Chinese Journal of Blood Purification

12 October 2018, Volume 17 Issue 10 Previous Issue    Next Issue

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How to diagnose AKI in CKD patients? 2018, 17 (10):  649-651.  doi: 10.3969/j.issn.1671-4091.2018.10.001 Abstract ( 387 )   PDF (352KB) ( 718 )   【Abstract】The occurrence of acute kidney injure (AKI) on the basis of chronic kidney disease (CKD) is one of the complications in CKD patients. AKI can occur at any stage of CKD and is affected by many factors. AKI and CKD are mutually influenced, leading to deleterious cycles and negative impacts on the prognosis of patients. Therefore, it is essential to early detect and intervene in the AKI in CKD patients. This paper discusses the key points about the clinical diagnosis of AKI in CKD patients. Metrics

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Study on the beginning of renal replacement therapy for acute kidney injury stage 3 in sepsis patients 2018, 17 (10):  652-657.  doi: 10.3969/j.issn.1671-4091.2018.10.002 Abstract ( 300 )   PDF (554KB) ( 602 )   【Abstract】Objective To determine whether early initiation of renal replacement therapy (RRT) can reduce all-cause mortality within 90 days in sepsis patients complicated with acute kidney injury (AKI). Methods Sixty-nine sepsis patients with AKI stage 3 were enrolled in this study and randomly assigned into early group (n=35) in which RRT was initiated immediately after randomization, or delayed group in which RRT was initiated when emergent indications appeared. Continuous hemofiltration combined with hemoperfusion was the RRT mode. The primary end point was all-cause mortality within 90 days after randomization. The secondary end points included mechanical ventilation period, staying in ICU period and hospitalization day. Results All-cause mortality within 90 days did not differ significantly between early group (42.9%) and delayed group (50%) (χ2=0.354, P=0.552). Mechanical ventilation time was similar between early group and delayed group (286±147h vs. 334±172 h; t=-1.125, P=0.265). The period staying in ICU was similar between the two groups [12 (10, 16) days in early group vs. 16 (12, 22) days in delayed group; Z=-1.555, P=0.120], but hospitalization day was significantly shorter in early group than in delayed group [20 (18, 24) days vs. 26 (19, 30) days; Z=-2.440, P=0.015]. Conclusions For sepsis patients complicated with AKI stage 3, there was no significant difference in mortality between early and delayed initiation of RRT. However, early RRT can reduce the average hospitalization day. Metrics

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The relationship between depression and dialysis-related clinical and biochemical parameters in maintenance hemodialysis patients 2018, 17 (10):  658-662.  doi: 10.3969/j.issn.1671-4091.2018.10.003 Abstract ( 330 )   PDF (448KB) ( 549 )   【Abstract】Objective To investigate the relationship between depression and dialysis- related clinical and biochemical parameters in maintenance hemodialysis (MHD) patients by using a cross- sectional study. Methods A total of 80 MHD patients compliant with the inclusion criteria and selected by the convenience sampling method were enrolled in this study. Their depression degree was evaluated by the Beck depression inventory (BDI), and their dialysis-related clinical and biochemical parameters in the recent one month were collected. They were then divided into depression group and non-depression group according to the BDI results. Chi-square test and independent-sample t test were used to compare the baseline characteristics and dialysis-related clinical and biochemical parameters between the two groups. Logistic regression was used to analyze the protective and risk factors for depression. Results A total of 75 patients completed the trial, including 53 cases in depression group and 22 cases in non- depression group, with the depression morbidity of 70.67%. There were no differences in age, dialysis vintage, gender, educational level and disease cause between the two groups (P>0.05). In non-depression group before dialysis, blood platelet (t=3.466, P=0.001), serum total protein (t=2.462, P=0.016), albumin (t=2.833, P=0.006), creatinine (t=2.547, P=0.013), calcium (t=2.938, P=0.004) and body mass index (BMI, t=2.582, P=0.012) were significantly higher than those in depression group, and alkaline phosphatase (t=-2.742, P=0.008), spKt/V (t=-2.127, P=0.037) systolic blood pressure (t=-4.385, P<0.001) and diastolic blood pressure (t=-3.168, P=0.002) were significantly lower than those in depression group. Logistic regression showed that higher interdialytic systolic blood pressure (OR=1.272, 95% CI: 1.031～1.568, P=0.025) was the independent risk factor for depression in MHD patients, and higher predialytic serum albumin (OR=0.552, 95% CI: 0.332～0.919, P = 0.022), creatinine (OR = 0.994, 95% CI: 0.990～0.999, P = 0.018), calcium (OR<0.001, 95% CI: 0～0.054, P = 0.006) and BMI (OR = 0.383, 95% CI: 0.189 ～0.777, P=0.008) were the independent protective factors for depression in MHD patients. Conclusion The prevalence of depression was higher in MHD patients. Interdialytic systolic blood pressure was the independent risk factor for depression in MHD patients, while higher predialytic serum albumin, creatinine, calcium and BMI were the protective factors for depression in MHD patients. Metrics

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EEffect of hemoperfusion and double-filtration plasmapheresis for the treatment of hyperlipidemia in severe acute pancreatitis patients 2018, 17 (10):  663-666.  doi: 10.3969/j.issn.1671-4091.2018.10.004 Abstract ( 347 )   PDF (430KB) ( 729 )   【Abstract】Objective To investigate the effect of hemoperfusion and double- filtration plasmapheresis for the treatment of hyperlipidemia in severe acute pancreatitis patients. Methods Fifty patients diagnosed as severe acute pancreatitis with hyperlipidemia between January 2016 and April 2018 were randomly divided into hemoperfusion (HP) group and double-filtration plasmapheresis (DFPP) group. Results HP group and DFPP group were comparable in terms of gender, age, body mass index (BMI), acute physiology and chronic health evaluation II (APACHE Ⅱ) score and blood lipid levels at admission. There were also no statistical differences in complications, changes of abdominal CT images, and number of death between the two groups. The medical expense of DFPP was higher than that of HP. The mean decrease percentages of plasma triglyceride (TG) and total cholesterol (TC) after one treatment were 60.1% and 37.0%, respectively, in HP group and were 63.2% and 41.8%, respectively, in DFPP group. In HP group before and after the treatment, plasma TG levels were (47.08±35.8)mmol/L and 17.49±20.37 mmol/L, respectively (t=4.124, P=0.001), and TC levels were (13.52±5.90)mmol/L and 10.01±6.11mmol/L, respectively (t=5.737, P=0.000). In DFPP group before and after the treatment, plasma TG levels were (44.42±42.30)mmol/L and (16.31±17.68)mmol/L, respectively (t=3.298, P=0.011), and TC levels were (18.29 ± 16.13) mmol/L, and (9.73 ± 7.17)mmol/L, respectively (t= 2.656, P=0.029). There were no differences in the decrease of TG [(18.55±21.99)mmol/L in HP group and (16.31 ± 17.68)mmol/L in DFPP group, t=0.207 P=0.084] and TC [(10.78 ± 6.27)mmol/L in HP group and (9.37±7.17)mmol/L in DFPP group, t=0.272 P=0.792] between the two groups. Conclusions Both HP and DFPP reduced TG and TC levels. Moreover, HP and DFPP had comparable effects on lowering blood lipid levels. Metrics

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Analysis of the risk factors for hypoparathyroidemia in peritoneal dialysis patients 2018, 17 (10):  667-671.  doi: 10.3969/j.issn.1671-4091.2018.10.005 Abstract ( 364 )   PDF (465KB) ( 551 )   【Abstract】Objective To analyze the prevalence of low serum intact parathyroid hormone (iPTH) level and to evaluate the risk factors for the low serum iPTH in patients on continuous ambulatory peritoneal dialysis (CAPD). Methods Patients with regular CAPD and followed up for more than 3 months in the Department of Nephrology, Beijing Luhe Hospital from January to December 2016 were enrolled in this study. They were retrieved from the Huibaitong medical database. Their general condition and follow-up information were recorded and analyzed. Results A total of 133 CAPD patients were included in this study. Their average age was (62.50±13.33) years. The prevalence of hypoparathyroidemia was 56.39% in these patients. Their average dialysis duration was 26.37 (13.39, 44.88) months. Age (Z=2.707, P=0.007), diabetes (χ2=8.512, P=0.004), serum calcium (Z=2.588, P=0.010), random blood glucose (Z=2.760, P=0.006) and carbon dioxide level (t=2.667, P=0.008) were significantly higher in hypoparathyroidemia patients than in non-hypoparathyroidemia patients; dialysis duration (χ2=2.419, P=0.032), serum phosphorus (t=3.914, P＜0.001), serum creatinine (t=3.272, P=0.001), serum albumin (Z=2.485, P=0.013) and geriatric nutritional risk index (Z=2.451, P=0.014) were significantly lower in hypoparathyroidemia patients than in non-hypoparathyroidemia patients. Logistic regression showed that higher serum calcium was the independent risk factor for hypoparathyroidemia (OR=145.062, 95% CI 9.957～2113.463, P＜0.001). Conclusions The prevalence of hypoparathyroidemia was higher in CAPD patients. Diabetic patients were more susceptible to have hypoparathyroidemia. Higher serum calcium was the independent risk factor for hypoparathyroidemia. Metrics

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The efficiency of plasmapheresis on removing circulating antibodies against glomerular basement membrane and on renal survival 2018, 17 (10):  672-676.  doi: 10.3969/j.issn.1671-4091.2018.10.006 Abstract ( 400 )   PDF (437KB) ( 716 )   【Abstract】Objective This study aimed to analyze the clinical features of anti-GBM patients with the treatment of plasmapheresis and to address the effect of plasmapheresis on removing circulating anti-GBM antibodies and on renal survival. Methods Sixty patients with anti-GBM disease in our department were enrolled, and all of whom received more than one session of plasmapheresis. The clinical features and the levels of anti-GBM antibodies before and after plasmapheresis were collected. Results ①After plasmapheresis, circulating anti-GBM antibodies disappeared in 33/60 (55%) patients. Patients with negative circulating anti-GBM antibodies after plasmapheresis had a significantly lower level of initial anti-GBM antibodies on diagnosis (123.00 vs. 200.00 RU/ml, Z=-3.976, P＜0.001) and a higher proportion of receiving intravenous pulse methylprednisolone (61.70% vs. 30.80%, χ2=3.937, P=0.047), compared to those who still had detectable circulating antibodies after plasmapheresis. The level of anti-GBM antibodies on diagnosis was the independent risk factor for antibody persistence after plasmapheresis (OR 7.727, 95% CI 1.911～31.240, P=0.004). ②In the present study, 38/60 (63.30%) patients progressed to end- stage renal disease (ESRD). They presented higher levels of serum creatinine (Z=-2.454, P＜0.001) and anti-GBM antibodies on diagnosis (Z=-2.089, P=0.037), a higher proportion of oliguria/anuria (χ2=6.334, P=0.012) and a lower proportion of antibody disappearance after plasmapheresis (χ2=6.962, P=0.008), compared to the patients without ESRD. There was no significant difference in the number of plasmapheresis sessions between patients with and without ESRD (Z=-1.534, P=0.125). Logistic regression model showed that renal survival was only predicted by serum creatinine (>600μmol/L) on diagnosis (OR 13.824, 95% CI 2.332～81.939, P=0.004). Conclusions Circulating anti-GBM antibodies could be efficiently removed by plasmapheresis. The level of anti-GBM antibodies on diagnosis was the independent risk factor for antibody persistence after plasmapheresis. Renal survival was predicted by serum creatinine (>600μmol/L) on diagnosis, but had no significant correlation with the number of plasmapheresis sessions. Metrics

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The effects of paricalcitol on inflammatory state and oxidative stress in maintenance hemodialysis patients 2018, 17 (10):  677-681.  doi: 10.3969/j.issn.1671-4091.2018.10.007 Abstract ( 440 )   PDF (422KB) ( 649 )   【Abstract】Objective to evaluate the role of paricalcitol in anti-inflammatory and anti-oxidative stress in maintenance hemodialysis (MHD) patients. Methods This study employed a pre- post self-comparison design method. A total of 23 MHD patients with secondary hyperparathyroidism (SHPT) treated in the Second Blood Purification Center, Shengjing Hospital, Chinese Medical University were enrolled in this study. After paricalcitol treatment for 2 months, the changes of biochemical, inflammatory and oxidative stress indices were evaluated in these patients. These indices included the biochemical indices of serum calcium after correction (cCa), phosphorus (P), intact parathyroid hormone (iPTH) and albumin (ALB); the inflammatory indices of peripheral white blood cells (WBC) and neutrophil cells (NE), serum C-reactive protein (CRP), interleukin-6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and tumor necrosis factor α (TNF-α); and the oxidative stress indices of serum malondialdehyde (MDA); superoxide dismutase (SOD), glutathione peroxidase (GSHPx), catalase (CAT) and thioredoxin (TRX). Based on the changes of biochemical indices examined monthly after the treatment, the dosage of paricalcitol was adjusted and the patients who did not meet the experimental requirements were excluded. A total of 21 patients finished the trial. SPSS 20.0 software was used to analyze the experimental results. Results After paricalcitol treatment for 2 months, the inflammatory indices decreased significantly, including CRP from (30.69 ± 6.03)mg/l to (22.12±8.89)mg/l (P=0.009), IL-6 from (10.44±4.52)pg/ml to (8.55±3.53)pg/ml (P=0.004), IL- 8 from (1637±315)pg/ml to (1338±221)pg/ml (P=0.002), TNF-α from (7.87±3.45)pg/ml to (6.22±2.41) pg/ml (P=0.018), but IL-10, WBC and NE had no statistical changes; oxidative stress indices increased significantly, including SOD from (875±323)U/g to (1572±454)U/g (P=0.001), TRX from (73.0 ± 24.6)ng/ml to 85.6 ± 30.9 ng/ml (P=0.025) and GSHPx from(75.10±12.96)U/mg to (84.29±20.24)U/mg (P=0.046), but MDA decreased from 9.31±1.93 nmol/ml to (7.79±2.44) nmol/ml (P=0.033), and CAT had no statistical change. Conclusion Paricalcitol can effectively treat SHPT, and at the same time, can improve the inflammatory state and oxidative stress in MHD patients. Metrics

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Protective effect of melatonin on renal ischemia reperfusion injury and its mechanism in rats 2018, 17 (10):  682-688.  doi: 10.3969/j.issn.1671-4091.2018.10.008 Abstract ( 289 )   PDF (1431KB) ( 532 )   【Abstract】Objective To investigate the protective effect of melatonin (MT) on renal ischemia reperfusion injury and its mechanism in rats. Methods The rat renal ischemia reperfusion model was established by clamping bilateral renal arteries and veins with non-invasive vascular clamp. The rats were then randomly divided into sham operation group, ischemia reperfusion (IR) group, MT 5mg group, MT 10mg group and VC group. Serum BUN and Cr, mitochondrial activity, SOD activity, total ATPase activity, malondialdehyde (MDA) content, nitric oxide (NO) content and eNOS expression in renal tissue, and Bax and Bcl-2 expression levels in renal cortex were detected after reperfusion for 6h and 24h. Results After reperfusion for 6h and 24h and compare to IR group, serum BUN and Cr were significantly decreased in MT 5mg group, MT 10mg group and VC group (for MT 5mg group: t=3.154, P=0.032; t=3.864, P=0.006; t=3.021, P=0.037; t=3.856, P=0.007; for MT 10mg group: t=3.268, P=0.029; t=4.327, P=0.005; t=3.215, P=0.026; t=4.026, P=0.003; for VC group: t=3.415, P=0.014; t=4.586, P＜0.001; t=3.534, P=0.012; t=721, P＜0.001); kidney mitochondrial activity, SOD activity and total ATP activity were significantly increased in MT 5mg group, MT 10mg group and VC group (MT 5mg group: t=1.894, P=0.097; t=0.864, P=0.247; t=16.154, P＜0.001; t=15.587, P＜0.001; t=4.361, P=0.004; t=3.327, P=0.031; MT 10mg group: t=3.762, P=0.016; t=4.143, P=0.008; t=19.637, P＜0.001; t=18.596, P＜0.001; t=5.397, P＜0.001; t=4.832, P＜0.001; VC group: t=3.758, P=0.017; t=3.972, P=0.011; t=18.026, P＜0.001; t=17.923, P＜0.001; t=5.403, P＜0.001; t=4.851, P＜0.001); MDA decreased significantly in MT 5mg group, MT 10mg group and VC group (MT 5mg group: t=4.241, P=0.004; t=5.436, P＜0.001; MT 10mg group: t=5.386, P=0.001; t=6.174, P＜0.001; VC group: t=6.352, P＜0.001; t=6.053, P＜0.001). NO increased significantly in MT 5mg group, MT 10mg group and VC group after reperfusion for 6h as compared that in IR group (MT 5mg group: t=5.821, P＜0.001; MT 10mg group: t=9.107, P＜0.001; VC group: t=8.728, P＜0.001). Conclusions Injection of MT at the early stage of ischemia reperfusion can effectively reduce the mild renal injury and improve renal function in renal ischemia reperfusion injury rats. Its mechanism may relate to the protection of mitochondrial function, the increase of antioxidant enzyme activity, the increase of protective NO content, and the reduction of apoptosis. Metrics

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Histopathological assessment of calcification in radial artery from patients with end-stage renal disease 2018, 17 (10):  689-693.  doi: 10.3969/j.issn.1671-4091.2018.10.009 Abstract ( 385 )   PDF (1231KB) ( 548 )   【Abstract】Objective To investigate clinical and biochemical factors for radial artery calcification (RAC) in end-stage renal disease (ESRD) patients through histopathological assessment of the arteries. Methodology Segments of radial artery were obtained during arteriovenous fistula (AVF) operation for ESRD patients. RAC samples were examined after alizarin red S staining. Clinical and biochemical data of the patients were collected. The parameters relating to RAC were analyzed by binary logistic regression analyses. Results Among 180 ESRD cases, 38 cases (21.1%) developed RAC at different degrees. Dialysis vintage >5 years (χ2=24.626, P=0.022), diabetes (χ2=24.626, P＜0.001), glycosylated hemoglobin (HbA1c) (t=2.736, P=0.009) were statistical different between calcification and non-calcification groups. Binary logistic regression analyses showed that dialysis vintage >5 years [OR=14.314, 95% CI (2.666, 36.502), P＜0.001] and diabetes [OR=16.099, 95% CI (2.796, 34.597), P＜0.001] were the independent risk factors for RAC. Dialysis vintage >5 years (χ2=11.378, P=0.001) and diabetes (χ2=14.741, P＜0.001) were significantly higher in patients with severe RAC than in patients without RAC. Diabetes (χ2=14.684, P＜0.001) and HbA1c (P=0.026) were significantly higher in patients with mild to moderate RAC than in patients without RAC. Conclusions RAC manifested as arterial media calcification was frequently observed in ESRD patients. Dialysis vintage >5 years and diabetes were the independent risk factors for RAC. Therefore, multiple factors persistent for a period of time promote the development of RAC. Metrics

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Effects of miR-29a on epithelial to mesenchymal transition in human peritoneal mesothelial cells 2018, 17 (10):  694-698.  doi: 10.3969/j.issn.1671-4091.2018.10.010 Abstract ( 226 )   PDF (1319KB) ( 569 )   【Abstract】Objective To investigate the effect of miR-29a on high glucose induced epithelial to mesenchymal transition (EMT) in human peritoneal mesothelial cells (HPMCs). Methods HPMCs were treated with high glucose to create a EMT model of HPMCs. Real-time PCR was used to quantify the expression of miR-29a and EMT makers including E-cadherin, α-SMA and fibronectin (FN) in HPMCs stimulated with various concentration of glucose for various period as well as in control cells. miR- 29a inhibitor was used to downregulate miR-29a expression in HPMCs, and the expression of miR-29a and EMT markers in these cells were then measured by real-time PCR. Results High glucose stimulated HPMCs for various concentration and period promoted the expression of α-SMA (1.5% glucose: 1.970±0.153 vs. 1, F=7.692, P=0.008; 2.5% glucose: 3.291±0.265 vs. 1, F=4.479, P＜0.001; 4.25% glucose: 4.301±0.346 vs. 1, F=5.496, P＜0.001; high glucose for 6h: 2.161±0.202 vs. 1, F=6.563, P=0.001; high glucose for 12h: 2.820±0.285 vs. 1, F=5.111, P＜0.001; high glucose for 24h: 3.291±0.265 vs. 1, F=4.479, P＜0.001; high glucose for 48h: 3.980±0.407 vs. 1, F=9.3769, P=0.006) and FN (1.5% glucose: 1.630 ± 0.157 vs. 1, F=7.092, P=0.002; 2.5% glucose: 2.910 ± 0.199 vs. 1, F=4.000, P＜0.001; 4.25% glucose: 3.601±0.301 vs. 1, F=5.575, P＜0.001; high glucose for 6h:1.761±0.172 vs. 1, F=7.144, P=0.002; high glucose for 12h: 2.390±0.170 vs. 1, F=4.499, P＜0.001; high glucose for 24h: 2.910±0.199 vs. 1, F=4.000, P＜0.001; high glucose for 48h: 3.601±0.300 vs. 1, F=4.570, P＜0.001), but inhibited the expression of E-cadherin (1.5% glucose: 0.693±0.065 vs. 1, F=4.665, P=0.001; 2.5% glucose: 0.452±0.045 vs. 1, F=4.994, P＜0.001; 4.25% glucose: 0.302±0.030 vs. 1, F=4.000, P＜0.001; high glucose for 6h: 0.802±0.084 vs. 1, F=4.000, P=0.012; high glucose for 12h: 0.630±0.070 vs. 1, F=7.030, P=0.001; high glucose for 24h: 0.452±0.045 vs. 1, F=4.994, P＜0.001; high glucose for 48h: 0.290±0.030 vs. 1, F=4.000, P＜0.001), suggesting that EMT occurred in HPMCs stimulated with high glucose. Moreover, miR-29a expression increased in HMPCs along with the increase of glucose concentration and stimulation period (1.5% glucose: 1.452 ± 0.147 vs. 1, F=13.411, P=0.001; 2.5% glucose: 3.120 ± 0.320 vs. 1, F=10.372, P＜0.001; 4.25% glucose: 4.130±0.368 vs. 1, F=12.497, P＜0.001; high glucose for 6h: 1.330±0.114 vs. 1, F=5.788, P=0.001; high glucose for 12h: 2.310±0.173 vs. 1, F=5.546, P＜0.001; high glucose for 24h: 3.100±0.236 vs. 1, F=10.372, P＜0.001; high glucose for 48h: 3.310 ± 0.211 vs. 1, F=4.929, P＜0.001). When HPMCs were transfected with the miR-29a inhibitor to inhibit the expression of miR-29a, the cells showed decreased expression of α-SMA and FN and increased expression of E- cadherin, indicating that the EMT induced by high glucose was inhibited in these cells (α-SMA: 1.871±0.206 vs. 3.291±0.265, F=0.104, P=0.002; FN: 1.782±0.156 vs. 2.910±0.199, F=0.091, P=0.002; E-cadherin: 0.873±0.085 vs. 0.452±0.045, F=0.760, P=0.002). Conclusion High glucose induced EMT in dose dependent and time dependent manner. In addition, there was a positive correlation between miR-29a and EMT; EMT induced by high glucose was attenuated in HPMCs in which miR-29a was downregulated. Metrics

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Hyperparathyroidism and cognitive impairment secondary to chronic kidney disease 2018, 17 (10):  699-701.  doi: 10.3969/j.issn.1671-4091.2018.10.011 Abstract ( 327 )   PDF (339KB) ( 636 )   【Abstract】Cognitive impairment is one of the complications in chronic kidney disease patients. Many factors affect the cognitive impairment. The secondary hyperparathyroidism is one of the important influence factors for cognitive impairment. Here we discuss the mechanism of cognitive impairment from the viewpoints of abnormal levels of PTH, calcium ion and vitamin D in secondary hyperparathyroidism patients. Metrics

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Postdialysis fatigue in hemodialysis patients: a literature review 2018, 17 (10):  706-709.  doi: 10.3969/j.issn.1671-4091.2018.10.013 Abstract ( 449 )   PDF (386KB) ( 690 )   【Abstract】In the paper, we review the status, concept, assessment tool, mechanism and influence factor of postdialysis fatigue in hemodialysis patients. The influence factors for postdialysis fatigue include demographic characteristics, ultrafiltration volume, intradialytic hypotension, dialysis temperature and laboratory examination results. Adjustment of dialysis parameters, exercise therapy and traditional Chinese medicine are useful for the improvement of postdialysis fatigue in hemodialysis patients. Metrics

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Non-thrombotic complications of long-term vascular access in maintenance hemodialysis patients 2018, 17 (10):  710-712.  doi: 10.3969/j.issn.1671-4091.2018.10.014 Abstract ( 358 )   PDF (359KB) ( 721 )   【Abstract】Hemodialysis is a common modality for renal replacement therapy in patients with end stage renal disease (ESDR). The favorable long-term vascular access ensures the success of hemodialysis. Longterm hemodialysis arteriovenous vascular access may induce a number of complications. In addition to the complication of thrombosis, other problems such as stenosis, aneurysm/pseudoaneurysm, steal syndrome, central venous obstruction, heart failure, neuropathy and infection may occur. These non- thrombotic complications are reviewed. Metrics

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Reliability and validity evaluation of the health promotion lifestyle scale for peritoneal dialysis patients 2018, 17 (10):  713-716.  doi: 10.3969/j.issn.1671-4091.2018.10.015 Abstract ( 303 )   PDF (381KB) ( 583 )   【Abstract】Objective To develop a health promotion lifestyle scale for peritoneal dialysis (PD) patients and to test the reliability and validity of the scale in order to provide a basis for evaluating the lifestyle in PD patients. Methods Through literature search and semi- structured interview, the conceptional dimension of the scale and the main source of item pool were established. The primary scale was formed after consultation through an expert meeting. Finally, the scale was verified and improved after a pilot survey. Results The health promotion lifestyle scale for PD patients included 6 dimensions and 35 items. The reliability of the questionnaire was 0.898, and the Cronbach's coefficient was 0.777～0.815. The retest reliability coefficient of the scale was 0.905, and the Cronbach's magnitude coefficient of each dimension was 0.762～0.805. The content validity index (CVI) was 0.800～1.000, and the average CVI was 0.867. Conclusion This scale has better reliability and validity, and is a suitable tool to assess health behavior for PD patients. Metrics

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Investigation of fatigue and its influencing factors in female hemodialysis patients 2018, 17 (10):  717-719.  doi: 10.3969/j.issn.1671-4091.2018.10.016 Abstract ( 326 )   PDF (345KB) ( 584 )   【Abstract】Objective To understand the fatigue status in female maintenance hemodialysis (MHD) patients and to explore its influencing factors in order to provide the theoretical basis for the improvement of fatigue status in these patients. Methods A total of 90 female MHD patients in our hospital were recruited by convenient sampling method and were investigated by using the self-designed general information questionnaire and the revised Piper fatigue scale to understand the fatigue status in these patients. Multiple stepwise regression analysis was conducted to analyze its influencing factors. Results The fatigue score was (5.080± 1.782) points in the female MHD patients in this center. The influencing factors included patients' age (P= 0.005), menstrual condition (P=0.009) and complications (P＜0.001). Conclusion Doctors and nurses should recognize the fatigue symptoms and its influencing factors during dialysis for female MHD patients, and carry out intervention measures according to different situations so as to improve their fatigue status and the quality of life. Metrics