Chinese Journal of Blood Purification

12 March 2017, Volume 16 Issue 03 Previous Issue    Next Issue

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The possible problems and their solutions in the development of hemodialysis in local community 2017, 16 (03):  145-147.  doi: 10.3969/j.issn.1671-4091.2017.03.001 Abstract ( 485 )   PDF (364KB) ( 499 )   In China, the number of patients under maintenance hemodialysis increases significantly. Now hemodialysis centers belonging to the public hospitals are fully occupied, while community hemodialysis centers are growing. In this review, we first discuss the current situation of dialysis in China and worldwide, and then comment on the possible problems and their solutions including government policy and implementation conditions (cost for space, equipment, consumables, laboratory examinations and personnel) in the development of community hemodialysis in China Metrics

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The effectiveness and safety of Jerry automated peritoneal dialysis machine for maintenance peritoneal dialysis patients: a multicenter, randomized, and two phase crossover trial 2017, 16 (03):  148-153.  doi: 10.3969/j.issn.1671-4091.2017.03.002 Abstract ( 1141 )   PDF (507KB) ( 618 )   Objective To evaluate the effectiveness and safety of Jerry automated peritoneal dialysis (APD) machine for maintenance peritoneal dialysis (PD) patients through a prospective, multicenter, randomized and controlled trial. Methods This study was carried out in 6 PD centers in China, and chronic renal failure patients treated with PD for more than 3 months were enrolled. Patients in the experimental group used JARI-APD-1AAPD machine, and those in the control group used Baxter HomeChoice APD machine. The calculated sample size should be 84 patients. A multicenter, randomized, two phase crossover, opened, and positive control trial was designed, and each phase lasted for one day. The primary effectiveness indices included consistency between displayed value and measured value of single cycle drainage volume and single cycle infusion volume. The secondary effectiveness indices included accuracy of temperature control, toxin removal, and correction of electrolyte and acid- base imbalance. Results from Jerry APD machine were compared to those from Baxter APD machine by non-inferiority test. The safety indices included clinical symptoms, vital signs, and occurrence of machine malfunction. SAS 9.4 software was used to analyze the results. Results ① A total of 84 patients (47 males and 37 females, average age 45.33±11.34 years old) were enrolled in this study. The predominant primary disease was chronic glomerulonephritis, accounting for 50% of the patients. The average dialysis duration was 37.70±27.67 months. ②As for primary effectiveness indices, the consistency between displayed value and measured value of single cycle drainage volume was 97.62% in experimental group, accurately controlling the single cycle drainage volume and not inferior to that (98.81%) in control group (Z=4.315, P＜0.001); the consistency between displayed value and measured value of single infusion volume reached the accuracy of volume control in both groups and showed no difference between the two groups by non-inferiority test (Z=9.456, P＜0.001). ③As for secondary effectiveness indices, the measured temperature was consistent with the required accuracy in both groups, and experimental group was not inferior to control group in this index; the changes of blood urea, creatinine and electrolytes before and after the treatment also had no differences between the two groups. ④As for safety indices, the presence of uncomfortable symptoms, adverse events, and vital sign changes had no differences between the two groups. No machine malfunction was seen in both groups. Conclusions The multicenter randomized, opened, and two phase crossover clinical trial showed that the Jerry APD machine conformed to the standards of primary effectiveness indices, secondary effectiveness indices, and safety indices. Jerry APD machine is not inferior to Baxter APD machine in the effectiveness and safety indices. Metrics

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A nutritional and dietary survey among CKD outpatients 2017, 16 (03):  154-157.  doi: 10.3969/j.issn.1671-4091.2017.03.003 Abstract ( 421 )   PDF (385KB) ( 488 )   Objective To perform a survey to evaluate diet and nutritional status among outpatients with CKD and to provide the bases for nutritional management in CKD patients. Methods The CKD outpatients followed in Peking University First Hospital were enrolled in this study. General characteristics including sex, age and follow-up period, estimated glomerular filtration rate (eGFR) and past dietary instruction were collected. Body mass index (BMI) was calculated, and subjective global assessment (SGA) was used to evaluate the nutrition status of the patients. Dietary information was collected using three-day food diary under the instruction of dietitians. Daily energy, protein, and high quality protein intake were calculated using corresponding software according to Chinese Food Ingredients (2002). At the same time, recommended intake was given by dietitians. Results A total of 120 patients (average age 60.491±14.167 years old) with CKD were enrolled. The average follow-up time was 3.403±2.707 years, and most of the patients were in CKD stage 3～4. Eight of the patients (6.667%) had BMI less than 18.5, and 16 patients (13.333%) were defined as mild to medium malnutrition (Stage B) by SGA evaluation. The actual daily energy intake was 26.798±6.236 kcal/kg· d, significantly lower than the recommended intake of 28.677±2.584 kcal/kg· d (t=-3.194, P=0.002) by dietitians. The actual daily protein intake was 0.963±0.281 g/kg· d, significantly higher than the recommend intake of 0.736± 0.090 g/kg· d (t=9.053, P＜0.001). However, the actual high quality protein intake ratio was 44.230±12.933%, significantly lower than the recommended ratio of 60.000±0.000% (t=-13.355, P＜0.001). Conclusions Our study indicates that malnutrition is not rare among CKD outpatients and the actual dietary condition is not quite rational concerning the recommendations by the guideline. Therefore, the nutritional management of CKD outpatients needs to be reinforced. Metrics

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Observational research of cinacalcet combined with small dose of calcitriol for the treatment of refractory secondary hyperparathyroidism in continuous ambulatory peritoneal dialysis patients 2017, 16 (03):  158-161.  doi: 10.3969/j.issn.1671-4091.2017.03.004 Abstract ( 530 )   PDF (382KB) ( 388 )   Objective To study the effect of cinacalcet combined with small dose of calcitriol for the treatment of refractory secondary hyperparathyroidism (SHPT) in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods We recruited 16 CAPD patients with SHPT refractory to short period of large dose of calcitriol during the period from May 2015 to Jan. 2016. We then observed the effect of cinacalcet combined with small dose of calcitriol in these patients. Serum and urine samples were collected, parathyroid ultrasonography was examined, and serum Ca, P, ALP, iPTH and albumin were assayed before and after the therapy. Results After the therapy of cinacalcet combined with small dose of calcitriol, serum iPTH, Ca, P, and CaxP product decreased significantly, as compared with those before the treatment (iPTH: 257.84±99.82 pg/ml, F=13.152, P<0.01; Ca: 2.22±0.11 mmol/L, F=4.602, P<0.05; P: 1.28±0.37 mmol/L, F= 8.723, P<0.01; CaxP product: 34.69±9.54 mmol2/L2, F=8.683, P<0.01); hemoglobin and albumin changed insignificantly (Hb: 112.81±10.80 g/L, F=0.744, P＞0.05; albumin: 37.34±4.98 g/L, F=0.624, P＞0.05). After the therapy, the size of parathyroid decreased in 8 of the 12 patients with parathyroid hyperplasia; in 13 symptomatic patients, clinical symptoms alleviated in 11 patients and relieved in one patient, and parathyroidectomy was conducted in one patient. Conclusion Cinacalcet combined with small dose of calcitriol is effective, noninvasive and low risk for the treatment of CAPD patients with refractory SHPT. Parathyroidectomy may not be necessary in some patients using this therapy. We recommend this therapy as the primary management for CAPD patients with refractory SHPT. Metrics

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Analysis of the causes of initiating dialysis in maintenance hemodialysis patients in a single center for 20 years 2017, 16 (03):  162-166.  doi: 10.3969/j.issn.1671-4091.2017.03.005 Abstract ( 328 )   PDF (559KB) ( 354 )   Objective To analyze the primary disease, the difference in clinical manifestation and the reason for initiating dialysis between diabetic nephropathy (DN) group and non-DN group, and the vascular access in the hemodialysis patients in our center in the recent 20 years. Methods We recruited the patients initiating the maintenance hemodialysis (MHD) during 1994 to 2015. Their primary disease, the direct cause leading to dialysis initiation, vascular access and laboratory tests were recorded. The differences in these parameters in DN and non-DN patients between the first 10-year period and the second 10-year period in 1994- 2015 were compared. Results A total of 289 patients were recruited. The leading primary disease was glomerulonephritis, followed by DN and hypertension. The proportion of DN patients increased significantly (16.000% to 21.296%) in the second 10-year period. At the initiating dialysis in DN patients, serum creatinine level was relatively low (659.036±350.533 μmol/L vs. 877.452±386.593μmol/L, t=3.789, P＜0.001), anemia was relatively severe (86.839 ± 18.890 g/L vs. 93.092 ± 22.795 g/L, t=2.064, P=0.041), serum phosphorus (1.648±0.481 mmol/L vs. 2.006±0.753 mmol/L, t=3.865, P＜0.001) and iPTH (236.150±203.332 pg/ml vs. 460.647±480.166 pg/ml, t=2.766, P=0.007) were relatively low, and metabolic acidosis was not very heavy (t=-2.483, P=0.014). The direct cause to initiate hemodialysis was mainly heart failure/edema in DN group and uremic symptoms in non-DN group. In the second 10-year period, blood urea nitrogen (30.427±14.519 mmol/L vs. 24.865±7.517 mmol/L, t=-1.312, P=0.036) increased significantly in all patients, but serum potassium (4.676±0.945 mmol/L vs. 5.200±0.745 mmol/L, t=1.880, P=0.037), calcium (2.154±0.369 mmol/L vs. 2.395±0.270 mmol/L, t=2.033, P=0.037), and iPTH (399.920±435.836 pg/ml vs. 968.000±705.377 pg/ml, t= 2.399, P=0.020) were controlled better than those in the first 10year period. Most patients initiated hemodialysis with central venous catheterization as the blood access. The proportion of arteriovenous fistula (AVF) for blood access had no significant change. Conclusions The leading primary disease of MHD was glomerulonephritis in our center, but the proportion of DN as the primary disease increased significantly in recent 10 years. DN patients initiated MHD earlier and often due to the refractory heart failure/edema. Controlling of chronic kidney disease complications became better in the recent 10 years. We should carefully take account of the appropriate time to create and the use of AVF in CKD patients. Metrics

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A clinical study about the intervention of morning blood pressure surge in maintenance hemodialysis patients 2017, 16 (03):  167-170.  doi: 10.3969/j.issn.1671-4091.2017.03.006 Abstract ( 321 )   PDF (369KB) ( 478 )   Objective To investigate the intervention of morning blood pressure surge (MBPS) in maintenance hemodialysis (MHD) patients. Methods Ambulatory blood pressure monitoring was done in 260 MHD patients. According to the diagnostic criteria of MBPS, MHD patients with MBPS were selected as the research objects. They took the antihypertensives of levamlodipine besylate and telmisartan before sleep for 12 weeks to interfere with MBPS. Ambulatory blood pressure monitoring was conducted before and after the antihypertenive intervention. QT dispersion (QTd), left ventricular mass index (LVMI) and intima- media thickness (IMT) were also measured. Results ①24h SBP, postprandial 2 hours blood glucose, triglyceride and age of the patients were higher in MBPS group than in non-MBPS group (24h SBP: t=4.518, P=0.001; postprandial 2 hours blood glucose: t=15.361, P=0.000; triglyceride: t =5.338, P=0.000; age: t=2.472, P=0.013); urea clearance index (kt/V) and hemoglobin were lower in MBPS group than in non-MBPS group (Kt/V: t =4.750, P=0.001; Hb: t =3.477, P=0.001). ②In MBPS group after the treatment, 24h SBP, mean systolic blood pressure at night (nmSBP), and mean systolic blood pressure drop rate at night decreased significantly (24h SBP: t=4.518, P=0.001; nmSBP: t=5.964, P=0.001; mSBP drop rate at night: t=5.964, P=0.001); MBPS, mean systolic blood pressure at day (dmSBP), and 2h mSBP in the morning decreased more significantly as compared with those before treatment (MBPS: t=7.280, P=0.000; dmSBP: t=8.547, P=0.000; morning 2h mSBP: t=9.002, P=0.000); diastolic blood pressure at night (nmDBP) drop rate (t=2.431, P=0.018) and nondipper hypertension rate (26% vs. 12%) decreased after the treatment. ③QTd, LVMI and IMT were abnormal in MHD patients with MBPS; QTd and IMT decreased after treatment (QTd: t=4.873, P=0.001; IMT: t=5.004, P=0.000). ④ Levamlodipine besylate and telmisartan have a higher trough to peak ratio (T/P) and smoothness index (SI). Conclusion MBPS exists in MHD patients; Levamlodipine besylate and telmisartan taken before sleep can effectively interfere with MBPS. Metrics

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Comparative study of different methods in the treatment of refractory secondary hyperparathyroidism in maintenance hemodialysis patients 2017, 16 (03):  171-175.  doi: 10.3969/j.issn.1671-4091.2017.03.007 Abstract ( 473 )   PDF (525KB) ( 706 )   Objective To investigate the efficacy and safety of paricalcitol plus cinacalcet and to compare the curative effect of paricalcitol plus cinacalcet with parathyroidectomy (PTX) for the treatment of refractory secondary hyperparathyroidism (SHPT) in patients on maintenance haemodialysis (MHD). Methods MHD patients with refractory SHPT treated in the First Affiliated Hospital of Harbin Medical University between Dec. 2013 and Jun. 2016 were enrolled in this retrospective study. Patients were divided into two groups: PTX group (n=11) and medication group (paricalcitol plus cinacalcet, n=13). Efficacy of the treatment was evaluated by changes of serum calcium (Ca), phosphorus (P), calcium-phosphate product, intact parathyroid hormone (iPTH), alkaline phosphatase (AKP) and clinical symptom before and after paricalcitol plus cinacalcet therapy for one week, 1, 3 and 6 months. Age, duration of dialysis, and plasma albumin were collected. Drug doses were adjusted according to the results of laboratory examinations. We compared the clinical indicators at the same treatment time points between the two groups. Results In PTX group after the surgery for one week, 1, 3 and 6 months, serum Ca, Ca×P product, iPTH and AKP decreased significantly (serum Ca: F=18.908, P<0.001; Ca×P: F=21.884, P<0.001; serum iPTH: F=24.251, P<0.001; serum AKP: F=95.459, P=0.001). In medication group after the treatment for 1, 3 and 6 months, serum Ca and iPTH decreased significantly (serum Ca: F=7.671, P<0.00; serum iPTH: F=4.037, P=0.006); serum P and AKP remained stable throughout the treatment period (serum P: F=0.378, P=0.824; serum AKP: F=0.718, P=0.583). Compared the differences between PTX group and medication group after the treatment for 6 months, serum Ca, serum P, Ca×P product and AKP had no significant differences (serum Ca: 2.40±0.15 mmol/L vs. 2.44±0.14 mmol/L, t=-0.797, P=0.434; serum P: 1.98±0.25 mmol/L vs. 2.20±0.39 mmol/L, t=-1.616, P=0.120; Ca×P: 4.74±0.27 mmol2/L2 vs.5.38±1.02 mmol2/L2, t=-1.740, P=0.096; serum AKP: 85.50±38.43 U/L vs. 113.33±36.83 U/L, t=-1.815, p=0.083), but serum iPTH differed significantly (525.81±242.12 pg/ml vs. 809.22±372.87 pg/ml, t=-2.161, P=0.042 ). Conclusions Both paricalcitol plus cinacalcet and PTX were able to treat the refractory SHPT. PTX quickly improved the higher serum Ca and P and bone metabolism. However, the long-term effects should be evaluated further through expanding the sample size and the observation period. Metrics

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Application of continuous blood purification for the treatment of severe viral encephalitis 2017, 16 (03):  176-178.  doi: 10.3969/j.issn.1671-4091.2017.03.008 Abstract ( 297 )   PDF (381KB) ( 382 )   Objective To study the clinical significance of continuous blood purification for the treatment of severe viral encephalitis. Methods We recruited 30 children with severe viral encephalitis treated in our hospital and divided them into treatment group (n=15) and control group (n=15). In treatment group, the patients were treated with continuous blood purification at bedside in addition to the routine therapy for encephalitis. Duration of fever, coma and seizures, hospitalization day, NSE (neuron- specific enolase), S100 protein and Glasgow Outcome Scale (GOS) were compared between the two groups. t test and X2 test were used for the analyses. Results The duration of fever, coma and seizures, hospitalization day, NSE level, S100 protein level and GOS were statistically different between the two groups (fever: t=2.289, P=0.030; coma: t=3.098, P=0.004; seizures: t=2.348, P=0.026; hospitalization day: t=2.213, P=0.035; NSE: t=2.841, P=0.008; S100 protein: t=2.192, P=0.037; GOS: χ2=4.774, P=0.029). Conclusion Blood purification can improve the prognosis of severe viral encephalitis patients at early stage. Metrics

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Burden of family caregiver for hemodialysis patients and its influence factors 2017, 16 (03):  179-182.  doi: 10.3969/j.issn.1671-4091.2017.03.009 Abstract ( 298 )   PDF (391KB) ( 356 )   Objective To investigate the burden of family caregivers for hemodialysis (HD) patients and its influence factors. Methods A total of 120 family caregivers for HD patients were investigated by the general self-designed questionnaire and zarit burden interview (ZBI). Results Total ZBI score of the caregivers was 30.28 ± 17.27, and 67.5% caregivers felt caregiver burden. The factors influencing the burden included social support, self- care ability, caregiver gender and the time spent on care (social support: β =-0.781, P＜0.001; self-care ability: β=0.236, P<0.001; caregiver gender: β=0.280, P=0.001; the time spent on care: β =-0.025, P =0.005). Conclusion Caregivers should have proper guidance and help to alleviate their physical and mental burden, in order to improve the quality of life of caregivers and hemodialysis patients. Metrics

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The mechanism of venous neointimal hyperplasis before the AVF operation in ESRD patients 2017, 16 (03):  183-187.  doi: 10.3969/j.issn.1671-4091.2017.03.010 Abstract ( 479 )   PDF (2448KB) ( 451 )   Objective Recently, some researchers found that venous neointimal hyperplasis existed before AVF operation in ESRD patients. We explored the mechanism of the venous neointimal hyperplasis. Methods We screened out 8 patients with venous neointimal hyperplasis during the first AVF operation (the AVF operation group), and 8 patients with venous neointimal hyperplasis during ateriovenous fistula repair operation (the AVF repair group). Venous samples were subjected to immunohistochemistry for the expression of smooth muscle actin (SMA), vimentin, desmin and a disintegrin-like and metalloproteinase with thrombospondin type l motifs-1 (ADAMTS1) to explore the mechanism of venous neointimal hyperplasis. Result In the AVF operation group, most cells in the hyperplastic neointima layer were myofibroblasts with SMA+, vimentin+ and desmin-, and a few cells were contractile smooth cells with SMA+, vimentin- and desmin+. In the AVF repair group, almost all cells in the hyperplastic neointima layer were myofibroblasts with SMA+, vimentin+, and desmin-. ADAMTS1 staining was negative in the AVF operation group and was positive in one venous sample in the AVF repair group. Conclusion Myofibroblasts play an important role in the neointimal hyperplasis before AVF operation in ESRD patients. Blocking the phenotypic transformation and migration of smooth muscle cells may be an effective way to cure the neointimal hyperplasis. Metrics

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The establishment and safety evaluation of a rabbit model for hemoperfusion 2017, 16 (03):  188-191.  doi: 10.3969/j.issn.1671-4091.2017.03.011 Abstract ( 348 )   PDF (846KB) ( 510 )   Objective To establish a rabbit model for hemoperfusion (HP) from peripheral vessels and to evaluate the safety of the animal model. Methods Twelve rabbits were randomly divided into two groups. For rabbits in HP group (n=6), the central ear artery at one side and ear marginal vein at the other side were cannulated with indwelling needles. Arterial indwelling needle, roller pump, hemoperfusion apparatus, triple valve and vein indwelling needle were connected by pipes. HP then begun and lasted for 2 hours with blood flow volume of 2mL/min. Blood sample were collected before HP and 2, 4, 8 and 24h after HP for blood routine, plasma proteins including total protein (TP), albumin (Alb) and globulin (Glb), and plasma electrolytes including Na+, K+, Ca2+and Cl- assays to evaluate the safety of the rabbit HP model. Control group (n=6) were managed as same as HP group except no hemoperfusion apparatus in the circuit. Results The rabbit HP model worked well and no animal died during HP. There were no significant changes in RBC (F=0.386, P=0.548), MCV (F=0.041, P=0.844), Hb (F=0.375, P=0.554), WBC (F=0.005, P=0.943), lymphocytes (F=0.212, P=0.655), monocytes (F=0.508, P=0.492), neutrophils (F=0.026, P=0.875), platelets (F=1.270, P= 0.286), mean platelet volume (F=0.037, P=0.851), Na+ (F=1.012, P=0.338), K+ (F=0.001, P=0.972), Ca2 + (F=1.812, P=0.208), TP (F=4.929, P=0.051) and Glb (F=2.641, P=0.135). However, Alb decreased after HP (F=27.490, P=0.000), and Cl- increased after HP (F=11.040, P=0.008). Conclusion The rabbit HP model was established successfully, safety evaluation showed that it is suitable for further research. Metrics

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Clinical value of color Doppler ultrasonography in the early diagnosis of arteriovenous fistula stenosis 2017, 16 (03):  199-200.  doi: 10.3969/j.issn.1671-4091.2017.03.014 Abstract ( 313 )   PDF (513KB) ( 334 )   Objective To study the clinical value of color Doppler ultrasonography in the early diagnosis of arteriovenous fistula stenosis. Methods Color Doppler ultrasonography was performed in 68 patients clinically considered to have arteriovenous fistula stenosis. We record the peak systolic velocity in the fistula and its upstream artery and calculated the blood flow velocity ratio. Results We found fistula stenosis and the blood flow velocity ratio ≥ 2.5 in 61 cases; the remaining 7 cases were negative, i.e., their blood flow velocity ratio ＜2.5. Conclusion Color Doppler ultrasonoggraphy is an effective method for the early diagnosis of arteriovenous fistula stenosis in clinical practice. Metrics

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Contrast enhanced ultrasonography to identify the tip position of tunneled cuffed catheter 2017, 16 (03):  201-203.  doi: 10.3969/j.issn.1671-4091.2017.03.015 Abstract ( 312 )   PDF (595KB) ( 348 )   Objective To explore the usefulness of conventional ultrasonography and contrast enhanced ultrasonography (CEUS) to identify the tip position of tunneled cuffed catheter (TCC). Methods A total of 45 patients were subjected to TCC placement under the guidance of body landmark and Seldinger’s techniques and beside real-time ultrasonography. After insertion of the catheter, conventional ultrasonography via subxiphoid cardiac view was used to observe the tip position. If the catheter tip was not visible on conventional ultrasonography, CEUS was performed to further confirm the catheter tip position. If the catheter tip was not in its target position, prompt adjustment was made. After the manipulation, a chest radiograph was made to reconfirm the tip positioning. Results Conventional ultrasonography identified the catheter tips in 77.8% (35/45) patients, and CEUS identified the tip position in the remaining 10 patients. Only 62.2% catheter tips located at the target position at the first attempt, and adjustment of the catheter tips was required in the remaining patients. Conclusions Conventional ultrasonography combined with CEUS can accurately and promptly identify the tip position of TCC. This method is safe, accurate, time-saving, convenient and free of radiation. We recommend its use following TCC insertion. Metrics

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A clinical study of percutaneous innominate vein catheterization for long-term hemodialysis vascular access 2017, 16 (03):  204-207.  doi: 10.3969/j.issn.1671-4091.2017.03.016 Abstract ( 349 )   PDF (688KB) ( 374 )   Objective This study aims to evaluate the safety and efficacy of percutaneous innominate vein catheterization for long-term hemodialysis vascular access. Method End-stage renal disease patients requiring long-term central venous access, suitable for innominate vein catheterization and treated in our hospital from Jan. 2014 to Jan. 2016 were enrolled in this study. Clinical history and preoperative examinations were carefully evaluated. Innominate vein catheterization was performed under X-ray fluoroscopy. Procedurerelated complications were recorded, and the patency of hemodialysis access was followed up. Results A total of 19 patients (4 male, 21.1%) were included in this study, with an average age of 63.6±8.4 yr and a median dialysis time of 30 (10, 84) months. All patients were successfully operated, and the catheters functioned well immediately after catheterization. After discharge, the patients were followed up for a median of 12 (6,20) months. All patients survived except one patient who died of upper gastrointestinal bleeding. No procedure- related major complication occurred. Three patients (15.8%) were hospitalized for access dysfunction, and the catheter function recovered after proper manipulation. The 12-month primary patency of accesses was 84.2%, and the secondary patency reached 100%. Conclusion Percutaneous innominate vein catheterization established under fluoroscopy guidance is safe and efficient for long-term hemodialysis access Metrics

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Explanation of Prisma Flex’s pressure testing principle and analysis of the breakdown repairmen 2017, 16 (03):  208-210.  doi: 10.3969/j.issn.1671-4091.2017.03.017 Abstract ( 482 )   PDF (819KB) ( 574 )   Objective In this paper, the causes and corresponding solutions of boot pressure self-checking failure of Baxter Prisma Flex continuous blood purification machine are explored through pressure test, seal test and reset of pressure scabbard film, in order to provide a practical and feasible maintenance method and route for peers treating continuous blood purification machine pressure failure. Methods The causes of the failure are examined and solved through equipment cabin programs for pressure test, seal test and reset of scabbard film to analyze the error code of self-check alarm, fault component prompt and corresponding sensor output value according to the principle of pressure test. Results This method follows the principle of stress test combined with the pressure self-check alarm prompt, which can quickly find out the fault location and the exact solution and is different from the method that needs professional pressure testing instrument and complex test procedures recommended in manufacturer maintenance manual. Conclusion Best knowledge about the Prisma Flex pressure testing principle is fundamental to analyze and solve the problems. The thought that systematically determines and excludes the problems using the pressure self-checking prompt is worthwhile to be recommended, and has a practical significance. Metrics