Chinese Journal of Blood Purification

12 November 2015, Volume 14 Issue 11 Previous Issue    Next Issue

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Evaluation of nutrition status among 44 maintenance hemodialysis patients by bioelectrical impedance analysis 2015, 14 (11):  640-643.  doi: 10.3969/j.issn.1671-4091.2015.11.001 Abstract ( 264 )   HTML ( 1 )   PDF (333KB) ( 254 )   【Abstract】Objective The purpose of this study was to discuss the application of bioelectric impedance analysis (BIA) in the evaluation of nutrition status among patients with maintenance hemodialysis (MHD). Methods Forty-four MHD patients in our hospital from Jun. to Dec., 2014 were enrolled in this study. Nutrition status of the patients was evaluated by BIA method, body mass index (BMI), and laboratory tests. Results The average BMI was 23.12±3.51, and 9.1% of the patients were at the risk of malnutrition. The laboratory tests showed that serum albumin, cholesterol, triglyceride and uric acid were 41.75 ± 6.34g/L, 3.60 ±0.93mmol/L, 1.23±0.85mmol/L and 402.56±85.99mmol/L, respectively. Serum albumin, cholesterol, triglyceride and uric acid below normal ranges were found in 29.5%, 15.9%, 2.3% and 2.3%, respectively of the 44 patients. The ratio of malnutrition evaluated by BIA was 45.5%, similar to the ratio evaluated by serum albumin (P=0.123) but significantly higher than that by BMI (P=0.000), total cholesterol (P=0.003), triglyceride (P= 0.000), and uric acid (P=0.000). In the 31 patients with normal serum albumin level, 12 cases (38.7%) were found to have lower body cell mass (BCM) suggesting malnutrition by BIA. Conclusion BIA can evaluate human body composition and detect malnutrition status earlier than other methods in MHD patients. BIA is a noninvasive, safe and stable method useful for nutrition evaluation in MHD patients. Metrics

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The early renal injury and its related factors in patients with chronic HBV infection 2015, 14 (11):  644-648.  doi: 10.3969/j.issn.1671-4091.2015.11.002 Abstract ( 269 )   HTML ( 0 )   PDF (370KB) ( 287 )   【Abstract】Background Clinically, hepatitis B virus (HBV) infection has been observed to be associated with nephropathy. Regular monitoring of renal function is recommended because comorbidities or antiviral treatment might further increase the renal injury. The well-established formulae using serum creatinine for the calculation of glomerular filtration rate (eGFR) are validated only for patients with substantially impaired renal function but not suitable for monitoring patients with normal renal function. There are few data of early renal injury evaluated in patients with chronic HBV infection. Methods A multicenter, retrospective and observational study was carried out in 2 hospitals in Tianjin, China between April 2012 and June 2013. The study recruited 90 patients with chronic HBV infection who never received antiviral treatment. Based on the hepatitis status, they were divided into three groups including chronic hepatitis group, liver cirrhosis group, and hepatic carcinoma group. Patients were assessed for early renal injury by urinary albumin, urinary transferrin,urinary IgG, and serum β2-microglobulin. Clinical information and other laboratory data including serum creatinine and eGFR were also collected for diagnosis. Patients’data from two laboratories were pooled together and analyzed among the three groups. Logistic regression analysis was conducted to determine the association between early renal injury and the variables including age, gender, comorbidities (diabetes and hypertension), and chronic disease stages. Results Serum creatinine level was in normal range in all patients. However, the abnormal rate of albumin, transferrin, IgG in urine, and serum β2-microglobulin were much higher than that of eGFR (72.2% vs. 12.7%, c2=56.25, P=0.000). The proportion of early renal injury was different in different status of chronic HBV infection. In patients with chronic hepatitis, cirrhosis and liver cancer, urinary transferrin levels were 1.91±1.06 mg/L, 2.66±3.01 mg/L, and 6.73±8.32 mg/L, (c2=7.671, P=0.001), respectively; abnormal urinary IgG level was found in 4/30 (13.3%), 15/29 (51.7%) and 11/30 (36.7%) (F=10.39, P=0.006), respectively of the patients; abnormal β2-microglobulin level was found in 10/30 (33.3%), 18/29 (62%) and 23/30 (76.7%) (F=12.75, P=0.00), respectively of the patients. Logistic regression analyses showed that aged patients and liver disease status were the independent risk factors for early abnormal renal function in patients with chronic HBV infection. Conclusions The prevalence of early renal injury with normal eGFR is higher in patients with HBV infection. Age and disease status are the main factors affecting the early renal injury. Assessment of early renal injury is required before antiviral treatment in these patients. Metrics

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Impact of vascular calcification on arteriovenous fistula dysfunction in hemodialysis patients 2015, 14 (11):  649-653.  doi: 10.3969/j.issn.1671-4091.2015.11.003 Abstract ( 294 )   HTML ( 0 )   PDF (687KB) ( 436 )   Objective To investigate the impact of vascular calcification (VC) on arteriovenous fistula (AVF) dysfunction in hemodialysis (HD) patients. Methods Segments of radial artery were obtained during the arteriovenous fistula operation for HD patients. VC was examined by von Kossa staining. Clinical and biochemical data were collected. Parameters relating to VC were then analyzed by binary logistic regression analysis. Results Among the 110 HD cases, 17 cases (15.45%) had VC in radial arteries of different degrees. Serum creatinine (1172.33±490.75 μmol/L) and dialysis duration [72.92 (8.40~182.170) months] were significantly higher in patients with severe VC than in those without VC or with mild to moderate VC (P＜0.05). AVF dysfunction was positively correlated with hemoglobin (r=0.408, P=0.000), phosphorus (r=0.256, P=0.007), calcium-phosphorus product (r=0.293, P=0.002), serum creatinine (r=0.309, P=0.001), and dialysis duration (r=0.266, P=0.005). Binary logistic regression analysis showed that hemoglobin correlated with AVF dysfunction. Conclusions Different degree of VC had no effect on AVF dysfunction in one year. Dialysis duration was the main influential factor for VC in HD patients. Higher hemoglobin correlated closely with AVF dysfunction. Metrics

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The impact of sodium concentration in dialysate and sodium gradient on maintenance hemodialysis patients 2015, 14 (11):  654-657.  doi: 10.3969/j.issn.1671-4091.2015.11.004 Abstract ( 322 )   HTML ( 0 )   PDF (410KB) ( 228 )   【Abstract】Background Maintenance hemodialysis (MHD) patients are associated with higher incidence of cardiovascular morbidity and mortality, for which the risk factors include hypertension, overhydration, etc. More interdialytic weight gain (IDWG) usually reflects water overload in MHD patients. Sodium gradient is defined as the difference of sodium concentration in dialysate and in predialysis serum. We hypothesize that lower absolute sodium gradient is associated with lower IDWG, and try to figure out the correlation of sodium gradient with water load and interdialytic hypotention in MHD patients. Methods We conducted a retrospective study on 81 MHD patients in our hemodialysis center from Mar. to Dec. in 2013. Basic clinic data, predialysis and postdialysis serum sodium concentrations, sodium gradient, IDWG, IDWG% (IDWG/dry body weight×100%), and the prevalence of interdialytic hypotension were recorded and analyzed. Results The dialysate sodium was 135 mmol/L for all patients, and the predialytic serum sodium was 138.81±3.27 (130.2～ 145.0) mmol/L with the absolute sodium gradient of 3.92±2.69 (0～10.0) mmol/L. IDWG and IDWG% were 2.06±0.82 (0.50～4.20) kg, and 3.71±1.42 (1.01～8.42) %, respectively. The absolute sodium gradient was positively correlated with IDWG (r=0.349, P=0.001) and IDWG% (r=0.269, P=0.013). The incidence of interdialytic hypotension had no significant correlation with absolute sodium gradient and IDWG. Age was negatively correlated with predialysis serum sodium, absolute sodium gradient, IDWG and IDWG%. Conclusions The absolute sodium gradient was directly associated with IDWG, and higher absolute sodium gradient was associated with higher IDWG. Individualized sodium concentration in dialysate for each MHD patient may be useful for the prevention of overhydration in MHD patients. Metrics

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Serum magnesium level and its correlation with nutritional status in maintenance hemodialysis patients 2015, 14 (11):  658-661.  doi: 10.3969/j.issn.1671-4091.2015.11.05 Abstract ( 353 )   HTML ( 0 )   PDF (392KB) ( 340 )   【Abstract】Objective To investigate serum magnesium level in maintenance hemodialysis (MHD) patients in a single HD center and to compare the serum magnesium (Mg) level with patients’nutritional status. Methods MHD patients with stable clinical conditions in our hemodialysis center were enrolled in this study. Demographic data, primary cause of the end stage renal disease, dialysis vintage, residual renal function were recorded. Body mass index, subjective global assessment (SGA) score, pre- dialytic serum album and Mg were obtained. Demographic data and nutritional markers were compared with the patients with different serum Mg levels. Results A total of 116 patents (69 males and 47 females; males: females=1.5:1) with the average age of 57.8±14.8 years were recruited for this study. The average serum Mg concentration was 1.18±0.14 mmol/L. Ninety- four patients (81.0%) had hypermagnesemia, 22 patients were in normal range, and no patients had hypomagnesemia. Hypermagnesemia patients were younger with higher albumin level, as compared with the patients having normal serum Mg. There were no statistical differences in gender, SGA score, BMI, dialysis vintage, primary cause and residual renal function between patients with normal serum Mg and those with hypermagnesemia. Conclusions Hypermagnesemia is prevalent in MHD patients. Patients with hypermagnesemia are younger with better nutritional status. Metrics

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Study on the improvement of cardiac function by continuous hemodiafiltration in patients with refractory heart failure 2015, 14 (11):  662-666.  doi: 10.3969/j.issn.1671-4091.2015.11.006 Abstract ( 283 )   HTML ( 1 )   PDF (471KB) ( 336 )   Objectives To investigate the improvement of cardiac function by continuous hemodiafiltration in patients with refractory heart failure. Methods Forty patients with refractory heart failure treated in Shihezi People’s Hospital from March 2013 to February 2015 were enrolled in this study. They were assigned into continuous venous- venous hemodiafiltration (CVVHDF) combined with conventional treatment group (experiment group, n=20) or conventional treatment group (control group, n=20) based on patient's preference. Urinary output before and after treatment was measured. Body weight (BW), plasma C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor alpha (TNF-α), and left ventricular ejection fraction (LVEF) were determined before treatment and after the treatment for 48 hours. Changes of these indicators (ΔCRP, ΔIL-6, ΔIL-8, ΔTNF-α, ΔBW, ΔLVEF) were then calculated. Multivariate linear regression model for predicting ΔLVEF was established. Results After the treatment for 48 hours, total fluid output (urine and ultrafiltration volume) was higher in experiment group than in control group (P＜0.001), and the levels of CRP, IL-6, IL-8 and TNF-α decreased significantly (P＜0.05) in experiment group but not in control group (P＞0.05) as compared with those before the treatment. BW became lower and LVEF became higher in both groups (P＜0.05) as compared with those before the treatment. Levels of CRP, IL-6, IL-8 and TNF-α were lower in experiment group than in control group (P＜0.05). BW was lower and LVEF was higher in experiment group than in control group but without statistical significance (P＞0.05). However, the increase of ΔLVEF and decrease of ΔBW were more in experiment group than in control group (P＜0.001). In experiment group, significantly positive correlations were found among ΔBW, ΔCRP, ΔIL-6, ΔIL-8, ΔTNF-αand ΔLVEF (P＜0.05); multiple linear regression analyses showed that ΔBW and ΔTNF-α were the independent factors for ΔLVEF, and ΔBW was the main independent factor for ΔLVEF. In control group, ΔLVEF was positively correlated with ΔBW (P＜0.001) but had no correlation with ΔCRP, ΔIL-6, ΔIL-8 and ΔTNF-α (P＜ 0.05); multiple linear regression analyses showed that only ΔBW was the independent factor for ΔLVEF. Conclusions Continuous hemodiafiltration increases LVEF in patients with refractory heart failure mainly through the clearance of inflammatory factors and especially through the removal of retained fluid. Metrics

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Application of portable water treatment system for maintenance hemodialysis in children with end stage renal disease 2015, 14 (11):  667-671.  doi: 10.3969/j.issn.1671-4091.2015.11.007 Abstract ( 237 )   HTML ( 0 )   PDF (516KB) ( 350 )   【Abstract】Objective To explore the usefulness and safety of single bed mobile dialysis water treatment system for maintenance hemodialysis (MHD) children with end stage renal disease (ESRD) in China. Methods The portable water treatment system is composed of three parts: water pretreatment, water softening and reverse osmosis, producing pure water for hemodialysis. We examined the quality of water from the system and retrospectively reviewed the dialysis adequacy, complication and outcome of 20 MHD children using the water for dialysate in our center during the period from Aug. 2010 to Mar. 2014. Results ①Water quality indices including endotoxin level, bacteria count and heavy metal content were consistent with the criteria of standard operation procedure (SOP) for blood purification issued by Chinese Ministry of Health. Endotoxin level in dialysis water decreased further after improvement of the water pretreatment device beginning from May 2013. Endotoxin reduced to <0.5 EU/ml in all water samples and to <0.25 EU/ml in 88% samples. ②No fever reaction, hemolysis, hard water syndrome and other water related complications occurred in the 20 MHD children using the water for hemodialysis dialysate. In the 20 children, dialysis Kt/V was 1.2±0.23 and urea reduction rate was 66.68±7.32%. After 6 months, 12 months and 18 months of HD therapy, the rate of hemoglobin achieved to the recommended level was 66.7%, 60% and 87.5%, respectively.③ At the end of follow- up, patient survival rate was 100%, 11 cases returned to normal school during MHD therapy, and 4 cases received renal transplantation. Conclusion The quality of dialysis water produced by the portable water treatment system conformed to the standard of dialysis water and was even superior to the criteria of SOP rec-ommendation. This water treatment system i suitable for children with MHD treatment in China, especially in centers with a small number of hemodialysis patients. Metrics

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Effects of calcitriol supplement on mico- inflammation and anemia in maintenance hemodialysis patients 2015, 14 (11):  672-675.  doi: 10.3969/j.issn.1671-4091.2015.11.008 Abstract ( 258 )   HTML ( 0 )   PDF (418KB) ( 361 )   【Abstract】Objective To investigate the prevalence of vitamin D deficiency in patients on maintenance hemodialysis (MHD) and to explore the effects of active vitamin D preparation on micro-inflammation, erythropoietin responsiveness and anemia. Methods We assayed serum 25-hydroxyvitamin D3 (25(OH)D3) level in MHD patients treated in our dialysis center, and then investigated the MHD patients with serum 25(OH) D3 ≤30 ng/ml. Seventy- four patients fulfilled the inclusion criteria, and were randomly divided into two groups: the treatment group (calcitriol 0.25μg every night for 12 weeks; n=37) and the control group (placebo for 12 weeks; n=37). Age, sex ratio, MHD duration, primary renal disease and laboratory parameters were comparable between the two groups. Blood hemoglobin (HGB), dose of erythropoietin (EPO), high-sensitivity C-reaction protein (hs-CRP) and 25(OH)D3 level were measured before and after the treatment. Results ① In the treatment group after the treatment for 12 weeks, HGB increased from 117.25±10.94 g/L to 122.72± 11.16 g/L (P＜0.05), hs-CRP decreased from 4.38±4.15mg/L to 2.92±1.77mg/L (P＜0.05), and EPO dose also decreased but without statistical significance. ② After the treatment for 12 weeks, hs-CRP was significantly lower in the treatment group than in the control group (2.92±1.77mg/L vs. 4.48±3.93mg/L, P＜0.05). HGB was higher in the treatment group than in the control group and EPO dose reduced more in the treatment group than in the control group but without statistical significances (for HGB, 122.72 ±11.16 g/L vs. 118.53± 9.56 g/L, P＞0.05; for EPO dose, 7694.44±3615.10 IU/w vs. 8666.67±4708.66 IU/w, P＞0.05). Conclusions Supplement of calcitriol can improve micro-inflammation, anemia, and EPO responsiveness in MHD patients. Metrics

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Expression changes of aquaporin 1, 5 and urea transporter B1 in brain tissues of uremic mice: the possible molecular basis for the brain-type dialysis disequilibrium syndrome in humans 2015, 14 (11):  676-680.  doi: 10.3969/j.issn.1671-4091.2015.11.009 Abstract ( 201 )   HTML ( 0 )   PDF (659KB) ( 165 )   Objectives To investigate the expression changes of aquaporin (AQP) 1, 5 and urea transporter B1 (UT-B1) in brain tissues of mice with chronic renal failure, which may be useful to explain the molecular basis of brain- type dialysis disequilibrium syndrome in humans. Methods We randomly divided BALB/c mice into 3 groups: normal group, sham operation group, and chronic renal failure group after diathermy of the 2/3 right kidney cortex and then nephrectomy of the left kidney. Five mice in each group were sacrificed at 10 days, 40 days and 70 days after operation. Renal pathology, serum creatinine and blood urea nitrogen were examined. AQP and UT-B1 expressions in brain were assayed by western blotting. Results In chronic renal failure group at 40, 70 days after operation, renal pathological examination showed glomerular proliferation and sclerosis, kidney tubule atrophy and fibrosis. In chronic renal failure group at 10, 40, 70 days after operation, serum creatinine was 841.80±336.93 μmol/L, 1885.17±689.49 μmol/L, and 1276.56±496.09 μmol/L, respectively, significantly higher than that in normal group and that in sham group at 10 days (F= 26.768, P=0.007), 40 days (F=34.928, P=0.004) and 70 days (F=29.998, P=0.005) after operation. In chronic renal failure group, brain AQP1 expression increased by 46.67% (1.10±0.05 vs. 0.75±0.05, t =0.122, P=0.001) at 10 days after operation, by 28.98% (0.89±0.02 vs. 0.69±0.04, t=4.926, P=0.001) at 40 days after operation, and by 30.26% (0.99±0.07 vs. 0.76±0.05, t= 8.471, P=0.001) at 70 days after operation, as compared with that in control group; brain AQP5 expression increased by 41.09% (1.03±0.03 vs. 0.73±0.02, t=0.012, P=0.001) at 10 days after operation, by 20.83% (0.87±0.03 vs. 0.72±0.04, t= 0.857, P=0.003) at 40 days after operation, and by 45.67% (1.18±0.09 vs. 0.81±0.04, t =3.352, P=0.001) at 70 days after operation, as compared with that in control group; brain UT-B1 expression reduced significantly as compared with that in normal group and in sham operation group at 10 days, 40 days and 70 days after operation. Conclusions The increase of AQP1, 5 expressions and decrease of UT-B1 expression in brain of chronic renal failure mice may suggest the molecular basis of brain-type dialysis disequilibrium syndrome in humans. During rapid hemodialysis, delayed urea clearance happened due to the low expression of UT-B1, resulting in a concentration gradient of urea between brain and blood which drives water into brain by the over-expressed aquaporins and brain edema. Metrics

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Internal arteriovenous fistula operation program for small vessels: a clinical study 2015, 14 (11):  681-685.  doi: 10.3969/j.issn.1671-4091.2015.11.010 Abstract ( 224 )   HTML ( 0 )   PDF (465KB) ( 303 )   【Abstract】Objective To explore the best operation program for autologous internal arteriovenous fistula using forearm small vessels in patients with chronic renal insufficiency. Methods Two hundred and twentyfour patients intended to undergo an operation for internal arteriovenous fistula but with arteries and veins ≥ 1.5mm and ＜2.0mm in diameter from preoperative vascular color Doppler ultrasonography were enrolled in this study. According to the vascular conditions at operation, one of the 4 operation methods was selected: endto- end anastomosis (n=21), arteriovenous anastomosis (n=14), end-to-side anastomosis (n=110), and modified end-to-side anastomosis (n=79). The diameter of anastomotic stoma was measured and the maturation index was monitored until maturation of the fistula or 12 weeks after the operation. The correlation of operation type with anastomotic stoma diameter, operation success rate and maturation rate was studied and analyzed. Results The success rate and maturation rate were 57.1% and 58.3%, respectively for end-to-end anastomosis, 78.6% and 63.6%, respectively for arteriovenous anastomosis, 80.9% and 84.3%, respectively for end-to-side anastomosis, and 89.9% and 94.4%, respectively for modified end-to-side anastomosis. The success rate and maturation rate was higher in modified end- to- side anastomosis than in end- to-end anastomosis (P＜0.01). The success rate was similar (P＞0.05) but the maturation rate was different (P＞0.05) between modified endto- side anastomosis and routine end-to-side anastomosis. The success rate and maturation rate were significantly higher in internal fistula operation with anastomotic stoma of 10～15mm diameter than in the operation with anastomotic stoma of ＜10～15mm diameter. Conclusions Modified end- to-side anastomosis is the best operation type for internal arteriovenous fistula of small vessels. Enlarging the anastomotic stoma diameter to 10～15mm during operation favors success and maturation of the internal fistula. Metrics

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Withdrawal time of the punctured needles after blood access on early complications of the freshly used arteriovenous fistulas 2015, 14 (11):  692-695.  doi: 10.3969/j.issn.1671-4091.2015.11.013 Abstract ( 261 )   HTML ( 0 )   PDF (389KB) ( 417 )   【Abstract】Objective To provide the basis for longer use of arteriovenous fistulas, we explored the withdrawal time of the punctured needles after hemodialysis on hemostasis time, exudative bleeding rate and hematoma formation rate at the punctured area, and internal fistula complications in maintenance hemodialysis (MHD) patients with freshly used internal fistulas. Methods A self- control method was carried out for 40 new MHD patients with freshly used internal fistulas. The punctured needle was withdrawn immediately or delayed for 10 min, and the punctured site was pressed for about 10 min after withdrawal. The first 10 punctures with a total of 400 punctures were analyzed. The pressed duration on punctured site and the internal fistula complications were analyzed between immediate withdrawal of the needles after hemodialysis and delayed withdrawal of the needles for 10 min. Results ①Press duration for hemostasis was (7.16±2.08)min and (13.68±3.21) min (t =-10.765, P＜0.001) for delayed and immediate withdrawal of the needles, respectively. Local bleeding volume was 0.98±1.03 ml and (4.15±1.55) ml (t=-10.83, P＜0.001) for delayed and immediate withdrawal of the needles, respectively. ②The prevalence of exudative bleeding, hematoma, and numbness/ swelling was 38.00%, 0.00% and 6.00%, respectively for delayed withdrawal of the needles, and was 51.50%, 4.00% and 22.50%, respectively for immediate withdrawal of the needles (χ2=7.371, 8.163, 25.823, respectively; P＜0.01). Conclusion The needle punctured into internal fistula should be remained in situ for 10 min after hemodialysis, and the punctured site was pressed after withdrawal. This method can significantly reduce the incidence of early fistula complications and extend the useful period of the fistulas. Metrics

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Epidemiological analysis of the maintenance hemodialysis patients over the past 5 years 2015, 14 (11):  698-702.  doi: 10.3969/j.issn.1671-4091.2015.11.015 Abstract ( 500 )   HTML ( 10 )   PDF (475KB) ( 974 )   【Abstract】Objective To obtain the data supporting standardized treatment and continuously improving the quality of hemodialysis, we investigated the current treatment status and epidemiology of maintenance hemodialysis (MHD) patients in our hemodialysis center. Methods We retrospectively reviewed the clinical records of 513 MHD patients treated for more than 3 months in the Blood Purification Center, the Second Hospital of Shanxi Medical University between Jan. 2010 and Dec. 2014. Gender, onset age, medical expense type, primary renal disease, the first vascular access type, complications, changes of treatment, cause of death, and survival rate were analyzed. All related data were collected through the Chinese National Renal Data System. Results ①In our hemodialysis center, the number of hemodialysis patients increased annually. Among the 513 MHD patients, 291 were males and 222 were females with a male/female ratio of 1.3 to 1. ②Most patients with end stage renal disease (ESRD) were in the age of 40 to 49 years and 50 to 59 years. ③In the 431 patients with defined causes of ESRD, the top 3 primary causes were glomerulonephritis (48.0%), diabetic nephropathy (25.9%), and hypertensive nephrosclerosis (10.7%). ④The first used vascular access at the beginning of hemodialysis was temporary central venous catheter (76.8% ), and primary arteriovenous fistula (21.5%). ⑤Anemia was the most common complication, followed by hypertension, bone and mineral disorders. The rates achieved to the recommended levels of hemoglobin, blood pressure, blood calcium, blood phosphorus and IPTH were less than 50%. ⑥Among 513 MHD patients, 12 received renal transplantation, 11 changed to peritoneal dialysis, 385 transferred to other hospitals for hemodialysis, 5 got rid of dialysis, 9 gave up the treatment, 24 died, and 67 were still hospitalized in our unit. Cardiovascular and cerebrovascular incidences were the leading causes of death. ⑦The survival rate of MHD patients was different: 93.3% in one year, 75.3% in five years, 14.6% in ten years, and one for more than 228 months and still under regular dialysis. Conclusion In our dialysis center, the majority of the MHD patients were middle aged and elderly males. The first three primary causes leading to ESRD were glomerulonephritis, diabetic nephropathy, and hypertensive nephrosclerosis. The major vascular access at the beginning of hemodialysis was temporary central venous catheter, suggesting that timely hemodialysis should be emphasized. The incidence rate of anemia, hypertension, bone and mineral disorders were high, but the control rates were low. Cardiovascular and cerebrovascular incidences were the leading cause of death. As the hemodialysis treatment was prolonged, the longterm survival rate of MHD patients was gradually reduced. Metrics