Chinese Journal of Blood Purification

12 June 2017, Volume 16 Issue 06 Previous Issue    Next Issue

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The mechanism and progression of vascular calcification in dialysis patients 2017, 16 (06):  361-363.  doi: 10.3969/j.issn.1671-4091.2017.06.001 Abstract ( 423 )   PDF (363KB) ( 441 )   Vascular calcification is an active process of vascular smooth muscle cells (VSMC) trans-differentiating into osteoblast-like cells under precise control. Hyperphosphatemia induces VSMC trans-differentiating into osteoblast- like cells and up-regulation of fibroblast growth factor (FGF23), which together with Klotho is the pathogenic factor for vascular calcification. Higher serum FGF23 is associated with vascular calcification, but Klotho protein expression is significantly reduced in kidney tissues of chronic renal failure patients. In animal uremia models, supplement of recombinant osteoprotegerin (OPG) alleviates vascular calcification in mice with insufficient LDL receptors, and increase of the receptor activator of nuclear factor-kappa B ligand (RANKL) mediates the vascular calcification induced by angiotensin II. The effects of oxidative stress on vascular calcification may relate to the peroxide products and the lower resistance to oxidative stress. High turnover bone disease is the most common osteopathy in uremic patients. Higher serum parathyroid hormone (PTH) promotes bone reconstruction, osteoclast formation and bone re-absorption. The decrease of calcification inhibitors such as fetuin A and pyrophosphate in the serum of uremic patients also accelerates the vascular calcification. Metrics

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Advances in the diagnosis and treatment of cardiovascular disease in chronic kidney disease patients 2017, 16 (06):  364-366.  doi: 10.3969/j.issn.1671-4091.2017.06.002 Abstract ( 300 )   PDF (355KB) ( 395 )   Cardiovascular disease (CVD) is one of the most important complications and the primary cause of death in chronic kidney disease (CKD) patients. The incidence of CVD increases dramatically with the development of CKD. Heart and kidney are pathophysiologically interacted each other. The risk factors for CVD in CKD patients are generally divided into traditional factors (those similar in healthy people) and nontraditional factors (those specific in CKD patients). Early prevention and treatment of CVD in CKD patients depend on the timely evaluation of CVD presentations and the risk factors for CVD and its complications and on the management of CVD progression, CVD risk factors and various complications derived from end stage renal disease. Metrics

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Studies on the target values of serum calcium, phosphorus and PTH for the treatment of chronic kidney disease-mineral and bone disorder Ya-ping FAN 2017, 16 (06):  367-369.  doi: 10.3969/j.issn.1671-4091.2017.06.003 Abstract ( 429 )   PDF (374KB) ( 1624 )   Chronic kidney disease- mineral and bone disorder (CKD-MBD) is a common complication during the progression of CKD, closely relating to the hospitalization rate, poor quality of life, cardiovascular calcification and cardiovascular or all- cause mortality in CKD patients. It is an important issue for clinical workers to identify the CKD-MBD related control targets of serum calcium, phosphorus and PTH values, and a series of clinical guidelines and consensus have been provided in the past years. The target values for serum calcium and phosphorus are basically consistent, i.e. to achieve and maintain the values in the normal reference ranges when possible. The calcium-phosphorus product is mainly affected by the phosphorus concentration and has less significance. The target value for PTH is quite broad. The suggestion in KDIGO guidelines that intact PTH (iPTH) should be controlled in 2-9 times of the upper normal limit is widely mentioned but is controversial. However, a narrow range for iPTH cannot be defined in the published results so far. Clinically, the dynamic changes of CKD-MBD parameters are more valuable than a single value of one parameter. Metrics

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Analyses of related factors and prevention strategy for vascular calcification in hemodialysis patients 2017, 16 (06):  370-372.  doi: 10.3969/j.issn.1671-4091.2017.06.004 Abstract ( 504 )   PDF (347KB) ( 435 )   The final treatment step for chronic kidney disease patients is maintenance dialysis. The selection of hemodialysis (HD) or peritoneal dialysis (PD) is based on conditions of the patients. HD patients have more factors for vascular calcification. The traditional factors include dyslipidemia, hypertension and diabetes. The nontraditional factors include the serum levels of FGF-23, Klotho, the extracellular end product receptor for advanced glycation end products (RAGE) binding protein S100A12 (EN-RAGE), serum soluble tumor necrosis factor like weak inducer of apoptosis (STWEAK), and fetuin A. This review further describes the factors involved in vascular calcification in hemodialysis patients and the strategies to reduce the risk of vascular calcification in dialysis patients. Metrics

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Relationship between low serum parathyroid hormone, malnutrition, inflammation, and adynamic bone disease in hemodialysis patients 2017, 16 (06):  373-377.  doi: 10.3969/j.issn.1671-4091.2017.06.005 Abstract ( 335 )   PDF (465KB) ( 493 )   Objective To investigate the influence factors for serum iPTH (intact parathyroid hormone, 1-84 PTH), and the relationship between low serum PTH,malnutrition, inflammation, and adynamic bone disease in hemodialysis patients. Methods A total of 162 maintenance hemodialysis patients were divided into low PTH group (iPTH≤150 pg/ml; n=77) and control PTH group (150 pg/ml＜iPTH ≤600 pg/ml;n=85). Anthropometrical parameters including triceps skin fold (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC) and body mass index (BMI) were collected. Serological markers including iPTH, Creactive protein (CRP), prealbumin (PA), albumin (ALB), total iron binding capacity (TIBC), serum calcium, serum phosphorus, triglyceride (TG), low density lipoprotein (LDL), total cholesterol (TC), interleukin 1β (IL-1β), interleukin 6 (IL-6) and bone alkaline phosphatase (BALP) were assayed. Albumin corrected calcium and calcium phosphorus product (Ca×P) were calculated. Malnutrition inflammation score (MIS) was assessed for nutritional status. Results Serum iPTH was negatively correlated with CRP (r=-0.297, P＜0.05), IL-1β (r=-0.334, P＜0.05) and albumin corrected calcium (r=-0.393, P＜0.01), and positively correlated with PA (r=0.426, P＜0.01), serum phosphorus (r=0.579, P＜0.01) and Ca×P (r=0.432, P＜0.01). PA was significantly lower in low PTH group than in control PTH group (349.75±78.29 g/L vs. 393.47±75.02 g/L, P＜0.05), while CRP, IL- 1β and MIS were significantly higher in low PTH group than in control PTH group [4.99 ± 3.40 mg/l vs. 3.28 ± 1.79 mg/l, P＜0.05 for CRP; 1476.09 (563.63～4020.16) pg/ml vs. 659.31 (466.79～1888.53) pg/ml, P＜0.05 for IL-1β; 12.23±5.59 vs. 9.0±4.23, P＜0.05 for MIS], indicating that low serum PTH is associated with malnutrition inˇammation complex syndrome (MICS). Serum BALP was generally low within 0.61～5 μg/L, indicating the lower bone metabolism rate in all hemodiaysis patients. Conclusion Serum iPTH was related to serum CRP, IL-1β, PA, albumin corrected calcium, serum phosphorus and Ca×P product. Low serum PTH was associated with MICS. Low serum BALP found in all hemodiaysis patients indicated lower bone metabolism rate. Appropriate intervention to improve nutritional status and to inhibit inflammation may be helpful in patients with low serum PTH and adynamic bone disease. Metrics

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Effect of lanthanum carbonate on vascular calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: a prospective pilot study 2017, 16 (06):  378-382.  doi: 10.3969/j.issn.1671-4091.2017.06.006 Abstract ( 1292 )   PDF (439KB) ( 448 )   Objective To explore the effect of lanthanum carbonate on vascular calcification and bone mineral density in maintenance hemodialysis (MHD) patients with diabetes complicated with adynamic bone disease. Methods A total of 92 MHD cases were divided into calcium carbonate (CC) group and lanthanum carbonate (LC) group. We compared serum calcium, phosphate, FGF23, bone alkaline phosphate (BALP), procollagen I N-terminal peptide (PINP), C-terminal telopeptide (β-CTX), matrix gla protein (MGP) and hsCRP, coronary artery calcification score (CACS) and bone mineral density at baseline and after 12 months between the two groups. SPSS 17.0 for Windows was used for statistical analyses. Results After the treatment for 12 months, serum levels of phosphate, FGF23 and MGP decreased significantly and serum levels of iPTH, BALP, PINP and β-CTX, CACS, and bone mineral density increased significantly in LC group, as compared with those at baseline (P＜0.05). After the treatment for 12 months, serum levels of calcium, phosphate, FGF23 and MGP, and CACS were lower in LC group than in CC group, and serum levels of iPTH, BALP, PINP and β-CTX, and bone mineral density were higher in LC group than in CC group. Pearson’s correlation analyses revealed that bone mineral density in forearm correlated positively with iPTH and MGP and negatively with CACS, and that CACS correlated positively with serum calcium, phosphate and FGF23 and negatively with serum MGP. Multivariate linear regression revealed that the changes of bone mineral density in forearm and collum femoris and serum FGF23 were the independent influence factors for the change of CACS (P＜0.05). Conclusions Slower progression of coronary artery calcification, improved bone turnover and increased bone mineral density occurred in the LC group as compared with those in the CC group. These results may result from the effects that lanthanum carbonate improves phosphate and MGP metabolism and directly antagonizes vascular calcification. Metrics

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Preliminary evaluation of cost and hemodialysis quality in a local area via big data analysis 2017, 16 (06):  383-386.  doi: 10.3969/j.issn.1671-4091.2017.06.007 Abstract ( 216 )   PDF (415KB) ( 418 )   Objective To analyze the related markers for cost and hemodialysis quality in hemodialysis patients in a local area in 2013 via big data analyses. Method Maintenance hemodialysis patients in 2013 were screened out from medical cost database in this area. Target population was divided into urban worker group and urban and rural resident group according to their medical insurance type. Results There was significant difference in total cost between hemodialysis patients in urban worker group and urban and rural resident group (t=23.107, P<0.001). Some biased data existed in hospitalization and rehospitalization, vascular access operation, blood transmissible disease, cost proportion for use of hemoperfusion apparatus and drug in certain hospitals, suggesting the potential risks for quality control in some hemodialysis centers. Conclusion Big data analytical method for cost-centered database can detect possible cost bias and medical quality defects, hopefully providing the data useful for the continuous hemodialysis quality improvement. Metrics

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TThe effect of single therapeutic plasma exchange via membrane filtration on hematocytes and electrolytes 2017, 16 (06):  387-391.  doi: 10.3969/j.issn.1671-4091.2017.06.008 Abstract ( 315 )   PDF (482KB) ( 405 )   Objective Therapeutic plasma exchange (TPE) is an effective and specific blood purification. However, studies about the single plasma exchange on hematocytes and electrolytes are limited. Methods Forty TPE sessions from 21 patients were enrolled in this prospective study. Hematocytes and electrolytes including albumin, calcium and potassium were measured before and after the TPE sessions. Results No difference in white blood cell count was found after TPE sessions, but lymphocyte counts decreased by 24.41% (0.70±0.52×109/L vs. 0.42±0.33×109/L, t=3.645, P=0.001). Plasma volume for exchange (β=-0.329, P=0.013) and total exchange volume (β=0.576, P=0.001) were the two independent factors for the change of lymphocyte count. Hemoglobin and platelet count decreased by 6.92% (87.21±10.72 g/L vs. 80.92±10.61 g/L, t= 5.222, P<0.001) and 12.83% (167.63±76.69×109/L vs. 149.13±72.47×109/L, t=5.346, P＜0.001), respectively. The reduction of hemoglobin was negatively correlated with the dosage of low molecular weight heparin (r= -0.330, P=0.043). The reduction of platelet count was positively correlated with the coagulation in blood circuit (r=0.388, P=0.016), and was negatively correlated with the dosage of low molecular weight heparin (r=- 0.425, P=0.008). Multivariate regression demonstrated that coagulation in blood circuit was the independent factor for reduction of platelet count (β =-14.562, P=0.008). Serum calcium decreased by 2.84% (2.16±0.14 mmol/L vs. 2.09±0.18 mmol/L, t=2.289, P=0.029), and was negatively correlated with the albumin volume used (r=-0.672, P＜0.001). Multivariate regression revealed that albumin volume used was the independent factor for reduction of calcium (β =-0.003, P＜0.001). Conclusions TPE via membrane filtration is a safe approach for blood purification. Mild reduction in hemoglobin, platelet and calcium were found after the sessions. Sufficient anticoagulation and supplement of calcium are necessary. Metrics

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C-reactive protein combined with serum albumin correlated with the mortality in maintenance hemodialysis patients 2017, 16 (06):  392-396.  doi: 10.3969/j.issn.1671-4091.2017.06.009 Abstract ( 273 )   PDF (601KB) ( 408 )   Objective To investigate C-reactive protein (CRP) combined with serum albumin (ALB) in the prediction of all-cause mortality in maintenance hemodialysis (MHD) patients. Methods A total of 314 MHD cases treated in the period from Jan. 2012 to Dec. 2016 in the Hemodialysis Center of Civil Aviation General Hospital were registered in Beijing Hemodialysis Quality Control and Improvement Center Network. Their general information, laboratory results and outcomes were recruited. Results In the 314 MHD cases, the average age was 63.32±13.57 years, the dialysis vintage was 65.00 (43.75, 100.00) months, and 88 patients (28.03%) died. CRP was positive (≥3 mg/L) in 157 cases (50.00%) and ALB was positive (＜38 g/L) in 126 cases (40.13%). According to CRP and ALB values, patients were divided into negative CRP and negative ALB group (n=109), positive CRP or positive ALB group (n=127), and positive CRP and positive ALB group (n=78); Statistical difference in all-cause mortality was found between the 3 groups (13.76%, 26.77% and 50.00% respectively; χ2=29.766, P＜0.001). Kaplan-Meier method showed that all- cause mortality was higher in patients with positive CRP and positive ALB than in patients with positive CRP or positive ALB, and was higher in patients with positive CRP or positive ALB than in patients with negative CRP and negative ALB (χ2=39.380, P＜0.001). Multivariate Cox regression showed that age (HR=1.022, 95% CI 1.001～1.045, P=0.044) and diabetes (HR=1.665, 95% CI 1.068～2.596, P=0.024) were the independent risk factors for allcause mortality, and serum creatinine was the independent protective factor (HR=0.998, 95% CI 0.997-0.999, P=0.005). If positive CRP or positive ALB group was used as a reference, positive CRP combined with positive ALB was the independent risk factor for all-cause mortality (HR=1.709, 95% CI 1.027～2.843, P=0.039). Conclusion C-reactive protein combined with serum albumin is closely related to all-cause mortality, i.e., positive CRP combined with positive ALB is the independent risk factor for all-cause mortality in MHD patients. Metrics

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Investigation of long-term renal outcome in women with preeclampsia 2017, 16 (06):  397-402.  doi: 10.3969/j.issn.1671-4091.2017.06.010 Abstract ( 251 )   PDF (420KB) ( 397 )   Objectives The purpose of this retrospective cohort study was to investigate the long-term renal outcome in women with preeclampsia. Methods In this retrospective cohort study, patients with preeclampsia between 2005 and 2011 and hospitalized in Obstetric Department of Peking University Third Hospital were recruited. The recovery of renal function and blood pressure after delivery was observed. The risk factors for persistent renal damage and hypertension after delivery were analyzed. Results ①The postpartum urinary protein was negative at discharge from the hospital in 39.4% (121/307) preeclampsia patients. Proteinuria persisted after 3 months in 49.2% (151/307) preeclampsia patients. ② Until the latest follow-up study, 5 patients (5/307, 1.6%) still had proteinuria, 18 patients (18/307, 5.9%) still had hypertension, and all participants had normal renal function. ③Multivariate logistic regression showed that the risk factors for continuous proteinuria after delivery for 3 months were prepartum urinary protein ≥3.0 g/24h (HR=3.560, 95% CI 1.694～7.482, P=0.001), prepartum systolic blood pressure (SBP) ≥155 mmHg (HR=2.031, 95% CI 1.049～3.934, P=0.036) and severe preeclampsia (HR=2.580, 95% CI 1.166～5.708, P=0.019); the risk factors for long-term hypertension were prepartum SBP ≥160 mmHg (HR=7.875, 95% CI 2.081～29.794, P=0.002) and hemoglobin level ≥123 g/L (HR=3.517, 95% CI 1.170～10.577, P=0.025). We could not find out the risk factors for persistent proteinuria due to the small samples. Conclusions The long-term renal outcome was optimistic in most preeclampsia women. Proteinuria (5/307, 1.6%) and hypertension (18/307, 5.9%) persisted in only a few patients. The risk factors for continuous proteinuria after delivery for 3 months were prepartum urinary protein ≥3.0 g/24h, prepartum SBP ≥155 mmHg and severe preeclampsia. The risk factors for long-term hypertension were prepartum SBP ≥160 mmHg and hemoglobin level ≥123 g/L. Longer follow- up period and larger samples are required to find out the risk factors for long-term renal outcome in preeclampsia women. Metrics

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Effect of individual management based on the 5E rehabilitation program on peritoneal dialysis related peritonitis in uremic patients undergoing peritoneal dialysis 2017, 16 (06):  403-406.  doi: 10.3969/j.issn.1671-4091.2017.06.011 Abstract ( 196 )   PDF (415KB) ( 367 )   Objective To study the effect of individual management based on the 5E rehabilitation program on peritoneal dialysis (PD)-related peritonitis in uremic patients undergoing PD. Methods A total of 110 PD patients were recruited and randomly divided into two groups: the control group (n=54) treated with routine care procedures and the experimental group (n=55) treated with individual management including encouragement, education, exercise, employment and evaluation (5E) in addition to the routine care procedures. After one year, peritonitis, PD operation behavior, and inflammation-related symptoms before and after the intervention were compared between the two groups. Results A total of 109 PD patients were enrolled in this study. The prevalence of peritonitis was lower in the experimental group than in the control group (t=3.939, P=0.037). PD operation behavior and inflammation-related symptoms were statistically insignificant (t=3.939, P=0.037 for PD operation behavior; χ2=0.019, P=0.889 for inflammation-related symptoms) before the intervention between the two groups, but were better in the experimental group than in the control group (χ2=5.928, P=0.013 for PD operation behavior; χ2=7.210, P=0.007 for inflammation- related symptoms). Conclusion The individual management based on the 5E rehabilitation program can reduce inflammation- related symptoms and PD-related peritonitis, and improve PD operation in PD patients. Metrics

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Effect of Apelin-13 on the epithelial-mesenchymal transition of renal tubular epithelial cells induced by high glucose 2017, 16 (06):  407-412.  doi: 10.3969/j.issn.1671-4091.2017.06.012 Abstract ( 191 )   PDF (3718KB) ( 336 )   Objective To explore the effect of Apelin-13 on epithelia-mesenchymal transition (EMT) of renal tubular epithelial cell line HK-2 cells induced by high glucose. Methods After pretreatment with Apelin-13 (10-8, 10-7 and 10-6 mol/L) for 30 min, HK-2 cells were cultured in the medium containing 30 mmol/L Dglucose for 48 h. Expression of mesenchymal cell markers alpha smooth muscle actin (α-SMA) in the HK-2 cells were tested by immunofluorescence assay. Ultrastructural changes of HK-2 cells were observed by transmission electron microscopy. Expressions of the epithelial marker E-cadherin, α-SMA, and autophagy related proteins were measured by western blot. Results Compared with the control group, HK-2 cells in the high glucose group showed long spindle shape and widened intercellular spaces, with down-regulated E-cadherin expression (t=4.751, P=0.011), up-regulated α-SMA expression (t=3.846, P=0.016), increased number of autophagy, increased expression of Beclin-1, LC3-II and LC3-II/LC3-I ratio (t=5.271, P=0.009 for Bectlin-1; t=4.695, P=0.012 for LC3- II; t=6.753, P=0.002 for LC3-II/LC3- I ratio), and decreased expression of p62 (t=4.562, P=0.012). Compared with the high glucose group, KH-2 cells in the Apelin-13 (10-7 and 10-6 mol/L) +high glucose group showed oval shape, with up-regulated E-cadherin expression (t=3.495, P=0.019 for 10- 7mol/L Apelin-13; t=4.124, P=0.013 for 10-6 mol/L Apelin-13), down-regulated α-SMA expression (t=4.014, P= 0.014 for 10-7 mol/L Apelin-13; t=4.283, P=0.012 for 10-6 mol/L Apelin-13), increased number of autophagy, increased expression of Beclin-1, and LC3-II and LC3-II/LC3-I ratio (t=3.487, P=0.018 for Beclin-1 and 10-7mol/L Apelin-13; t=4.059, P=0.014 for Beclin-1 and 10- 6 mol/L Apelin-13; t=5.342, P=0.009 for LC3-II and10- 7 mol/L Apelin-13; t=4.271, P=0.011 for LC3-II and 10- 6 mol/L Apelin-13; t=5.360, P=0.005 for LC3-II/LC3-I ratio and 10-7 mol/L Apelin-13; t=5.851, P=0.004 for LC3-II/LC3-I ratio and 10-6 mol/L Apelin-13), and decreased expression of p62 (t=4.342, P=0.012 for 10-7 mol/L Apelin-13; t=3.557, P=0.019 for 10-6 mol/L Apelin-13). Conclusions Apelin-13 inhibits the EMT of renal tubular epithelial cell line HK-2 cells induced by high glucose. The increase of autophagy induced by Apelin-13 may relate to the inhibition of EMT in HK-2 cells. Metrics

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Study of autosomal dominant tubulointerstitial kidney disease in a Chinese cohort 2017, 16 (06):  413-419.  doi: 10.3969/j.issn.1671-4091.2017.06.013 Abstract ( 331 )   PDF (1306KB) ( 397 )   Objectives In the study, we screened genetic variations in UMOD, REN and HNF1B genes in a Chinese autosomal dominant tubulointerstitial kidney disease (ADTKD) cohort and studied the pathogenesis of ADTKD with novel UMOD mutations. Methods Forty-four probands from 44 different families were recruited according to the KDIGO report of diagnostic criteria for suspected ADTKD. We sequenced all exons of the three genes and used multiple ligation-dependent probe amplification (MLPA) assays for copy number variations in HNF1B. We then detected uromodulin expression after transfection of the mutant UMOD cDNA plasmid into HEK293 (human embryonic kidney) cells. Results We detected 11 mutations (10 in UMOD, 1 in HNF1B) in this cohort, and 3 of them (c.104G>A, c.113A＞T and c.860G>T) were novel mutations in UMOD. Point mutations in REN and copy number variations in HNF1B were not found. We divided the 44 probands into two groups according to the presence and absence of UMOD mutation and found no distinct discrimination in clinical characteristics between the two groups. Uromodulin expression were significantly decreased in HKE293 cells after transfected with the mutant plasmid (F=14.241, P＜0.001), consistent with the previous research results. Conclusions About 25% of patients in our ADTKD cohort were found to have mutations in UMOD gene. Clinical features were nonspecific in patients with UMOD mutations. These results indicate that gene sequencing is one of the important methods for the diagnosis of ADTKD. Metrics

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The effects of humorous video on anxiety and depression in maintenance hemodialysis patients 2017, 16 (06):  420-422.  doi: 10.3969/j.issn.1671-4091.2017.06.014 Abstract ( 308 )   PDF (402KB) ( 393 )   Objective To study the effects of watching humorous videos on anxiety and depression in maintenance hemodialysis (MHD) patients. Methods We choose 69 MHD patients in our hospital. They were randomly divided into experimental group and control group, Patients were treated with conventional hemodialysis nursing. Patients in the experimental group watched the humorous videos, and those in the control group randomly watched the TV programs. Self- rating anxiety scale (SAS) and self- rating depression scale (SDS) were used to evaluate the effects before and after the intervention. Results Before the intervention, there were no statistical differences in scores of anxiety (χ2=0.358, P=0.859) and depression (χ2=0.276, P=0.926) between the experimental group and the control group. After the intervention, the scores of anxiety (χ2=9.687, P=0.012) and depression (χ2=10.509, P=0.010) were statistical different between the experimental group and the control group. Conclusion Watching humorous videos can relieve anxiety and depression in MHD patients. Metrics

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Risk factors for catheter-related blood stream infection in uremia patients 2017, 16 (06):  423-426.  doi: 10.3969/j.issn.1671-4091.2017.06.015 Abstract ( 353 )   PDF (396KB) ( 436 )   Objective To explore the risk factors for catheter- related bloodstream infection (CRBSI) in end-stage renal disease patients in order to provide references and suggestions for the prevention of CRBSI. Methods We recruited age, gender, type of central vein catheterization (CVC), serum albumin, serum total protein, hemoglobin, diabetes, co-infection of 343 patients (50 cases with CRBSI and 293 cases without CRBSI) using CVC for hemodialysis access during Jan. 1, 2013 to Dec. 31, 2014. Clinical data were analyzed by SPSS 21.0, and P＜0.05 was defined as statistical significance. Results After analyses of clinical data, we found that femoral vein catheterization was more susceptible to CRBSI than internal jugular vein catheterization (χ2=19.107, P＜0.001), temporary catheterization was more susceptible to CRBSI than long-term catheterization (χ2=8.009, P=0.005), and patients with co-infection were more susceptible to CRBSI than those without co-infection (χ2=4.248, P=0.039). Age was younger in the CRBSI group than in the non-CRBSI group (t=-2.123, P=0.034). Serum albumin was lower in the CRBSI group than in the non-CRBSI group (t=-2.177, P=0.030). There were no differences in gender (χ2=1.662, P=0.197), diabetes (χ2=0.004, P=0.948), serum total protein (t=- 1.530, P=0.127), and hemoglobin (t=- 0.846, P=0.388) between the two groups. Conclusions CRBSI is a common complication in hemodialysis patients. The prevalence of CRBSI may relate to the type of CVC, serum albumin and co-infection in hemodialysis patients Metrics

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Use of ultrapure dialysate for blood purification 2017, 16 (06):  427-430.  doi: 10.3969/j.issn.1671-4091.2017.06.016 Abstract ( 304 )   PDF (588KB) ( 447 )   Hemodialysis patients are exposed to a large volume of water during hemodialysis. Purity of the dialysate especially the microbial purity is closely related to the acute and long-term complications of hemodialysis. With the advances in technology, ultrapure dialysate with substantially lower bacterial and endotoxin contaminants is widely used clinically. The ultrapure dialysate can improve inflammation status, malnutrition, erythropoietin hyporesponsiveness and progressive atherosclerosis, and decrease the morbidity and mortality in hemodialysis patients. Metrics