluded central vein
    LIU Lifang, LIU Wei, ZHAN Shen, CUI Rui, LIU Ruilin, YANG Tao, WANG Yuzhu
    2012, 11 (9):  485-488.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 153 )   HTML ( 0 )   PDF (334KB) ( 235 )  
    【Abstract】Objective To explore the creation of vascular access in hemodialysis patients whose venous resource was nearly exhausted.  Methods We studied six maintenance hemodialysis patients, who had previously undergone multiple central venous catheterizations, and were unable to create an arteriovenous fistula or graft anymore. Color Doppler ultrasound and CT angiography (CTA) confirmed multiple sites of central venous stenosis or obstruction in these patients. Percutaneous transluminal angioplasty (PTA) was performed for the stenotic or occluded brachiocephalic vein, followed by placement of indwelling central venous catheter via an internal jugular vein after successful angioplasty.  Results The catheter in one case provided a blood flow of only 180 ml/min in the second hemodialysis session, and reached 250 ml/min after being regulated the site of the catheter. The catheters in all other cases functioned well during hemodialysis (blood flow rate >250 ml/min). No catheter dysfunction or infection were discovered in any case in the following 2～6 months.  Conclusion Interventional recanalization of the stenotic or occluded central veins for the placement of indwelling hemodialysis catheter is a safe and effective method for patients whose conventional access sites have been exhausted.
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    Analyses of endothelial cell injury and tissue factor change in maintenance hemodialysis patients with type II diabetes and without diabetes
    LIU Ning, HUANG Wen, JIANG Liping
    2012, 11 (9):  489-492.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 131 )   HTML ( 0 )   PDF (212KB) ( 117 )  
    【Abstract】Objective To investigate the pathogenesis of endothelial cell injury and coagulation disorder in hemodialysis patients with different primary diseases. Methods Enzyme linked immunosorbent assay was used to measure the plasma soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor (vWF) and tissue factor (TF) in maintenance hemodialysis patients (MHD group, n=42) and healthy volunteers (control group, n=22).  Results (a) The levels of sVCAM-1, vWF and TF were significantly higher in MHD group than in control group (t=-7.809, -6.559 and -16.821, respectively; P =0.005, 0.004 and 0.000, respectively). The levels of sVCAM-1, vWF and TF were significantly higher in MHD patients with type II diabetes (2-DM) than those without diabetes (t=-20.605, 12.792 and 8.600, respectively; P=0.046, 0.032 and 0.047, respectively); (b) Logistic regression analysis showed that sVCAM-1, vWF and TF levels correlated to the presence of 2-DM. (c) vWF level after a hemodialysis session increased significantly as compared to the level before the hemodialysis session (t=-5.943, P = 0.000). TF level increased after a hemodialysis session but without statistical significance (t=-3.558, P =0.205). The differences of vWF and TF levels before and after hemodialysis sessions were insignificant between MHD patients with 2-DM and those without diabetes (t=-3.058, -2.241, -5.931, and -8.439, respectively; P =0.070, 0.302, 0.085, and 0.155, respectively). The difference of vWF level before and after hemodialysis sessions correlated positively with hemodialysis age (r=0.328, P＜0.05).  Conclusion Endothelial cell injury and hypercoagulation state exist in MHD patients with 2-MD as well as in those with other primary diseases. These changes aggravate after hemodialysis especially in those with longer hemodialysis age.
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    The correlation of radial augmentation index with abdominal aortic calcification index, intima-media thickness and cardiac function in maintenance hemodialysis patients
    YANG Ning, LIN Hong-li, LI Long-kai, ZHAO Guang-ben, ZHOU Na, ZHANG Yu, JIANG Xue
    2012, 11 (9):  493-496.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 244 )   HTML ( 0 )   PDF (218KB) ( 310 )  
    【Abstract】 Objective To approach the correlation of radial augmentation index (AI) with abdominal aortic calcification (AAC), intima-media thickness (IMT) and cardiac function in maintenance hemodialysis patients.  Methods A total of 41 maintenance hemodialysis patients treated in the hemodialysis center of the First Hospital of Dalian Medical University were enrolled and investigated. Augmentation index was measured by HEM9001 tonometer, and semiquantification of calcium deposit in abdominal aorta as the percentage of aortic calcification volume (% ACV) was detected by spiral CT. We determined IMT, LVDd, LVPW, LVMI, IVS, E/A and EF by color Doppler sonography. Data are presented as mean±S.D. Relationships between variables were assessed by Pearson correlation analysis and multiple liner regression. 　Results Our study showed that AI significantly correlated to AAC (r=0.435, P＜0.05) and IMT (r=0.458, P＜0.05). AI also positively correlated to LVDd (r=0.537, P＜0.01), LVPW (r=0.469, P＜0.05), LVMI (r=0.59, P＜0.01) and IVS (r=0.478, P＜0.01), and negatively correlated to E/A (r=-0.523, P＜0.01) and EF (r=-0.534, P＜0.01). Multiple liner regression showed that gender, age, BMI, MPA, AAC, IMT, LVDd, LVPW, LVMI and IVS were the factors affecting AI.　Conclusion Radial augmentation index correlates to AAC, IMT and cardiac function in maintenance hemodialysis patients.
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    Assessment of dry weight among maintenance hemodialysis patients with the application of bioelectrical impedance prediction equation
    DU Jing, SUI Xiao-ni, ZHAO Zhan-yun, ZOU Zuo-jun
    2012, 11 (9):  497-500.  doi: 10.3969/j.issn.1671-4091.2012.09.00
    Abstract ( 102 )   HTML ( 0 )   PDF (215KB) ( 160 )  
    【Abstract】 Object To explore the accuracy of bioelectrical impedance prediction equation in the evaluation of dry weight among maintenance hemodialysis (MHD) patients. Methods Dry weight of 60 MHD patients was estimated using electrical impedance value of 50 KHz frequency measured by bioelectrical impedance analyzer, combined with slope method and new 3-compartment model. Dry weight of these participants was the post-dialysis weight, measured by inferior vena cava diameter (IVCD) method which was deemed as golden standard. Another 90 individuals with matched gender, age, height, body weight and BMI were selected to construct coefficient and compare the human body parameters with MHD patient.  Results Pearson correlation coefficient between the evaluated dry weight by slope method and true dry weight was 0.991. Bland- Altman plot showed these two approaches bore poor consistency and the difference between them was far from zero. Pearson correlation coefficient between assessed dry weight by new 3-compartmental model and true dry weight was 0.993. Bland- Altman plot revealed good consistency between the two methods with stable and minor diffidence as their differences fluctuated near zero.  Conclusion Different bioelectrical impedance measuring instrument gives rise to the impact on measured data. In this study, the new 3-compartment model predicts the dry weight of MHD patients more accurately.
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