Chinese Journal of Blood Purification

12 June 2013, Volume 12 Issue 06 Previous Issue    Next Issue

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dialysate calcium concentration selection based on mechanism of calcium balance 2013, 12 (06):  291-292.  Abstract ( 231 )   HTML ( 1 )   PDF (143KB) ( 600 )   Metrics

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Investigation of the correlation of chronic inflammation and cardiac structure and function in maintenance hemodialysis patients. 2013, 12 (06):  293-296.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 204 )   HTML ( 1 )   PDF (254KB) ( 411 )   【Abstract】Objective: To investigate the relationship between the level of inflammation factors in blood serum and the heart construction and function from CHD patients.Methods: To detect the levels of hsCRP, IL-6, TNF-α in in blood serum from CHD patients. The patients were divided into two experiment groups depending on the level of hsCRP, the normal group and the abnormal group. The parameters of LAD, LVDd, LVDs, LVPWT, IVST, LVMI, LVEF, E/A, CO were measured from the two experiment groups by color Doppler ultrasonoscope.Results: Compared with the normal hsCRP group, patients have high levels of IL-6 and TNF-α in in blood serum from abnormal hsCRP group(P<0.01).Contrast to the normal hsCRP group, the levels of LAD, LVDd, LVDs, LVPWT, IVST and LVMI from abnormal hsCRP group is more higher than that from normal group( P< 0.05). The incidence of left ventricular disfunction, including hypertrophy, contractile hypofunction, ventricular compliance from abnormal hsCRP group is more higher than that from normal group( P< 0.01). The dependability analysis between inflammation factors in blood serum and the heart parameters showed that the levels of hsCRP, IL6,T NF-αhave positive correlation with LAD、LVDd、LVDs、LVPWT、IVST、LVMI (P< 0.05), but negative correlation with LVEF、E/A、CO (P< 0.05). And the level of hsCRP has positive correlation with IL-6 and T NF-α(P< 0.05).Conclusion: The level of inflammation factors in blood serum maybe is correlative to the heart construction and function from CHD patients, which is helpful to the diagnose and therapy for ESRD patients. Metrics

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Study the relationship between high-sensitivity C-reactive protein level and intima-media thickness variability on different peritoneal permeability of the maintenance peritoneal dialysis patients 2013, 12 (06):  297-300.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 120 )   HTML ( 0 )   PDF (235KB) ( 171 )   Objective :To study the relationship between high-sensitivity C-reactive protein level and intima-media thickness variability on different peritoneal permeability of the maintenance peritoneal dialysis patients．Methods: Selected 56 patients followed-up more than 6 months in our peritoneal dialysis center, exclude peritonitis, cancer, primary hypertension and taking statins of last 3 month. According to the peritoneal equilibration test(PET), the observed object were divided into high permeability group（D/P＞0.65）and low permeability group（D/P≤0.65）.And according to the PET, development of dialysis prescription, so that to achieve weekly clearance rate of the creatinine (Ccr)> 50L/W.1.73m2 and urea clearance index of KT/ V ≥ 1.7。Simultaneous determination of high-sensitivity C-reactive protein (Hs-CRP), serum creatinine (Scr),total cholesterol, high-density lipoprotein（HDL）, blood pressure(BP). Through ultrasound examination to determinate carotid intima-media thickness (IMT). Again determination of these serum markers and ultrasound examination 6 month after. Using the different value of the two measurements of IMT as the IMTV value. Using the average of two examination results of serum to analysis the relationship between IMTV and the other indicators. P <0.05 description difference was statistically significant. Result: ① The level of Hs-CRP , mean arterial pressure（MAP）and intima-media thickness variability（IMTV）in high permeability group of MPD patients were significantly higher than the low permeability group (P <0.05), HDL was significantly lower than the low permeability group (P <0.05).But no significant differences between the two groups of IMT（P＞0.05）② Pearson correlation analysis found that the IMTV in the peritoneal patients body's was a positive correlation with Hs-CRP, MAP and peritoneal permeability (D / P value) , negative correlation with HDL，no relationship with SBP,DBP and TCH . ③Multivariate logistic regression analysis found， the important influencing factors on IMTV were Hs-CRP levels and D / P value. Conclusion: ①High permeability group of inflammatory conditions is more serious than the low permeability group, this is the independent risk factors affecting the patients on intima-media thickness variability. ② Control the level of micro-inflammation especially for high permeability group is the important means of mitigate the level of IMTV, retard atherosclerosis and reduce the complications of cardiovascular events of MPD patients. Metrics

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Comparison of clopidogre and dipyridamole for preventing dysfunction of the autologous fistula by great saphenous venous transposition 2013, 12 (06):  301-304.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 174 )   HTML ( 0 )   PDF (251KB) ( 219 )   【Abstract】 Objective To compare the efficacy and safety of clopidogre and dipyridamole for the prevention of autologous great saphenous venous transposition fistula dysfunction. Methods We prospectively recruited patients who received the operation of autologous great saphenous venous transposition fistula. After the surgery, patients were randomly assigned into either clopidogre group (group A) or dipyridamole group (group B). At the 3rd and 6th months after the enrollment, fistula patency, stenosis rate, arterial anastomotic diameter, venous anastomotic diameter, diameters of the arterial/venous graft segments (3cm from arterial/venous anastomotic sites), complications, and adverse events were recorded. Data were analyzed by using SPSS 17.0 software. Results We observed 30 patients, of which 16 were in group A, and 14 were in group B. At the time points of 3rd and 6th months, group A had a higher fistula patency rate and a lower stenosis rate than group B. At the 6th month, fistula patency was statistically significant between the two groups (P=0.024). Arterial and venous anastomotic diameters were slight wider in group A than in group B but without statistical significance (P＞0.05) at the 3rd month, and were significant larger in group A than in group B (P=0.041 and 0.042, respectively) at the 6th month. Diameters of the arterial/venous graft segments were similar between the two groups at 3rd and 6th months. No severe adverse effects were reported in either of the two groups. Conclusions Clopidogre is superior to dipyridamole in the prevention of thrombosis and stenosis in autologous great saphenous venous transposition fistula without notable adverse effects. As an anti-platelet therapy for fistula preservation, clopidogre shows better effects for clinical use. Metrics

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The Relationship Between Serum Level of Fibroblast Growth Factor 23 and Left Ventricular Hypertrophy in Dialysis Patients 2013, 12 (06):  305-308.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 121 )   HTML ( 0 )   PDF (245KB) ( 102 )   To determine the serum level of fibroblast growth factor 23(FGF23) in maintenance hemodialysis(MHD) patients and explore the relationship between FGF23 and ventricular hypertrophy. Methods: Forty MHD patients and twenty people(control group ) whose renal functions were normal were enrolled in this study. Phosphate、calcium、alkaline phosphatase in their serum were determined . The level of FGF23 and 1,25-(OH)2D3 in serum were detected by the method of ELISA.The patients in MHD were divided into LVH group and non-LVH group according as LVMI. Results: (1)The Log FGF23 and LogPTH in MHD group was much higher than control, Log1,25-(OH)2D3 in MHD group was lower than control.(2)The Log FGF23 and Log PTH in LVH group was much higher than non-LVH group .(3)LVMI was positively correlated with Log FGF23 and Log ALP.(4)Multiple linear regression analysis revealed that the level of Log FGF23 and LogALP was the influencing factor of LVH in MHD patients.Conclusion: The serum level of FGF23 in MHD patients is extremely higher, and the elevation of FGF23 is relative to the left ventricular hypertrophy. Metrics

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The value of urinary angiotensinogen in renal function in those diabetic patients who without hypertension 2013, 12 (06):  309-312.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 123 )   HTML ( 0 )   PDF (230KB) ( 219 )   Abstract:Objective: To demonstrate the value of urinary angiotensinogen (UAGT) in renal function in those diabetic patients who without hypertension. Methods: Single centre and cross section study. 102 DM Patients who were hospitalized in Peking University third Hospital from September 2012 to December 2012，had not received ACEI or ARB treatment. Desided by UALB-creatinine ratio (UALB/Cr) devided the patients into three groups: urine protein negative group, microalbuminuria group, macroalbuminuric group. And 18 health people selected to be the control group. To recorded patients’ gender, age, blood pressure, renal function, urinary protein and measured angiotensinogen by ELISA. Results: UAGT–creatinine ratio (UAGT/Cr) UAGT/Cr was significant raised(p < 0.001) in urine protein negative DM group than the control group. At the same time with the diastolic blood pressure significant raised and eGFR significant decreased. (p<0.01). This tendency was more obviously in macroalbuminuric DM group. The result of correlation analysis indicated that UAGT/Cr was the single factor with diastolic blood pressure and UALB/Cr（p<0.01）. Regression analysis indicated that the UAGT was the negative factor for eGFR in DM patients. Conclusion: These data indicate that UAGT was increased in urine protein negative DM patients who without hypertension, and more increased in diabetic nephropathy. The elevator of UAGT maybe correlated with the progress of damage of renal function in diabetic nephropathy patients. The UAGT may to be a marker for prognosis renal damage in diabetic patients. Metrics

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Investigation and analysis of vascular access used at the start of hemodialysis of end stage of renal disease patients 2013, 12 (06):  313-315.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 141 )   HTML ( 0 )   PDF (217KB) ( 302 )   Objective To investigate vascular access used at the start of hemodialysis of end stage of renal disease（ESRD）patients，arteriovenous ?stula（AVF）or central venous catheters（CVCs）, and analyse the causes of without using AVF. Methods Incident patients with ESRD starting hemodialysis between 1 October 2007 and 30 September 2012 were included in the study. To investigate vascular access used at the start of hemodialysis. The clinical data were collected to analyse the causes of without using AVF. Results A total of 160 patients were included in this study. Hemodialysis started with a AVF in 32 patients and with CVCs in 128 patients. Using CVCs were associated with older age, higher CCI, higher eGFR and lower Hb levels. There were more patients with heart failure and emergency start, less patients with nephrology follow-up in CVCs group. The two main causes of using CVCs were without transfer to the nephrology and delayed planning of vascular access. Conclusions Most ESRD patients started hemodialysis without a AVF. Multiple causes were associated with this fact, many of which are modi?able. Metrics

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The effect of resin-absorbed hemoperfusion on the Renin-angiotensin-aldosterone system in hemodialysis patients with resistant hypertension 2013, 12 (06):  316-319.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 128 )   HTML ( 1 )   PDF (246KB) ( 109 )   Objective: To investigate the effect of resin-absorbed hemoperfusion on Renin-angiotensin-aldosterone system in hemodialysis patients with resistant hypertension. Methods: 64 patients in our hospital were randomly divided into 2 groups, each group has 32 cases. Each patient has 2 or 3 times dialysis for a week in the group of HD. And other group of patients received 1 time resin-absorbed hemoperfusion on the basis of conventional dialysis once a week. Observed the changes of blood pressure, renin , angiotensin II and parathyroid hormone before treatment and after 8 weeks treatment. Result: 1. The blood pressure, renin , angiotensin II and parathyroid hormone of the patients were no significant difference compared with before treatment in the group of HD. 2. After 8 weeks treatment, the blood pressure, renin , angiotensin II and parathyroid hormone of the patients in the group of HD+HP were significantly lower than before, and each index were significantly lower than the group of HD at the same tiame. Conclusion: Resin-absorbed hemoperfusion combined with hemodialysis can better control the bloodpressure and effectively reduce the levels of renin and angiotensin II of uraemia patients. Metrics

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Clinical observation of the early application of the native arteriovenous fistula after removed thrombus operation 2013, 12 (06):  320-322.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 181 )   HTML ( 0 )   PDF (223KB) ( 214 )   Objective To observe the effects of early application of the native arteriovenous fistula(AVF) after removed thrombus operation. Methods 50 maintenance hemodialysis patients were randomly divided into two groups, whose AVF were mature and suffered from obstruction after been applicated. ALL of them received removed thrombus operation and anastomosis. The observation group 25 cases used AVF 1 month later, while the control group 25 cases used AVF within 1 week. The blood flux, using time, and relative complications were compared. Results (1)The blood fulx of all AVFs maintained or overed 235ml/min after using 1 month, 3 month, 6 month and 12 month, and there were no statistical differences between both groups. (2)The using time of AVFs overed 1 year in the two groups. (3)8 cases occurred aneurysm, 9 cases occurred stenosis of AVF in control group, while 2 cases occurred aneurysm, 3 cases occurred stenosis of AVF in observation group. There were obviously statistical differences between both groups. 7 cases occurred hypodermal hematoma in control group, while 5 cases occurred in observation. There were no statistical differences between both groups. No vein embolism wer in two groups. Conclusion The early application of the AVF after removed thrombus operation is safety and effective, and can induce the incidence of complication. Early application of the AVF can lighten patients’ pains and economical burdens. Metrics

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The expresssion of integrin linked kinase and connective tissue growth factor in rat peritoneal mesothelial cells induced by high glucose 2013, 12 (06):  323-326.  doi: 10.3969/j.issn.1671-4091.2013.06.00 Abstract ( 384 )   HTML ( 0 )   PDF (256KB) ( 107 )   Objective To observe the expression of integrin liked kinase(ILK) 、connective cells(RPMCs) induced by high glucose. Methods RPMCs were isolated ,cultured and passaged by trypsin,then identified.The second generation of cultured RPMCs were used in the experiment . RPMCs were divided into normal control group ,high glucose(1.5%,2.5%,4.25%) for 24 hours ,high glucose (2.5%) for 12,24,48,72 hours.ILK and α-SMA mRNA were detected by real time RT-PCR.ILK protein was detected by Western blot.CTGF protein in supernatants was detected by ELISA. Results Compared with the control group ,the expresssion of ILK、CTGF and α-SMA were significantly increased in groups stimulated by high glucose(P<0.05). Conclusions High glucose can up-regulate the expression of ILK and CTGF.ILK and CTGF may play a role in the pathogenesis of peritoneal dialysis related peritoneal fibrosis. Metrics