Chinese Journal of Blood Purification

12 November 2019, Volume 18 Issue 11 Previous Issue    Next Issue

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History of hemodialysis in China 2019, 18 (11):  735-737.  doi: 10.3969/j.issn.1671-4091.2019.11.001 Abstract ( 1041 )   PDF (400KB) ( 1072 )   【Abstract】Hemodialysis is one of the first clinical treatment technologies featured by blood extracorporeal circulation. It has been used for the treatment of uremic patients for more than 100 years. In recent 20 years, a series of blood purification technologies have been developed based on hemodialysis. To date, hemodialysis is still the most widely used blood purification technology. This paper summarizes the development of hemodialysis technology in China, including the development of equipment (including materials) and hemodialysis methods. Metrics

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Incidence and risk factors of acute renal injury after coronary artery bypass grafting 2019, 18 (11):  738-741.  doi: 10.3969/j.issn.1671-4091.2019.11.002 Abstract ( 366 )   PDF (386KB) ( 651 )   【Abstract】Objective To investigate the prevalence and risk factors of acute kidney injury (AKI) in patients after coronary artery bypass surgery (CABG). Methods In the period from September 2011 to November 2013, a total of 1,615 consecutive patients undergoing isolated CABG in Fuwai Hospital were enrolled in this retrospective study. Kidney Disease Improving Global Outcomes (KDIGO) diagnostic criteria were used to evaluate the kidney injury 7 days after surgery. Logistic regression model was used to analyze the potential risk factors for AKI. Results A total of 1,574 patients with complete clinical data were finally enrolled in this study. The mean age of the patients was 60.3±8.4 years and 20.5% were females. Of the studied patients, 70.2% met the criteria for AKI, including 891 (56.6%) with AKI Ⅰ, 182 (11.6%) with AKI Ⅱ and 32 (2.0%) with AKI Ⅲ. Logistic regression analysis showed that age (OR=1.04, 95% CI 1.02～1.05, P＜0.001), cardiopulmonary bypass (OR=1.53, 95% CI 1.23～1.92, P＜0.001) and preoperative left ventricular ejection fraction (LVEF) <50% (OR=1.46, 95% CI 1.01～2.09, P=0.042) were the independent risk factors for postoperative AKI in CABG patients. In addition, CABG patients will be more likely to meet the AKI diagnostic criteria by KDIGO when their blood creatinine levels of the last preoperative measurements were lower (OR=0.98, 95%, CI 0.97～0.99, P＜0.001). Conclusion The higher incidence of postoperative AKI in CABG patients should be concerned by clinicians. Age, application of extracorporeal circulation and preoperative LVEF <50% are the independent risk factors for postoperative AKI in CABG patients. Patients with lower creatinine levels before bypass surgery were more likely to meet the AKI diagnostic criteria by KDIGO. Metrics

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The application of inner fixation of the peritoneal dialysis catheters to prevent its displacement 2019, 18 (11):  742-744.  doi: 10.3969/j.issn.1671-4091.2019.11.003 Abstract ( 215 )   PDF (506KB) ( 616 )   【Abstract】Objective Malfunction of the peritoneal dialysis (PD) tubes, especially displacement and occlusion of the tubes, are the main factors for non-infective PD-tube complications. We developed a new surgical technology that fixes the tubes on the inner surface of abdominal wall to prevent the occurrence of these situations. Method This was a retrospective study involving 278 end-stage renal disease patients treated in the Department of Nephrology, Renmin Hospital of Wuhan University. The conventional surgery of PD-tube placement was used in 123 patients (non-fixation group), and PD-tube placement surgery plus inner fixation of the tubes was performed in 155 patients (fixation group). PD-tube related complications including infections, leakage, pain during dialysate infusion, tube displacement, and wrapped PD-tubes in the follow-up period of 6 months were compared between the two groups. Results In non-fixation group, the rate of tube displacement was 13.8%. In fixation group, the operation time was longer, no tube displacement occurred in the follow-up period of 6 months, and the early technical survival rate of PD-tubes became higher. Conclusion Inner fixation of the PD-tubes was effective to prevent the non-infective PD-tube complications, and the early technical survival rate of PD-tubes became higher. Metrics

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Effects of different doses of intravenous iron supplement on inflammatory response and oxidative stress in maintenance hemodialysis patients#br# 2019, 18 (11):  745-749.  doi: 10.3969/j.issn.1671-4091.2019.11.004 Abstract ( 252 )   PDF (428KB) ( 639 )   【Abstract】Objective To compare the effects of different doses of intravenous iron supplement on inflammatory response and oxidative stress in maintenance hemodialysis (MHD) patients with persistent iron loss. Method A total of 55 MHD patients with serum ferritin 200-500 ng/ml from the Hemodialysis Center of Beijing BOAI Hospital were randomly divided into group A (sucrose iron 100mg/week×10 times, 400mg/month) and group B. (100mg/2 weeks × 10 times, 200mg/month). The total amount of sucrose iron was 1,000mg in both groups. The changes of inflammatory response and oxidative stress indicators including hypersensitive C-reactive protein (hsCRP), serum superoxide dismutase (SOD), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and glutathione peroxidase (GSH-px) were compared before treatment and after the treatment for 1, 2, 4, 6, 8 and 12 weeks between the two groups. Result There were no significant differences in hsCRP (F=2.161, P=0.067), SOD (F=1.858, P=0.113), IL-6 (F=1.667, P=0.157), TNF-α (F=1.433, P=0.229) and GSH-px (F=2.161, P=0.067) before treatment and at different time points after treatment. There were no significant differences in hsCRP (F=2.179, P=0.065), SOD (F=0.477, P=0.821), IL- 6 (F=0.853, P=0.538), TNF-α (F=0.761, P=0.605) and GSH-px (F=0.720, P=0.636) between the two groups. The coefficient of hemoglobin variation during the treatment period (t=-0.983, P=0.330), and the changes of recombinant human erythropoietin doses (Z=- 0.139, P=0.889), transferrin saturation (t=0.536, P=0.594) and serum ferritin (t=-0.161, P=0.873) before and after the treatment had no statistical differences between the two groups. Conclusion There were no differences in the effects on inflammatory response and oxidative stress in MHD patients treated with intravenous iron 200mg/month and 400mg/month. The two iron therapeutic methods had equal effects for anemia treatment in MHD patients. Metrics

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The influence of hierarchical and individualized management model on the incidence of renal end-point events in chronic kidney disease patients at stage 4-5#br# 2019, 18 (11):  750-754.  Abstract ( 191 )   PDF (481KB) ( 629 )   【Abstract】Objective To analyze the influence of hierarchical and individualized management model on the incidence of end-point events in chronic kidney disease (CKD) patients at stage 4-5. Methods This was a retrospective cohort study that enrolled the hospitalized CKD patients at stage 4-5 but without renal replacement therapy (RRT) from Sept. 2014 to Dec. 2015 in the Department of Nephrology, Xinqiao Hospital of Army Medical University. They were divided into experimental group and control group based on whether they received the long-term regular follow-up in the CKD Management Center. Death and renal replacement therapy were compared between the two groups at December 2018. Results A total of 233 patients were enrolled in this study, in which 91 were in experimental group and 142 were in control group. At the end of the study, 8 patients in experimental group and 11 patients in control group died (χ2＝0.081, P＝0.776); 36 patients in experimental group (kidney transplant, 2 patients; peritoneal dialysis, 3 patients; hemodialysis, 31 patients) and 76 patients in control group (kidney transplant, 9 patients; peritoneal dialysis, 6 patients; hemodialysis, 61 patients) treated with RRT (χ2＝4.330, P＝0.037); 7 patients in experimental group and 2 patients in control group used arteriovenous fistula for blood access at the beginning of hemodialysis (χ2＝8.677, P＝0.003). Conclusions The hierarchical and individualized management model can decrease the use of RRT and temporary catheterization for blood access in CKD patients at stage 4-5. Metrics

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The correlation between the serum levels of Vaspin, Apelin and Chemerin and the nutritional metabolism status in uremic patients undergoing hemodialysis#br# 2019, 18 (11):  755-759.  doi: 10.3969/j.issn.1671-4091.2019.11.006 Abstract ( 223 )   PDF (409KB) ( 661 )   【Abstract】Objective To measure the serum levels of visceral adipose tissue derived serine protease inhibitor (Vaspin), adipokine (Apelin) and Chemerin in uremia patients undergoing maintenance hemodialysis (MHD), and to correlate the serum levels with the nutritional metabolism status in these patients. Methods A total of 100 uremia patients undergoing MHD were selected as the study group, and 120 healthy people were recruited as the control group. Serum levels of Vaspin, Apelin and Chemerin and the indicators relating to nutritional metabolism status were measured. Results Serum levels of calcium (Ca), Vaspin, Apelin and high density lipoprotein cholesterol (HDL) were lower (t=12.783, 10.271, 10.989 and 13.592 respectively; P＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively), while serum levels of C-reactive protein (CRP), creatinine (CRE), blood urea nitrogen (BUN), Chemerin, triglyceride (TG) and low density lipoprotein cholesterol (LDL) were higher in study group before dialysis than in control group (t=26.372, 29.789, 32.423, 22.455, 7.891 and 3.616 respectively; P＜0.001, ＜0.001, ＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively). After MHD for 6 months, serum levels of Ca, Vaspin, Apelin, HDL and LDL decreased (t =4.270, 18.343, 19.478, 6.662 and 2.408 respectively; P＜0.001, ＜0.001, ＜0.001, ＜0.001 and 0.017 respectively), while serum phosphorus (P), fasting blood sugar, CRP, CRE, BUN, Chemerin and TG increased (t= 12.251, 4.184, 18.729, 37.385, 41.026, 26.809 and 8.137 respectively; P＜0.001, ＜0.001, ＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively). Serum levels of CRE, BUN, Vaspin, Apelin, TG, LDL were lower (t=4.814, 7.223, 6.423, 7.936, 2.455 and 5.214 respectively; P＜0.001, ＜0.001, ＜0.001, ＜0.001, 0.015 and ＜0.001 respectively), while serum levels of Ca, P, fasting blood sugar, Chemerin and HDL were higher in study group after MHD for 6 months than in the group before MHD (t =7.692, 9.972, 3.463, 12.129 and 7.250 respectively; P＜0.001, ＜0.001, 0.001, ＜0.001 and ＜0.001 respectively). Serum levels of total protein (TP) and albumin (Alb) were lower in study group after MHD for 6 months than in those before MHD and in control group (t=8.831, 8.447, 7.714 and 8.269 respectively; P＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively). Pearson test showed that serum levels of Vaspin and Apelin were negatively correlated with serum TG levels (t =-0.402 and -0.487; P=0.025 and 0.017), and positively correlated with serum levels of HDL, LDL, TP and Alb in study group after MHD for 6 months (r=0.419, 0.460, 0.506, 0.499; 0.423, 0.438, 0.517 and 0.513 respectively; P=0.009, 0.023, 0.034, 0.021; 0.026, 0.011, 0.018 and 0.031 respectively); serum Chemerin levels were positively correlated with serum TG level (r=0.461, P=0.015), and negatively correlated with serum levels of HDL, LDL, TP and Alb (r=-0.512, -0.473, -0.519 and -0.458 respectively; P=0.021, 0.015, 0.041 and 0.015 respectively), but not correlated with serum TC level in study group after MHD for 6 months (r=0.162, P=0.109). Conclusion Serum levels of Vaspin, Apelin, and Chemerin were correlated to the nutritional metabolism status. hey may be used as monitoring indices for nutrition metabolism status in MHD patients. Metrics

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The technical characteristics of peritoneal dialysis in children 2019, 18 (11):  763-765.  doi: 10.3969/j.issn.1671-4091.2019.11.008 Abstract ( 196 )   PDF (355KB) ( 693 )   【Abstract】Peritoneal dialysis (PD) has become the main renal replacement therapy for children with renal failure. The choice of children with PD, the successful establishment of PD access, and the prevention of PD-related infections are essential to ensure a long-term PD. In this paper, we introduce the technical characteristics of PD in children in order to improve the quality of PD and to enhance the comprehension of PD technology in medical professionals. Metrics

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Research progress in sclerostin in the pathogenesis of renal osteodystrophy 2019, 18 (11):  766-768.  doi: 10.3969/j.issn.1671-4091.2019.11.009 Abstract ( 231 )   PDF (348KB) ( 607 )   【Abstract】Renal osteodystrophy is one of the common and serious complications in CKD patients, leading to a significant increase in fracture risk and morbidity and seriously affecting the quality of life. Sclerostin is a glycoprotein expressed by bone cells, affects bone growth and metabolism at all stages, and participates in the pathogenesis of renal osteodystrophy. This review introduces the advances in the study of sclerostin in renal osteodystrophy. Metrics

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Dilemma of double lifelines: pacemaker and tunnel-cuffed catheter 2019, 18 (11):  772-775.  doi: 10.3969/j.issn.1671-4091.2019.11.011 Abstract ( 274 )   PDF (468KB) ( 628 )   【Abstract】Objective To explore the feasibility of implanting tunneled cuffed catheter (TCC) through internal jugular vein in the presence of heart pacemaker leads and the co-existence of catheters and leads. Methods Seventeen patients with pacemaker leads were recruited from the Department of Nephrology, Beijing Haidian Hospital from April 2014 to August 2018. TCCs were implanted under digital subtraction angiography (DSA) for these patients. The position of pacemaker electrode and leads and the function of pacemaker were examined during and after the operation. The infection around catheter and pacemaker lead, the symptomatic venous hypertension, and the ease of catheter removal were observed during the follow- up period. Results In the 17 patients, the tips of the catheters were successfully placed in the upper-middle part of right atrium in 15 patients, the catheter was implanted after balloon dilatation of the superior vena cava stenosis in one patient, and the catheter tip was first bumped the pacemaker wire and then arrived to upper-middle part of right atrium after adjustment of the tip direction in one patient. During and after the operation, the pacemaker electrodes and leads were not displaced and the functions of the pacemakers were normal. There were no pacemaker lead infection and pacemaker dysfunction during the follow-up period. One patient developed catheterrelated infection after the catheterization for one year but without infection of the pacemaker leads; the infection was cured after anti- infective therapy and replacement of the catheter. Mild swelling of upper limb occurred in one case, but no clinical intervention was required. The catheters were replaced in situ in 9 cases, and no catheter got stuck during removal of the original catheters. Conclusions In patients with pacemaker leads but without severe vascular stenosis, the implanting of TCC under DSA was highly successful and safe. The coexistence of catheters and pacemaker leads did not cause infection around pacemaker lead and pacemaker dysfunction at least in a short follow-up period. Symptomatic venous hypertension was rare. Metrics

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The application of indwelling tunneled cuffed catheter in femoral vein for hemodialysis 2019, 18 (11):  776-779.  doi: 10.3969/j.issn.1671-4091.2019.11.012 Abstract ( 237 )   PDF (424KB) ( 619 )   【Abstract】Objective To investigate the application of indwelling tunneled cuffed catheter (TCC) in femoral vein for hemodialysis. Method Forty-two patients with TCC indwelling in femoral vein and 32 patients with TCC indwelling in internal jugular vein for maintenance hemodialysis during January 2016 to December 2017 were enrolled in this study. The applications of these catheters were analyzed. Results There was no significant difference in urea clearance index between the two groups using the catheters for 4 and 24 weeks (t=0.429, P=0.670 for 4 weeks; t=1.231, P=0.225 for 24 weeks). The incidence of catheter dysfunction was obviously higher in femoral vein group than in internal jugular vein group (χ2=5.891, P=0.017 for 4 weeks; χ2=51.080, P=0.000 for 12 weeks; χ2=20.857, P=0.000 for 24 weeks; χ2=24.000, P=0.000 for 36 weeks); but the blood flow of the two groups still met with the dialysis requirement after sealing the catheters with a low dose of urokinase (5000 IU/ml). Catheter- related infection developed in 3 cases in femoral vein group, but not found in internal jugular vein group. No deep vein thrombosis occurred in both groups. After 6 months in femoral vein group, the dose of urokinase increased obviously, urea clearance index decreased significantly (t=3.810, P=0.001) lower than that in internal jugular vein group (t= 3.810, P=0.001), and the rate of infection and venous thrombosis increased. Conclusion TCC indwelling in femoral vein for a short period of time (<24 weeks) can be used in patients requiring a transitional blood access for hemodialysis. This method avoids central venous stenosis and does not interfere with the establishment of autologous arteriovenous fistula or arteriovenous fistula graft. Metrics

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Application and clinical observation of a separate membrane needle-free closed infusion joint in central#br# venous catheter of hemodialysis#br# 2019, 18 (11):  780-782.  doi: 10.3969/j.issn.1671-4091.2019.11.013 Abstract ( 398 )   PDF (389KB) ( 640 )   【Abstract】Objective To observe the clinical effect of separate membrane needle-free joints applied to hemodialysis central venous catheters. Methods From January 2017 to June 2017, 36 patients with central venous catheter for maintenance hemodialysis were chosen from the Blood Purification Center of the General Hospital of Chinese PLA. They were randomly split into observation group and control group, with 18 patients in each group. The observation group used a separate membrane needle-free joint, and the control group used a conventional small cap. The side-effects of catheter-related bloodstream infection, rupture or erosion of the catheter port, bleeding and air embolism during the use of central venous catheters, and the use of a septum needle-free closed connector on blood flow during hemodialysis were noted. Results The incidence of catheter-related bloodstream infection, catheter rupture or corrosion, bleeding and air embolism were statistically significant between the two groups (P=0.043). There was no significant difference in the effect of blood flow during treatment (arterial pressure: t= -1.71, P=0.087; venous pressure t=-1.19, P=0.236). Conclusion There is no any effect on the blood flow during treatment before and after use. The use of a separate membrane needle-free connector reduces the occurrence of catheter rupture, corrosion, bleeding and air embolism. This joint can be recommended for clinical use. Metrics

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Investigation on the cause of severe sleep disorder in maintenance hemodialysis patients 2019, 18 (11):  783-786.  doi: 10.3969/j.issn.1671-4091.2019.11.014 Abstract ( 353 )   PDF (460KB) ( 694 )   【Abstract】Objective The sleep quality in maintenance hemodialysis (MHD) patients was investigated and its influencing factors were analyzed. Methods The sleep quality of 112 MHD patients was investigated using the Pittsburg Sleep Quality Index (PSQI) scale, Social Support Rating Scale (SSRS), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). According to the PSQI score, patients with scores less than or equal to 10 were classified as a group without severe poor sleep quality (G1), and those with scores of >10 were classified as a group with severe poor sleep quality (G2). SSRS, SAS and SDS were used to evaluate the influences of anxiety and depression on sleep quality. Results Thirty-eight of the 112 MHD patients (33.93%) had a PSQI score of >10. Four factors were significant different between the two groups: age (62.20 ± 10.62 years vs. 51.51±15.12 years, t=4.253, P＜0.001), months of dialysis (78.46±88.96 months vs. 46.12±45.68 months, t=2.028, P=0.048), albumin (37.94±2.86 g/L vs. 39.37±2.49 g/L, t=2.542, P=0.013), and PTH (243.32±158.85 pg/ml vs. 327.54±209.34 pg/ml, t=2.324, P=0.022). SDS score was also significant different between the two groups (χ2=7.110, P=0.029). A logistic regression model was established to predict the sleep quality: f(x) =1/(1 + e0.074289x1 + 0.055897x2 + 0.99036) (x1 is age; Z =- 2.600, P =0.009, and x2 is SDS score, Z =-2.004, P=0.028). The model had the accuracy of 71.9% and the area under curve of 0.748. Conclusions Sleep quality is a common problem in MHD patients. Severe sleep quality problem usually exists in elderly patients, patients with long dialysis period, low albumin, and low PTH. Patients with depression are easily to have severe sleep problem. We have established a logistic regression model to predict sleep quality, which may be clinically useful. Metrics

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Cognitive and behavioral investigation of low- sodium diet in maintenance hemodialysis patients 2019, 18 (11):  787-790.  doi: 10.3969/j.issn.1671-4091.2019.11.015 Abstract ( 210 )   PDF (385KB) ( 637 )   【Abstract】Objective To discuss the cognition and behavior changes in maintenance hemodialysis (MHD) patients on low sodium diet. Methods A self- designed "Cognition and behavior questionnaire for MHD patients on low-sodium diet" was used to investigate a total of 148 MHD patients. Results The awareness rate of low- sodium diet and the risk of non- compliance with low- sodium diet in MHD patients was 40.54%. The average percentage of low-sodium diet behavior was 41.89%. Age and education level of the patients and education level of the primary caregivers were significantly correlated with the knowledge level of low-sodium diet in MHD patients. Conclusion Knowledge and behavior of low-sodium diet are at the middle and lower level in MHD patients. Medical staff should take active measures to educate the patients about the importance of low-sodium diet to improve their quality of life. Metrics

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The awareness of dialysis related knowledge and its influence factors in hemodialysis patients 2019, 18 (11):  791-794.  doi: 10.3969/j.issn.1671-4091.2019.11.016 Abstract ( 213 )   PDF (426KB) ( 630 )   【Abstract】Objective To investigate the awareness of dialysis related knowledge and its influence factors in maintenance hemodialysis (MHD) patients. Methods A cross-sectional survey was conducted in 104 MHD patients treated in the Hemodialysis Center, University Town Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine. Self-made dialysis related knowledge questionnaire was used to assess the awareness of dialysis related knowledge and its influence factors. Results The total score of dialysis related knowledge was 56.41+10.09 in the MHD patients. The percentages of the MHD patients with good, moderate and low levels of the knowledge were 1.9%, 33.7% and 64.4% respectively. Age was the influence factor for the knowledge scores of hyperkalemia, calcium and phosphorus disorders, and dietary principle (β =-0.226, -0.341 and -0.216 respectively; P=0.025, 0.000 and 0.023 respectively). Education level was the influence factor for the knowledge scores of volume control, renal anemia and dietary principle (β =0.209, 0.230 and 0.187 respectively; P=0.039, 0.023 and 0.045 respectively). Dialysis protocol was the influence factor for the knowledge scores of calcium and phosphorus disorders and dietary principle (β=0.235 and 0.254 respectively; P=0.013 and 0.010 respectively). The service year of the responsible nurses was the influence factor for the knowledge scores of renal anemia, dietary principle and vascular access (β=0.256, 0.316 and 0.284 respectively; P=0.040, 0.008 and 0.025 respectively). Conclusion The awareness of dialysis related knowledge in MHD patients is insufficient. Medical staff should focus the education about the dialysis related knowledge on the patients with older age, lower education level and a single dialysis protocol. Administrators of hemodialysis should enhance the training especially for nurses with lower service years, through which their health education ability can then be improved. Metrics

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Application of a medical film for exit site care in home-based peritoneal dialysis patients 2019, 18 (11):  795-797.  doi: 10.3969/j.issn.1671-4091.2019.11.017 Abstract ( 207 )   PDF (401KB) ( 615 )   【Abstract】Objective To investigate the effectiveness of a medical film for exit site care in home-based peritoneal dialysis (PD) patients. Methods A total of 155 patients undergoing PD tube placement surgery at the Department of Nephrology, Zhujiang Hospital of Southern Medical University were enrolled in this study. After two weeks when sutures have been removed, a medical film was used in experimental group, and the bag for anal ostomy patients was used only during bath in control group. The satisfaction of exit site protection and the incidence of exit site infection were compared between the two groups. Results There were a higher satisfaction (92.2% vs. 67.9%, χ2=14.252, P＜0.001) and less wetness at exit site (0% vs. 37.2%, χ2=35.217, P＜0.001) in experimental group than in control group. Exit site infections was lower in experimental group than in control group but without statistical significance (3.9% vs. 10.3%, χ2=2.377, P＝0.123); it became statistically significant after adjustment of the percentage with bath frequency (χ2=5.164, P=0.023). Conclusion The use of the medical film for exit site care increased the comfort feeling and decreased the obstacle to bath and exit site infection. Metrics

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Clinical application of a simple holder for the hemodialysis arm 2019, 18 (11):  798-800.  doi: 10.3969/j.issn.1671-4091.2019.11.018 Abstract ( 218 )   PDF (730KB) ( 637 )   【Abstract】Objective To discuss the clinical application of a simple holder for the hemodialysis arm. Method During the hemodialysis session, the intervention group used a simple holder device for the hemodialysis arm, while the control group used the traditional fixation method for the hemodialysis arm. The adverse events of arteriovenous fistula and the comfort of dialysis arm were compared between the two groups. After the use, the satisfaction of the simple holder for the hemodialysis arm was assessed by the patients and nurses. Result The adverse events of arteriovenous fistula and the comfort degree of dialysis arm were significantly higher in intervention group than in control group (t=11.145, P<0.001). The satisfaction degree of the simple holder method was significantly higher than that of traditional fixation method (Z=-5.463, P＜0.001) in both the patients and the nurses. Conclusion The simple holder has a good fixation and protection effects on the hemodialysis arm and can significantly reduce the adverse events of arteriovenous fistula during hemodialysis. Metrics

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A comparative study of two different types of dialysis machines 2019, 18 (11):  801-804.  doi: 10.3969/j.issn.1671-4091.2019.11.019 Abstract ( 721 )   PDF (657KB) ( 852 )   【Abstract】Objective To compare the cleanliness and failure rate between the dialysis machines with central dialysis fluid delivery (CDDS) system and the conventional dialysis machines, and to analyze the clinical application advantages of the dialysis machines with CDDS system. Methods From August 2017 to March 2018, the bacteria number and endotoxin level at the inlet and outlet sites were compared between the dialysis machines with CDDS system (5 sets) and the Berengdejia dialyzer (5 sets) in the PLA General Hospital Dialysis Center. A retrospective analysis was performed on the incidence of water, circuit and other faults occurred in the dialysis machines with CDDS system (18 sets) and the Berengdejia dialyzer (18 sets) during the period from March 2017 to March 2019. Results The bacteria number and endotoxin level at the inlet were lower in the dialysis machines with CDDS system than in the conventional dialysis machines (t=11.215 and 6.468 respectively; P＜0.001). The bacteria number and endotoxin level at the outlet were also lower in the dialysis machines with CDDS system than in the conventional dialysis machines (t=9.154 and 5.490 respectively; P＜0.001). The incidence of water, circuit and other faults were lower in the dialysis machines with CDDS system than in the conventional dialysis machines (t=9.147, P=0.010). Conclusion CDDS system can improve the cleanliness of dialysate and reduce the failure rate of dialysis machines during clinical applicati Metrics