Chinese Journal of Blood Purification

12 August 2020, Volume 19 Issue 08 Previous Issue    Next Issue

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Clinical analysis of the 265 secondary hyperparathyroidism cases treated with total parathyroidectomy 2020, 19 (08):  505-508.  doi: 10.3969/j.issn.1671-4091.2020.08.001 Abstract ( 489 )   PDF (478KB) ( 842 )   【Abstract】Objective To analyze the clinical characteristics of the 265 secondary hyperparathyroidism (SHPT) patients who underwent total parathyroidectomy (t-PTX). Methods Clinical manifestations, laboratory results and pathological changes of the SHPT patients who underwent t-PTX from January 2018 to December 2019 were retrospectively analyzed. Results In the 265 patients, the SHPT lasted 1-9 (3.07±2.13) years, 5 had heterotopic paraglands (1.89%), 220 had 4 paraglands removed (83.02%), 182 had nodular hyperplasia, 6 had adenomatous hyperplasia, and 64 had both types of hyperplasia. After operation, 218 patients developed hypocalcemia (82.26%). During hospitalization, 557.86±376.20 ml of higher concentration calcium was supplemented intravenously. After operation, 6 patients recurred (22.64%), and 2 patients died in peri-operation period (0.75%). Before operation, serum PTH was 588～2934 (1729.15±345.18) pg/ml, Ca was 1.95～2.93 (2.43±0.19) mmol/L, and P was 1.3～3.59 (2.38±0.52) mmol/L; during operation, PTH decreased to 49.00～895.00 (286.97±179.25) pg/ml; after operation, PTH, CA and P levels decreased significantly (t=6.630, - 2.965 and - 3.412 respectively; P＜0.001, 0.005 and 0.001 respectively). Bone pain was found in 246 patients (92.83%), with the bone pain course of 0~8 years (2.30±1.95) years and bone pain score of 0～10 (5.08 ± 2.65) points. Bone density measurement found normal bone mass in 34 patients (12.83%), lower bone mass in 105 patients (39.62%), and osteoporosis in 126 patients (47.55%). Skin itch was found in 197 patients (74.34%), with the itch course of 0~8 years (2.13±1.25) years and itch score of 0～10 (3.58±1.19) points. After operation 6 morrths, bone pain and itch improved significantly (t=7.897 and 2.542 respectively; P<0.001 and 0.014 respectively). Conclusions t-PTX is a safe and effective method to treat SHPT. Most SHPT patients have severe bone pain and itching. The pathological changes of parathyroids were mainly nodular lesions. SHPT can be significantly improved by t-PTX surgery. Severe hypocalcemia may occur after surgery, which should be carefully monitored. Metrics

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The effect of plasma exchange at early disease stage on clinical outcome of the patients with non-mild hypertriglyceridemic pancreatitis 2020, 19 (08):  509-512.  doi: 10.3969/j.issn.1671-4091.2020.08.002 Abstract ( 461 )   PDF (493KB) ( 774 )   【Abstract】Objective To observe the effect of plasma exchange (PE) at early disease stage on clinical outcome of the patients with non-mild hypertriglyceridemic pancreatitis (HTGP). Methods A total of 67 non-mild HTGP patients treated in the ICU of our hospital from August 2013 to August 2019 were recruited. The patients were divided into early PE group (PE after abdominal pain for <48hours; n=33) and late PE group (PE after abdominal pain for >48hours; n=34). Clinical data of the patients were collected. The main outcomes including in-hospital mortality, organ failure, intra-abdominal hypertension (IAH), acute peri-pancreatic fluid accumulation, acute pancreatic necrosis, pancreatic pseudocyst, infected pancreatic necrosis, and surgical intervention were recorded during hospitalization. The period of staying in ICU, total length of staying in hospital and medical expenses were calculated. Results were analyzed using SPSS 19.0 statistical software. Results Compared to the patients in late PE group, patients in early PE group had lower rates of acute pancreatic necrosis, pancreatic pseudocyst, surgical interventions, transient organ failure, persistent respiratory failure and persistent renal failure (χ2＝7.923, 7.403, 5.518, 4.377, 4.750 and 3.945 respectively; P＝0.005, 0.007, 0.019, 0.036, 0.029 and 0.047 respectively), shorter period of staying in ICU and total length of staying in hospital (Z＝-2.243 and -2.426 respectively, P＝0.019 and 0.015 respectively), and lower medical expenses (Z＝- 2.982, P＝0.003). However, there were no significant differences in in- hospital mortality rate (3.0% vs. 2.9%, P＝1.000) and incidence of infectious pancreatic necrosis (6.1% vs. 23.5%, χ2＝2.766, P＝0.096) between the two groups. Conclusion Early PE may be useful in reducing local complications and organ failure in patients with non-mild hypertriglyceridemic pancreatitis. Metrics

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Correlation between interdialytic weight gain and intradialytic hypotension  2020, 19 (08):  513-516.  doi: 10.3969/j.issn.1671-4091.2020.08.003 Abstract ( 413 )   PDF (437KB) ( 858 )   【Abstract】Objective To analyze the correlation between interdialytic weight gain and intradialytic hypotension (IDH). Methods A total of 146 patients with maintenance hemodialysis (MHD) admitted to Daxing Teaching Hospital of Capital Medical University from January 2017 to June 2018 were enrolled in this study. All patients underwent regular bicarbonate dialysis (3 times/week). Their baseline data, blood biochemistry, body mass before and after dialysis, and blood pressure before and after dialysis were collected. According to the presence or absence of IDH during dialysis, the patients were divided into IDH group (53 cases) and non-IDH group (93 cases). The analysis of related factors affecting IDH was performed. The correlation between interdialytic weight gain (IDWG), IDWG% and blood pressure reduction before and after dialysis was analyzed. Results Age, prevalence of diabetes, IDWG, IDWG%, systolic blood pressure (SBP) before dialysis, mean arterial pressure (MAP) before dialysis, ultrafiltration volume and ultrafiltration rate in IDH group were higher than those in non-IDH group (t or χ2=6.413, 12.23, 6.821, 6.561, 3.123, 10.059 and 9.717 respectively; P＜0.001). Albumin before dialysis in IDH group was lower than that in non- IDH group (t=3.852, P＜0.001). Age (OR=2.186, 95% CI: 1.329～3.596, P=0.002), SBP before dialysis (OR=2.232, 95% CI:1.338～3.723, P=0.002), IDWG (OR=2.815, 95% CI:1.557～5.088, P=0.001), IDWG% (OR=3.093, 95% CI: 1.671~5.723, P＜0.001), ultrafiltration volume (OR=2.109, 95% CI: 1.216～3.657, P=0.008) and ultrafiltration rate (OR=2.284, 95% CI: 1.375～3.795, P=0.002) were the independent risk factors for IDH during dialysis in MHD patients. IDWG and IDWG% were positively correlated with the reductions of SBP (r=0.372 and 0.379; P＜0.001), DBP (r=0.381 and 0.395; P＜0.001) and MAP (r=0.314 and 0.305; P=0.002 and 0.003) before and after dialysis. The risk of IDH in patients with IDWG% ≥4.1% was higher than that in patients with IDWG% ＜4.1% (log rank test=21.670, P＜0.001). Conclusion There are many factors affecting the occurrence of IDH during dialysis in MHD patients. Interdialytic weight gain is related to the occurrence of IDH. It is necessary to strictly control the interdialytic weight gain. Metrics

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The value of SPECT/CT tomography in rEoperation therapy of secondary hyperparathyroidism 2020, 19 (08):  517-520.  doi: 10.3969/j.issn.1671-4091.2020.08.004 Abstract ( 275 )   PDF (370KB) ( 761 )   【Abstract】Objective To evaluate the value of 99Tcm-MIBI SPECT/CT dual-phase tomography in rEoperation therapy of secondary hyperparathyroidism. Methods A total of 19 patients with secondary hyperparathyroidism who underwent rEoperation from Jan. 2016 to Mar. 2019 were retrospectively analyzed. All patients underwent 99Tcm-MIBI SPECT/CT dual- phase tomography before rEoperation, and the results were compared with those of neck ultrasonography. The diagnostic efficacy of 99Tcm-MIBI SPECT/CT dualphase tomography and ultrasonography for parathyroid lesions was compared with the "golden standard", pathological findings of the surgical samples. Results The sensitivities of 99Tcm-MIBI SPECT/CT dualphase tomography and neck ultrasonography were 95.2% and 52.3% respectively for the diagnosis of secondary hyperparathyroidism (P=0.004) and were 90.9% and 18.2% respectively for the diagnosis of ectopic parathyroid gland (P=0.008). The accuracies of 99Tcm-MIBI SPECT/CT dual-phase tomography in the diagnosis of secondary hyperparathyroidism and ectopic parathyroid gland were 71.4% and 83.3%respectively, higher than those of neck ultrasonography (34.3% and 18.2% respectively). Conclusions 99Tcm-MIBI SPECT/CT dual-phase tomography is more sensitive than ultrasonography in detection of parathyroids, especially in detection of ectopic parathyroids, in rEoperation therapy of secondary hyperparathyroidism. This method is clinically valuable for the localization of parathyroids in secondary hyperparathyroidism patients before rEoperation. Metrics

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Hypersensitivity reactions to dialyzer: analysis of 18 cases and review of the literature 2020, 19 (08):  521-524.  doi: 10.3969/j.issn.1671-4091.2020.08.005 Abstract ( 610 )   PDF (389KB) ( 1066 )   【Abstract】Aims To assess the incidence and characteristics of hypersensitive reactions to dialyzer in hemodialysis patients. Methods We retrospectively analyzed the patients necessary to change dialyzers due to hypersensitivity to the dialyzers in the four hospitals in Liaoning province during December 2016 to December 2019. Their clinical data including symptoms, onset time, offending dialyzer, duration of exposure to the dialyzer, and the alternative dialyzer were collected. Results Eighteen patients out of 853 patients (2.11%) had hypersensitive reactions. The most frequent symptoms were dyspnea (50% of reactions) and skin itch (33.33%). Hypersensitive reactions occurred within the first 30 minutes of hemodialysis in 12 cases, and during the first week of dialysis in 9 cases. The membranes involved were polysulfone (n=9), polyamix (n=8) and polyethersulfone (n=2). Thirteen cases were treated with hemodialysis, and 5 cases with hemodiafiltration. The dialyzers were sterilized by steam. Three cases still had hypersensitive reactions when the dialysis membranes were replaced by different types of PS/PAES membranes. All of the cases became asymptomatic when cellulose triacetate membranes were used. Conclusion The incidence of hypersensitive reactions associated with synthetic membranes is less changed compared with that 20 years ago. Cellulose triacetate membrane appears to be a better alternative, of which the reason needs to be further studied. Metrics

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Effect of real-time dynamic weight monitoring combined with non-invasive hemodynamic monitoring in continuous blood purification 2020, 19 (08):  525-527.  doi: 10.3969/j.issn.1671-4091.2020.08.006 Abstract ( 255 )   PDF (388KB) ( 736 )   【Abstract】Objective To investigate the guiding role of real- time dynamic body weight monitoring combined with non- invasive hemodynamic monitoring in nursing care of patients undergoing continuous blood purification (CBP) treatment. Methods A total of 100 patients treated with CBP and with noninvasive hemodynamic monitoring before and after the treatment were enrolled in this study. They were randomly divided into two groups. In control group (n=50 cases), body weight was measured before and after CBP; in experiment group (n=50 cases), body weight was measured every hour before, during and after CBP by using a weighing bed, and the deviations were corrected. The compliance rates of volume load and body weight and the incidence of complications were compared between the two groups. Results For volume status, thoracic fluid content (TFC) in males, TFC in females, central venous pressure (CVP) and mean arterial pressure (MAP) were significantly lower in the experiment group as compared those in the control group (t=4.938, 3.621, 4.292 and 5.539 respectively; P＜0.001); the compliance rate of body weight was higher (χ2= 4.001, P=0.046) and the incidence of complications was lower (χ2=4.496, P=0.036) in the experiment group as compared those in the control group. Conclusion The use of real-time dynamic weight detection combined with non-invasive hemodynamic monitoring during CBP can easily observe the patients’volume status, correct the deviation immediately, and adjust the ultrafiltration volume accurately, thus useful for the performance of CBP treatment and nursing protocols in critically ill patients. Metrics

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Correlation between serum sclerostin level and brachial-ankle pulse wave velocity in maintenance hemodialysis patients 2020, 19 (08):  528-532.  doi: 10.3969/j.issn.1671-4091.2020.08.007 Abstract ( 263 )   PDF (463KB) ( 687 )   【Abstract】Objective To investigate the serum sclerostin level and explore its relationship with brachialankle pulse wave velocity (baPWV) in maintenance hemodialysis (MHD) patients. Methods A total of 110 stable MHD patients undergoing hemodialysis for at least three months and 40 healthy individuals as the controls were enrolled in the study. Serum level of sclerostin was measured by ELISA and baPWV was determined. Their baseline characteristics and laboratory measurements were collected, and correlation analysis of sclerostin with baPWV and other parameters was performed. Results Serum sclerostin level and baPWV were significantly higher in MHD patients as compared with those in healthy controls (73.34±30.08 ng/L vs. 21.13±13.69 ng/L, t=5.654, P＜0.001 for serum sclerostin; 1875.96±375.38 cm/s vs. 1343.14±131.38 cm/s, t=3.722, P＜0.001 for baPWV). Sclerostin level was positively correlated with intact parathyroid hormone (iPTH) (r=0.397, P＜0.001), phosphorus (P) (r=0.364, P＜0.001), high sensitive c-reactive protein (hsCRP) (r=0.536, P＜0.001), and mean arterial pressure (MAP) (r=0.397, P=0.037). Multivariate stepwise regression showed that hsCRP (β=0.286, P=0.021), P (β=0.218, P=0.027) and iPTH (β=0.196, P=0.033) were the independent risk factors for sclerostin. Based on baPWV value, the degree of arterial sclerosis in MHD patients can be categorized into non-, slight, moderate and severe arteriosclerosis. The incidence of arteriosclerosis (baPWV ＞1400 cm/s) was 91.8% in this series of MHD patients. Sclerostin (F=16.043, P＜0.001), hsCRP (F=3.552, P=0.021), MAP (F=4.736, P=0.010) and age (F=9.074, P＜0.001) were significantly higher in baPWV ≥1800 m/s patients. In MHD patients, baPWV was positively correlated with age (r= 0.368, P＜0.001), MAP (r=0.397, P＜0.001), sclerostin (r=0.571, P＜0.001), P (r=0.224, P=0.035) and hs-CRP (r=0.278, P= 0.008). Multivariate stepwise regression showed that sclerostin level was still the independent risk factors for baPWV in MHD patients (OR=1.292, 95% CI=1.017～1.641, P=0.012) after adjusting age and MAP. Conclusion The incidence of arteriosclerosis is high in MHD patients. Serum sclerostin level may relate to arterial stiffness. Higher sclerostin level is the independent risk factors for arteriosclerosis. Metrics

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Effects of erythropoietin on acute kidney injury in patients undergoing cardiac surgery 2020, 19 (08):  533-536.  doi: 10.3969/j.issn.1671-4091.2020.08.008 Abstract ( 353 )   PDF (494KB) ( 693 )   【Abstract】Objective To investigate whether prEoperative administration of erythropoietin (EPO) can improve acute kidney injury (AKI) and its prognosis in patients undergoing cardiac surgery. Methods A singlEcenter randomized controlled study including 92 patients undergoing cardiac surgery in Department of Thoracic and Cardiovascular Surgery of Nanjing First Hospital was conducted. Patients were randomly divided into EPO group and control group. Post-operative prognosis indicators such as incidence of AKI, requirement of renal replacement therapy, death and length of stay in hospital were compared between the two groups. Renal function and inflammation indicators at different stages after surgery were analyzed by repeated measurement analysis of variance. Results Compared with the control group, the early renal injury biomarkers of neutrophil gelatinase associated lipocalin (NGAL) and interleukin-18 (IL-18) in the EPO group were significant decrease at different stages after operation (F= 15.330 and 8.243 respectively, P＜0.001 and 0.006 respectively). The incidence of AKI was lower in the EPO group but without statistically significance (19.6% vs. 32.6%, χ2=2.029, P=0.235). There were no statistical differences in other parameters of post-operative prognosis between the two groups. Conclusions PrEoperative administration of EPO is safe and may have renal protection effects in patients undergoing cardiac surgery. However, the effects of EPO on other parameters of post-operative prognosis are unknown. Metrics

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Dynamic change of red blood cell distribution width predicts mortality in peritoneal dialysis patients 2020, 19 (08):  537-542.  doi: 10.3969/j.issn.1671-4091.2020.08.009 Abstract ( 332 )   PDF (572KB) ( 722 )   【Abstract】Objective To explore the relationship between the values of baseline red blood cell distribution width (RDW), time-averaged RDW and RDW dynamic trends and the all-cause mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods We reviewed 89 incident patients undergoing (CAPD) between July 1, 2005 and June 30, 2017 treated at the Peritoneal Dialysis Center of Beijing Hospital and examined the changes of RDW from baseline to December 31, 2018. We then assessed the relationship between the values of baseline RDW and time-averaged RDW and the risk of mortality. The optimal cut-off value of time- averaged RDW was determined based on receiver operating characteristic (ROC) curve. We assigned the patients into four groups according to baseline RDW and time-averaged RDW: "double-low" RDW group at baseline and follow-up; low baseline and high follow-up RDW group; high baseline and low followup RDW group; and "double-high" RDW group at baseline and follow-up. The difference of prognosis was observed among the four groups. Results This study included 89 patients, with an average age of 62.6 years and a mean follow-up duration of 48.0 (32.0～66.0) months. Thirty-three patients (37.1%) died in the followup period. Baseline RDW and time-averaged RDW correlated positively with mortality (r=0.365, P＜0.001;r=0.520, P＜0.001). Multivariate COX regression analysis showed that time-averaged RDW was a significant predictor of all-cause mortality in the CAPD patients (HR=1.833, 95% CI: 1.158～2.899, P=0.010). The area under the curve (AUC) in ROC for time-averaged RDW was 0.881 (95％ CI: 0.686～0.808, P＜0.001), and the optimal prediction cut-off value was 14.1%. Compared with the "double-low" RDW group at baseline and follow-up, the cumulative survival rate was lower in the "double-high" RDW group and low baseline and high follow-up RDW group (c2=17.172, P＜0.001; c2=11.232,P=0.001). Conclusions Higher time-averaged RDW was associated with a higher risk of mortality among CAPD patients. Compared with the patients with persistently low RDW, those with persistently high RDW or low baseline and high follow-up RDW had poorer survival outcomes. Metrics

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Application of regional citrate anticoagulation in different blood purification modalities  2020, 19 (08):  543-546.  doi: 10.3969/j.issn.1671-4091.2020.08.010 Abstract ( 531 )   PDF (433KB) ( 1139 )   【Abstract】Anticoagulation is of major importance for successful performance of blood purification. Currently, the classic anticoagulation methods are heparin and low molecular weight heparin. Regional anticoagulation of citrate (RCA) is now widely used for continuous blood purification due to its safety, effectiveness, wider application range and better biocompatibility. RCA has been recommended in domestic and foreign guidelines. Citrate anticoagulation is an ideal method, which has been confirmed by a large number of studies in different blood purification modalities. However, citrate has several drawbacks found in clinical practice, including complicated monitoring and adjustment and many potential side effects. Optimized protocols of citrate anticoagulation are therefore explored and recommended in order to provide new ways for the better use of citrate as an anticoagulation agent in blood purification. In this paper, we review the progress in monitoring and adjusting RCA in different blood purification modalities. Metrics

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Recent advances in secondary hyperparathyroidism and the related complications after renal transplantation 2020, 19 (08):  547-549.  doi: 10.3969/j.issn.1671-4091.2020.08.011 Abstract ( 371 )   PDF (336KB) ( 746 )   【Abstract】 Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease patients. Hyperparathyroidism may still occur in some patients after successful kidney transplantation due to the changes of calcium and phosphorus metabolism that lead to the abnormal functions of parathyroid gland. Recently, it is found that hyperparathyroidism after kidney transplantation increases the risks of loss functions of the graft, bone metabolic disorders, cardiovascular diseases, post-transplantation diabetes mellitus and death. In this paper, the relationship between SHPT and kidney transplantation related complications is discussed. Metrics

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Effect of the neutrophil/lymphocyte ratio on patency rate of autologous arteriovenous fistulas after PTA 2020, 19 (08):  554-558.  doi: 10.3969/j.issn.1671-4091.2020.08.013 Abstract ( 280 )   PDF (500KB) ( 739 )   【Abstract】Objective To investigate the effect of neutrophil/lymphocyte ratio (NLR) on patency of autologous arteriovenous fistulas (AVF) after percutaneous transluminal angioplasty (PTA). Methods This study consisted of 84 patients with successful PTA treated in the Department of Nephrology, the Second Hospital of Anhui Medical University between June 2018 and July 2019. Their clinical data and follow-up information were recruited. Patients were divided into two groups according to the level of NLR before PTA: high NLR group (n=42) and low NLR group (n=42). Survival analyses and log-rank test were used to compare the patency rate between the two groups. Multivariate Cox regression was used to analyze the interference factors for patency rate. Results There were 47 males and 37 females. The average follow- up time was 263.51±120.41 days. The rEstenosis rate was significantly higher in high NLR group compared to low NLR group (χ2=7.683, P=0.006). Serum magnesium was lower in high NLR group (t=2.486, P=0.015). The patency of AVF was significantly lower in high NLR group than in low NLR group (log rank test: χ2=7.885, P=0.005). Conclusion Higher NLR is an independent risk factor for the patency of AVF after PTA. Metrics

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Epidemiological analysis of the death of maintenance hemodialysis patients inWuhan city#br# 2020, 19 (08):  562-565.  doi: 10.3969/j.issn.1671-4091.2020.08.015 Abstract ( 293 )   PDF (481KB) ( 723 )   【Abstract】Objective To retrospectively analyze the epidemiology of maintenance hemodialysis (MHD) in Wuhan in the period from 2015 to 2018 in order to provide the supporting data for the improvement of quality control of hemodialysis. Methods Information of the MHD patients registered in the Quality Control System of Dialysis in Wuhan from 2015 to 2018 was retrospectively studied. Age, sex, dialysis age, primary disease, vascular access pathway and cause of death of the patients were analyzed. Results ①The decrease tendency of annual mortality was present in the MHD patients (χ2=22.668，P＜0.001), and their dialysis age became longer (χ2=18.950, P＜0.001). ②Proportion of the MHD patients died in the first dialysis year became less (χ2=20.069, P＜0.001). ③Diabetes accounted for the highest proportion of primary diseases in death cases (26.4% ), followed by hypertension (25.1% ) and primary glomerulonephritis (22.1%). ④The cause of death was cardiovascular events (25.3%), cerebrovascular events (15.8%), infection (5.9%) and gastrointestinal bleeding (3.6%). ⑤The proportion ofAVF in the middlEaged group (45～59 years old) was significantly higher than that in other age groups, and the proportion ofAVF in the elderly group was the lowest (χ2=45.927, P＜0.001). ⑥ The median survival time ofAVF patients was 40 (65, 20) months, significantly longer than that of 19 (38,9) months in non-AVF patients (χ2=104.818, P＜0.001). Conclusion The annual mortality rate of MHD patients inWuhan city was decreasing. In the death MHD patients, dialysis age became longer, the most important primary disease was diabetes, the most important cause of death was cardiovascular events, and the survival time was relatively longer inMHDpatients withAVF. Metrics

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The application of grade I quality control in homogeneous management of blood purification centers 2020, 19 (08):  566-568.  doi: 10.3969/j.issn.1671-4091.2020.08.016 Abstract ( 256 )   PDF (377KB) ( 811 )   【Abstract】Objective To investigate the application effect of grade I quality control in the homogeneous management of large blood purification centers in tertiary hospitals. Methods A grade I quality control management network of the blood purification center was established in April 2018, and all nurses participated in quality control and feedback in time for renovation. Satisfaction from patients in one year (March 2018 to April 2019) was compared before and after grade I quality control management. The average knowledge and operation scores were compared between groups before and after grade I quality control management in certificated hemodialysis nurses working less than 3 years and those working more than 3 years. Results Satisfaction from patients increased significantly after grade Ⅰ quality control management (χ2=5.065, P=0.024). The average knowledge and operation scores improved significantly after one year of grade I quality control management in the two groups of nurses (t=4.271 and 2.430, P=0.002 and 0.025). The average scores were different between the two groups before grade I quality control management (t=5.347, P=0.001) and became no differences after grade I quality control management for one year (t=0.547, P= 0.589). Conclusion The application of grade I quality control in homogeneous management of blood purification centers improved the knowledge and operation levels of nurses, especially nurses with less experiences. Eventually, satisfaction from patients increased and patients benefited from homogeneous and standardized nursing services. Metrics

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Summary of the best evidence for central venous catheterization in hemodialysis patients 2020, 19 (08):  569-572.  doi: 10.3969/j.issn.1671-4091.2020.08.017 Abstract ( 348 )   PDF (390KB) ( 962 )   【Abstract】Objective To retrieve, evaluate and integrate the best evidence for central venous catheterization in hemodialysis patients, and to summarize the best evidence. Methods A computer search of the Cochrane Library, PubMed, Embase, Medline, Wanfang, China Knowledge Network, Weipu and other databases and Yimaitong Clinical Guide Network, JBI EvidencEbased Nursing Database and Chinese database CNKI was performed. The searched evidence and results of randomized controlled experiments were summarized. The search period was from the time of construction to March 1, 2020. Results A total of 10 articles were enrolled, including 2 guidelines, 3 systematic reviews, 1 expert consensus, and 4 randomized controlled trials. Conclusion The best evidence of central venous catheterization for hemodialysis patients was summarized and specific recommendations were formed, which provide evidencEbased nursing for clinical medical staff, and instructive significance for scientific nursing of central venous catheterization in hemodialysis patients. Metrics

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Investigation and analysis on the family burden of caregivers for home peritoneal dialysis patients 2020, 19 (08):  573-576.  doi: 10.3969/j.issn.1671-4091.2020.08.018 Abstract ( 260 )   PDF (418KB) ( 755 )   【Abstract】Objective To understand the family burden among caregivers for home peritoneal dialysis patients and to explore its influencing factors. Methods The general information questionnaire of patients and caregivers, the Family Burden Scale of Disease (FBS) and the Social Support Rating Scale (SSRS) were used to investigate 112 pairs of peritoneal dialysis patients and their caregivers who were reviewed in the Peritoneal Dialysis Clinic of the First Affiliated Hospital of Nanchang University. Results Moderate or high family burden was found in 44.6% of the caregivers. The highest standardization score and proportion of family burden were family economic burden (58.0% ), followed by family leisure and entertainment (47.3%), family daily life (42.9%), family relationship(22.3%), family member psychology health (18.7%), and physical health of family members (2.7%). Multivariate linear regression analysis showed that patients' age (β=-0.240, P=0.002), caregivers' monthly family income (β=-0.353, P=0.001), daily patient care time (β=0.437, P<0.001), and utilization of social support (β =-0.232, P<0.001) were the main factors affecting caregivers' family burden, which jointly accounted for 48.9% of the total variation. Conclusion Caregivers have various degrees of family burden of the illness. Attentions should be paid to caregivers with lower monthly family income, with longer care time, and for younger patients with low support utilization. Targeted measures should be carried out to reduce the family burden among caregivers. Metrics