Chinese Journal of Blood Purification

12 December 2022, Volume 21 Issue 12 Previous Issue    Next Issue

Select

Advances in strategies for diagnosis and treatment of anemia in peritoneal dialysis patients in various countries JIANG Hong , MA Xiao-xiao 2022, 21 (12):  865-868.  doi: 10.3969/j.issn.1671-4091.2022.12.001 Abstract ( 324 )   PDF (453KB) ( 193 )   Anemia is an important and common complication of chronic kidney disease. With the progression of chronic kidney disease, the incidence of anemia also increases. However, anemia in patients with different types of dialysis may have different physiology, prevalence, diagnosis, and treatment strategies. This article reviewed the diagnosis and treatment strategies of renal anemia in maintenance dialysis patients.  Metrics

Select

Research progresses in the mechanism of high-flux hemodialysis for the correction of renal anemia    WANG Hong-ye, YANG Jie, ZHANG Rui 2022, 21 (12):  869-872.  doi: 10.3969/j.issn.1671-4091.2022.12.002 Abstract ( 145 )   PDF (386KB) ( 304 )   Chronic kidney disease is one of the public health problems harmful to human beings. Anemia is a major complication in chronic kidney disease patients, mainly caused by the decreased ability of erythropoietin (EPO) production in kidneys. Substances inhibiting erythropoietin production, iron deficiency, imbalance of iron homeostasis, chronic inflammation and short erythrocyte life span are the additional factors for anemia. Blood loss during hemodialysis is also involved in the anemia. Renal anemia may lead to cognitive impairment, increased hospitalization rate due to cardiovascular disease, and higher socio-economic burden, resulting in lower quality of life and higher mortality of the patients. High-flux dialysis is a blood purification method by using high-flux dialyzers instead of conventional dialyzers, having the advantage of efficient removal of medium and large molecular toxins to correct anemia. This paper summarizes the recent studies on the correction of anemia through dialysis, in order to clarify the mechanism of high-flux hemodialysis in the treatment of anemia. Metrics

Select

Efficacy and economic evaluation of roxadustat in the treatment of anemia in peritoneal dialysis patients QIU Mei-lan, CHEN Yong-ping 2022, 21 (12):  873-877.  doi: 10.3969/j.issn.1671-4091.2022.12.003 Abstract ( 241 )   PDF (922KB) ( 62 )   Objectives  To observe the efficacy, safety and economy of roxadustat in the treatment of renal anemia in peritoneal dialysis patients.  Methods  We collected peritoneal dialysis patients with renal anemia in Longyan Second Hospital from January 2020 to December 2021. 32 patients treated with roxadustat selected as the roxadustat group, and 32 patients treated with recombinant human erythropoietin (rHuEPO) were randomly selected as the EPO group. The changes of hemoglobin, iron metabolism indexes and adverse reactions of the patients before and at the first, third and sixth months of the treatment were observed. Cost-effectiveness analysis and incremental analysis were used to evaluate the economy of drug treatment and conduct single actor sensitivity analysis.  Results  The hemoglobin level of the two groups both increased after treatment, but it was higer in roxadustat group than EPO group (the first month: t=0.025，P=0.616；the third month: t=0.286，P=0.136，the sixth month: t=0.417，P=0.045). After treatment, the ferroprotein of the two groups (the first month：t= -0.319，P=0.137；the third month：t=-0.254，P=0.096；the sixth month：t=-0.645，    P=0.064)、transferin saturation (the first month：:t=0.241，P=0.314；the third month：t=0.354，P=0.216；the sixth month：t=0.415，P=0.335), and the total iron binding capacity (the first month: t=6.272，P=0.235；the third month: t=2.334，P=0.327；the sixth month: t=2.696，P=0.284) were no significant differences between the two groups. Meanwhile, there were no serious adverse reactions in the two groups. The cost of roxadustat group were higher than EPO group (t=29.150，P＜0.001). The incremental cost-effectiveness ratio (ICER) is 51049.58, which was 1-3 times of per capita gross domestic product (GDP)，so the increased cost was acceptable. Single factor sensitivity analysis based on the decline of drug cost shown that when the drug price decreases by 25%, ICER was less than 1 time of per capita GDP, indicating that its economy was better.   Conclusions  Roxadustat is effective in the treatment of renal anemia in peritoneal dialysis patients and can improve iron metabolism safety. And roxadustat cost higher but the increased cost is acceptable, with better economy when drug prices decrease by 25%. Metrics

Select

Associations between bone mineral density and body composition in patients on maintenance hemodialysis HU Xiao-hua, YU Hua, WU Bi-bo, HE Yun-lan, YU Yong, ZHANG Li-ming 2022, 21 (12):  878-882.  doi: 10.3969/j.issn.1671-4091.2022.12.004 Abstract ( 152 )   PDF (513KB) ( 165 )   Objective  To investigate the relationship between bone mineral density and body composition in maintenance hemodialysis patients.  Methods  124 patients with stable conditions on regular dialysis in Shanghai Jing 'an District Zhabei Central Hospital at March 2021 were selected. General data such as age, sex, height, weight and body mass index (BMI), primary disease, and dialysis vintage was recorded for each patient. The body fat mass (BFM), Soft Lean Mass (SLM), Fat Free Mass (FFM), Skeletal Muscle Mass (SMM), Percent Body Fat (PBF) and Skeletal Muscle Index (SMI) were measured using a body composition analyzer. Bone density of the proximal radius was measured using a dual-energy X-ray absorptiometry. Calcium, phosphorus, and parathyroid hormone levels were also recorded. The bone mineral density (BMD) and related factors were statistically analyzed.  Results  BMD, SLM, FFM, SMM, and SMI were significantly higher in male patients (t=8.267, P＜0.001; Z=-7.492, P＜0.001; Z=-7.481, P＜0.001; Z=-7.495, P＜0.001;         t=6.560, P＜0.001), while PBF and dialysis age were lower than in female patients (Z=-4.555, P＜0.001;     Z=-2.444, P=0.015). The results of Spearman correlation analysis showed no correlation between BFM and BMD (r=0.121, P=0.181); SLM, FFM, SMM, BMI, and SMI were positively correlated with BMD (r=0.652, P＜0.001; r=0.648, P＜0.001; r=0.650, P＜0.001; r=0.294, P=0.001; r=0.632, P＜0.001), and PBF was negatively correlated with BMD (r=-0.209,P=0.020). The results of multiple linear regression analysis showed that dialysis vintage, gender, and SMI were important factors affecting BMD, and SMI was positively correlated with BMD among body composition (β=0.406, P＜0.001), while BFM, SLM, FFM, SMM, BMI, and PBF were not correlated with BMD (β=0.084, P=0.208; β=-0.178, P=0.400; β=-0.192, P=0.349; β=-0.133, P=0.518; β=0.081, P=0.339; β=0.089, P=0.214).  Conclusion  SMI in body composition has an important effect on bone mineral density in maintenance hemodialysis patients. Metrics

Select

Relationship between red blood cell distribution width, miR-133a and heart failure in maintenance hemodialysis patients  FANG Qian, WU Li-li, SUN Dong-ying, LI Hui-yan 2022, 21 (12):  883-887.  doi: 10.3969/j.issn.1671-4091.2022.12.005 Abstract ( 117 )   PDF (464KB) ( 40 )   Objective  To explore the relationship between peripheral red blood cell distribution width (RDW), microRNA-133a, and heart failure in maintenance hemodialysis (MHD) patients.  Method   A total of 80 MHD patients admitted to The First Hospital of Qinhuangdao from December 2020 to December 2021 were recruited and divided into a heart failure group (n=23) and a non-heart failure group (n=57) according to the presence or absence of heart failure. End-stage renal disease (ESRD) patients not on dialysis were recruited as the ESRD control group, and 40 healthy people with normal physical examinations during the same period were recruited as the healthy control group. Their RDW was measured. miR-133a content in peripheral blood was measured by real-time quantitative PCR. The relationship between RDW, miR-133a level and heart failure in MHD patients was then evaluated.  Result   Peripheral blood RDW was higher in heart failure group than in non-heart failure group (t=11.896, P＜0.001), ESRD control group (t=12.010, P＜0.001), and healthy control group (t=3.570, P＜0.001); the difference between the four groups was statistically significant (F=61.144, P＜0.05). Serum miR-133a was lower in heart failure group than in non-heart failure group (t=8.321, P＜0.001), ESRD control group (t=8.321, P＜0.001), and healthy control group (t=10.395, P＜0.001); the difference between the four groups was statistically significant (F=73.835, P＜0.05). Stroke volume (SV) and left ventricular ejection fraction (LVEF) were lower in heart failure group than in non-heart failure group (t=12.335, 14.044, P＜0.001), ESRD control group (t=17.609, 17.782, P＜0.001), and healthy control group (t=19.195, 20.149, P＜0.001); the differences between the four groups were statistically significant (F=120.238, 161.756, P＜0.05). Left ventricular mass index (LVMI) was higher in heart failure group than in non-heart failure group (t=5.46550, P＜0.001), ESRD control group (t=17.515, P＜0.001), and healthy control group  (t=18.124, P＜0.001); the difference between the four groups was statistically significant (F=274.669, P＜0.05). Pearson correlation analysis showed that peripheral RDW was negatively correlated with SV and LVEF (r=-0.357, -0.422, P＜0.001), and positively correlated with LVMI (r=0.458, P＜0.001); serum miR-133a was positively correlated with SV and LVEF (r=0.412, 0.437, P＜0.001), and negatively correlated with LVMI (r=-0.416, P＜0.001). ROC curve showed that combined detection of peripheral blood RDW and miR-133a had an area under the curve of 0.83 for predicting heart failure in MHD patients, with a sensitivity and specificity of 82.49% and 68.37%.  Conclusion   Peripheral RDW and serum miR-133a are closely related to the heart function in MHD patients, and have a better value for predicting heart failure in MHD patients. Metrics

Select

Multivariate analysis on cognitive impairment in patients with end-stage renal disease receiving different dialysis methods  HUO Di, YAO Ya-ru, CHEN Wei-dong, LIU Lei 2022, 21 (12):  888-892.  doi: 10.3969/j.issn.1671-4091.2022.12.006 Abstract ( 136 )   PDF (554KB) ( 267 )   Objective  To analyze the risk factors of cognitive impairment (CI) in patients with end-stage renal disease and receiving different dialysis methods.  Methods  A total of 93 patients on maintenance hemodialysis (MHD) and 50 patients on peritoneal dialysis (PD) treated in the First Affiliated Hospital of Bengbu Medical College from November 2021 to April 2022 were recruited as the research subjects. According to the scores of Montreal cognitive assessment, the patients were divided into CI group of MHD patients, non-CI group of MHD patients, CI group of PD patients, and non-CI group of PD patients. CI and related risk factors was analyzed between the groups.  Results  A total of 143 patients were enrolled in this study, 70 (48.95%) were males, and the mean age was 52.25±11.37 years old. A total of 75 patients had CI, with a prevalence rate of 52.45%. Multivariate logistic regression showed that age, platelet/lymphocyte ratio (PLR), cystatin C, and homocysteine (Hcy) were the independent risk factors for CI in MHD patients (OR=1.080, 1.017, 1.749 and 1.167 respectively; 95% CI：1.001～1.166, 1.003～1.030, 1.205～2.541 and 1.003～1.358 respectively; P=0.047, 0.013, 0.003 and 0.046 respectively); while age, hemoglobin, PLR, and 25-hydroxy-vitamin-D were the independent risk factors for CI in PD patients (OR=1.253, 0.907, 1.027 and 0.696 respectively; 95% CI：1.042～1.507, 0.830～0.992, 1.001～1.054 and 0.491～0.989 respectively; P= 0.016, 0.032, 0.044 and 0.043 respectively). Receiver operating characteristic curve analysis showed that age, PLR and the model of the combined two had better predictive values for CI in MHD and PD patients, and the combined model had the highest predictive value (for MHD patients: AUC=0.714, 0.723 and 0.798 respectively; 95% CI：0.611～0.817, 0.620～0.826 and 0.711～0.886 respectively; P＜0.001; for PD patients: AUC=0.684, 0.810 and 0.849 respectively; 95% CI：0.533～0.836, 0.679～0.941 and 0.736～0.962 respectively; P=0.027, ＜0.001 and ＜0.001 respectively).  Conclusion  Age, PLR, cystatin C and Hcy are the independent risk factors for CI in MHD patients; age, PLR, hemoglobin and 25-hydroxy-vitamin-D are the independent risk factors for CI in PD patients. Therefore, these factors should be closely monitored during treatment of MHD and PD patients. Early intervention of these factors may delay or avoid the occurrence of CI in dialysis patients. Metrics

Select

The clinical study of Roxadustat in the treatment of renal anemia with low erythropoietin response in hemodialysis patients GUO Gang-ling, WU ling-yu, FAN Pei-qi, PAN Zhen-xin, ZHANG Ping, LI Jing, WANG Li-hua 2022, 21 (12):  893-897.  doi: 10.3969/j.issn.1671-4091.2022.12.007 Abstract ( 137 )   PDF (412KB) ( 221 )   Objective  To observe the efficacy and safety of Roxadustat in the treatment of renal anemia with low erythropoietin (EPO) response in hemodialysis (HD) patients.  Methods   The HD patients treated with Roxadustat for renal anemia and low EPO response were enrolled in this retrospective and self-controlled study. Baseline was defined as the conditions before switching to Roxadustat treatment. Hemoglobin (Hb), iron metabolism indexes, blood lipids, biochemical indexes, blood pressure and hematological indexes were measured at baseline and observation time points after treatment. Adverse drug reactions during the treatment period were collected.   Results   Forty-two HD patients were enrolled in this study. Their average age was 49±13 years old, and dialysis age was 36.88±30.44 months. The leading primary diseases were chronic glomerulonephritis (n=22, 52.38%) and diabetic nephropathy (n=10, 23.81%). The baseline Hb was 85.85±11.14 g/L. The average Hb levels at the 2nd, 4th, 8th, 12th, and 24th weeks of the treatment were significantly higher than the baseline Hb level (F=55.590, P<0.001). After 24 weeks of Roxadustat treatment, the compliance rate of Hb was 83.33% (35 cases), and the response rate to Roxadustat was 92.86% (39 cases). After 12~24 weeks of Roxadustat treatment, serum iron (F=6.706, P=0.003), total iron binding capacity (F=32.368,   P＜0.001), hematocrit (F=22.513, P＜0.001), red blood account (F =26.738, P＜0.001), mean corpuscular volume (F=3.327, P=0.046), and mean corpuscular hemoglobin (F=4.589, P=0.016) increased, and serum ferritin (F=3.584, P=0.037) and low density lipoprotein (F=8.169, P=0.007) declined. No serious adverse events occurred in these patients.  Conclusion  Roxadustat can safely and effectively improve iron metabolism, reduce blood lipids, and increase Hb level in HD patients with renal anemia and low EPO response. Metrics

Select

Advanced progress of new potassium-binding agents for patients with chronic kidney disease PAN Jin-ru, ABI Nan-zha, DONG Jie 2022, 21 (12):  898-902.  doi: 10.3969/j.issn.1671-4091.2022.12.008 Abstract ( 142 )   PDF (443KB) ( 93 )   Chronic kidney disease (CKD) is a worldwide disease with higher prevalence, and makes a tremendous burden to the societies. Hyperkalemia is a common and  life-threatening electrolyte imbalance complication, and is closely related to the higher all-cause and cardiovascular mortality of this disease. Meanwhile, the use of renin-angiotensin-aldosterone system inhibitor (RAASi) in CKD patients with cardiovascular disease aggravates the risk of hyperkalemia, which may limit the use of RAASi in this particular population. Therefore, appropriate use of potassium-binding agents is of great significance to improve the overall prognosis and to relieve their economic burden. This review aims to summarize the application of patiromer and sodium zirconium cyclosilicate (SZC) in CKD patients in order to provide references for further studies. Metrics

Select

Recent advances in the diagnosis of renal osteodystrophy XIE Sheng, OUYANG Chun 2022, 21 (12):  903-906,916.  doi: 10.3969/j.issn.1671-4091.2022.12.009 Abstract ( 147 )   PDF (398KB) ( 329 )   Renal osteodystrophy (ROD) refers to the skeletal alterations of chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with chronic kidney disease (CKD). Tetracycline-labeled bone biopsy is a golden standard for the diagnosis and classification of ROD. However, bone biopsy is often rejected by the patients and professionals due to the invasive operation. This review focuses on recent advances in the diagnosis of ROD, including modified bone biopsy, non-invasive imaging techniques, and novel bone turnover markers, enabling to develop a non-invasive and accurate virtual bone biopsy that improves diagnostic performance. Metrics

Select

Recent progresses in the evaluation, diagnosis and treatment of peritoneal dysfunction MA Tiao-juan, WU Xiao-qing, ZHU Yan-ting, WANG Xiao-ming 2022, 21 (12):  907-911.  doi: 10.3969/j.issn.1671-4091.2022.12.010 Abstract ( 232 )   PDF (457KB) ( 33 )   Peritoneal dysfunction is an important factor for the quality of long-range peritoneal dialysis. Therefore, early identification and prevention of peritoneal dysfunction and protection of peritoneal function are the hot points for peritoneal dialysis practitioners and researchers. This paper reviews the principles of peritoneal transport function, and the classification, evaluation, diagnosis and treatment of peritoneal dysfunction, aiming to improve the quality of peritoneal dialysis. Metrics

Select

The relationship between nasal carrying staphylococcus aureus and peritoneal dialysis related infections LI Xin-qiu, DONG Jie 2022, 21 (12):  912-916.  doi: 10.3969/j.issn.1671-4091.2022.12.011 Abstract ( 146 )   PDF (387KB) ( 92 )   Peritoneal dialysis related infection is one of the main complications in peritoneal dialysis, and Staphylococcus aureus (s. aureus) is one of the common pathogens. Nasal carrying s. aureus plays an important role in its endogenous infection. This paper investigates the relationship between nasal carrying s. aureus and the occurrence of peritonitis, and analyzes the effect of eliminating nasal carrying s. aureus on the prevention of peritoneal dialysis related infection. Metrics

Select

Application of bypass surgery for reconstruction of outflow tract of dysfunctional internal fistula Zhi-yong, WANG Gou-qin 2022, 21 (12):  917-920.  doi: 10.3969/j.issn.1671-4091.2022.12.012 Abstract ( 132 )   PDF (383KB) ( 170 )   Objective  To explore the clinical effect of bypass surgery to repair the long occlusion in the outflow tract of arteriovenous fistula (AVF).  Methods  A total of 15 cases subjected to bypass surgery to repair the long occlusion in the outflow tract of AVF in our hospital from June 2016 to June 2020 were retrospectively analyzed. Patients with a short occlusion in the outflow tract of AVF and subjected to percutaneous transluminal angioplasty (PTA) in the same period were recruited as the controls. The clinical effects were compared between the two groups.  Results  The great saphenous vein or artificial vessel was used for the bypass surgery to repair the long occlusion in the outflow tract of AVF. The successful rate of repair was 100%. Compared to the PTA group, the 2-year intervention rate was lower (P=0.032), and the 2-year patency rate was higher (P=0.046) in the bypass surgery group.  Conclusion  Bypass surgery is a safe, economical and effective method to repair the long occlusion in the outflow of AVF. Metrics

Select

Clinical application of percutaneous transluminal balloon angioplasty for removal of the stuck cuffed catheter and re-catheterization WANG Dao-yang, MA Xu-xiang, HUANG Yu-ping, ZHOU Yu-ye, ZHUO Li, ZONG Xiao-ying, WANG De-guang 2022, 21 (12):  921-925.  doi: 10.3969/j.issn.1671-4091.2022.12.013 Abstract ( 153 )   PDF (496KB) ( 42 )   Objective  To study the clinical application of percutaneous transluminal balloon angioplasty (PTA) for removal of the stuck cuffed catheter and re-catheterization in situ.  Methods  Clinical data of the 11 patients with stuck tunneled cuffed catheter in the Department of Nephrology, the Second Affiliated Hospital of Bengbu Medical College during the period between November 2018 and October 2021 were retrospectively analyzed. The stuck tunneled cuffed catheters in these patients were detected during the replacement of tunneled cuffed catheter when removal of the catheters by regular technique was impossible. According to the inner diameter of the tunneled cuffed catheter, balloons of various diameters on operating rod were imported to expand the whole length of the vessel in which the original dialysis catheter located. After release of the fibrin sheath, the stuck tunneled cuffed catheter was removed, and a larger balloon was used for further expansion of the fibrin sheath. A new tunneled cuffed catheter was then placed in situ. The clinical efficacy of the PTA operation was followed up for 5～35 months.  Results  The stuck cuffed catheters were removed following PTA in all 11 patients. A new cuffed catheter was successfully placed in situ in 10 patients. No operation-related complications occurred, including heart arrhythmia, central venous rupture, hemo-pneumothorax, mediastinal hematoma, cardiac tamponade and other complications. During the followed-up period, one patient underwent kidney transplantation, and one died of multiple myeloma; their blood access volumes were 200 and 240 ml/min. The blood access volumes were 220-240ml/min in other patients.  Conclusion  PTA for removal of the stuck cuffed catheter and replacement of a new cuffed catheter in situ is a safe and efficient operation, which should be recommended as the first choice for treatment of the stuck hemodialysis cuffed catheters. Metrics

Select

The present status and influencing factors of dietary compliance behaviors in peritoneal dialysis patients  ZHOU Rui, QIE Shu-wen, LI Zhi, DING Yuan-qing 2022, 21 (12):  926-930.  doi: 10.3969/j.issn.1671-4091.2022.12.014 Abstract ( 131 )   PDF (428KB) ( 91 )   Objective  To investigate the present status and influencing factors of dietary compliance behavior in peritoneal dialysis (PD) patients.  Methods  A total of 210 PD patients treated in the Peritoneal Dialysis Center of Guizhou Provincial People’s Hospital  between September 2021 and March 2022 were recruited as the research subjects. General data questionnaire, kidney disease dietary compliance scale, PD dietary knowledge questionnaire, chronic kidney disease dietary self-efficacy scale, and perceived social support scale were used for the investigation.  Results  The dietary compliance behavior score was 69.47±2.49, dietary knowledge score 14.71±1.66, dietary self-efficacy score 57.62±3.37, and perceived social support score 64.25±2.44. Multivariate linear regression indicated that age (β=0.124, P＜0.001), the number of complication (β=0.097, P=0.008), education level (β=0.079, P=0.024), dietary knowledge (β=0.373, P＜0.001), dietary self-efficacy (β=0.273, P＜0.001) and perceived social support (β=0.329, P＜0.001) were the influencing factors for dietary compliance behavior in PD patients.  Conclusion   The dietary compliance behavior in PD patients was at a moderate level. Medical professionals should give more diet health education to PD patients to promote positive diet compliance behavior in these patients. Metrics

Select

Development and application of a dietary management software for peritoneal dialysis patients at home  WANG Hai-yan, XI Hui-jun, ZHAO Li-fang, WANG Tie-yun, DU jun, LAI Xue-li, GUO Zhi-yong, LU Xiao-ying 2022, 21 (12):  931-934.  doi: 10.3969/j.issn.1671-4091.2022.12.015 Abstract ( 165 )   PDF (438KB) ( 96 )   Objective  To explore the application effect of a diet management software for peritoneal dialysis (PD) patients at home.  Methods   Patients regularly followed up in the Peritoneal Dialysis Center, The First Affiliated Hospital, Naval Medical University between July and December 2020 were recruited as the research subjects. They were divided into experimental group (n=35) and control group (n=35) by random number method. The control group received routine follow-up management, and the experimental group used the dietary management software. They were followed up for 3 months. Serum albumin and potassium, and blood phosphorus were compared between the two groups.  Results  Compared to the control group, serum albumin was higher (t=2.101, P=0.040) and serum phosphorus was lower (t=-2.054, P=0.044) in the experimental group after the intervention for 3 months. In the experimental group, serum albumin became higher (t=3.226, P=0.002) and serum phosphorus became lower (t=2.007, P=0.049) after the intervention for 3 months. The prevalence of abnormal serum potassium in the follow-up period was lower in the experimental group (χ2=3.913, P=0.048).  Conclusion  The dietary management software can help PD patients have rational dietary, improve serum albumin and blood phosphorus, and reduce the incidence of abnormal blood potassium. Metrics

Select

Progresses in the diagnosis and treatment of tumoral calcinosis in hemodialysis patients and report of 2 cases LI Xiao-kun, CHEN Yong-zhe, BAI Lu, LIU Ji-cun, LIU Mao-dong, WANG Bao-xing 2022, 21 (12):  935-938.  doi: 10.3969/j.issn.1671-4091.2022.12.016 Abstract ( 235 )   PDF (471KB) ( 78 )   Tumoral calcinosis (TC) is an uncommon type of pathologic calcification in soft tissues, characterized by tumor-like masses around joints. The prevalence of TC ranges from 0.5 to 3% in hemodialysis patients. This article reviews the literature and discusses the recent progresses in naming, characteristics, epidemiology, pathogenesis, risk factors, diagnosis and treatment of TC. We also report 2 cases of TC we diagnosed and treated. Metrics