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Chinese Journal of Blood Purification    DOI: 10.3969/j.issn.1671-4091.2019.06.001 Accepted: 03 January 2020

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Investigation and analyses on the peritoneal dialysis fees and the reimbursement from medical insurance in Chinese mainland Chinese Hospital Association Blood Purification Center Branch Chinese Journal of Blood Purification    2023, 22 (05): 321-326.   DOI: 10.3969/j.issn.1671-4091.2023.05.001 Abstract （2396）      PDF（pc） （485KB）（450）       Knowledge map    Objective  To investigate the items and costs of peritoneal dialysis (PD) management and the reimbursement of the expenses by medical insurance in PD patients from different regions in China, in order to reduce the financial burden of the patients and to promote the use of PD through the standard items and prices of PD and the rational rules of reimbursement by medical insurance.  Methods  A self-designed questionnaire on PD items and medical insurance was used to investigate the PD patients in 137 hospitals that provide PD in 30 provinces and big cities in China. Descriptive statistical analysis was performed on the collected data, and Kruskal-Wallis rank sum H test was used to examine the differences among groups.  Results  The nationwide median rates of reimbursement by medical insurance were 80.0 (70.0, 85.0)%, 85.0 (80.0, 90.0)% and 90.0 (80.0, 90.0)% for residents, urban employees, and retired employees, respectively. The monthly expense of continuous ambulatory peritoneal dialysis (CAPD) was significantly lower than that of automated peritoneal dialysis (APD) (H=26.717, P＜0.0001). The monthly reimbursable amount increased with the monthly total expense of CAPD or APD (H=58.367, P＜0.001). The prices of PD varied significantly in different provinces and big cities. The prices of surgical removal of granulation tissue at the outlet, waste bag, removal of polyester cuff in PD tube, and treatment of PD catheter-related tunnel infections had not been set up in 63%, 60%, 50% and 47% provinces and big cities respectively. The commonly used disposable materials necessary for PD safety such as dressing, waste bag and disinfectants could not be reimbursed by medical insurance in 77% provinces and big cities.  Conclusions   This study analyzed the current administration situations of PD management. We therefore recommend that ①the organization and administration of the basic medical insurance system must be continuously reinforced, and the encouragement mechanisms underlying PD services must be improved; ② the prices of PD items should be properly adjusted to support the passions of the hospitals providing high quality of PD services, and ③ the reimbursable PD items are required to be increased to support the safety and quality of PD services. Reference | Related Articles | Metrics

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Guideline on the management of hyperkalemia in maintenance hemodialysi patients in China Expert group of guideline on the management of hyperkalemia in maintenance hemodialysis patients in China Chinese Journal of Blood Purification    2022, 21 (增刊): 1-16.   DOI: 10.3969/j.issn.1671-4091.2022.S.001 Abstract （2073）      PDF（pc） （905KB）（3269）       Knowledge map    Reference | Related Articles | Metrics

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Comparisons of the therapeutic effects between patients with subtotal parathyroidectomy and those with less-than subtotal parathyroidectomy CHEN Hao-xiong, LIU Ri-guang, LI Jian-wen, CHEN Lin, CHEN Lei, FU Jun-zhou. Chinese Journal of Blood Purification    DOI: 10.3969/j.issn.1671-4091.2012.07.00

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Clinicopathological manifestations of the renal damage due to cholesterol crystal embolism Chinese Journal of Blood Purification    2022, 21 (01): 15-19.   DOI: 10.3969/j.issn.1671-4091.2022.01.004 Abstract （1983）      PDF（pc） （1550KB）（490）       Knowledge map    【Abstract】Objectives Kidney is frequently involved in cholesterol crystal embolism, but this renal injury is easily to be disregarded and misdiagnosed. Objective To investigate the clinicopathological features, treatment and outcome of the renal injury due to cholesterol crystal embolism. Methods The clinicopathological data of the patients with renal injury due to cholesterol crystal embolism were retrospectively reviewed. Results In this cohort, 10 of the 11 patients had atherosclerosis. The renal injury was induced by interventional therapy in 7 patients and by newly administered warfarin in 2 patients, and occurred spontaneously in 2 patients. Blue toe syndrome was found in 6 patients, and eosinophilia was present in 9 patients. All the patients had proteinuria, and 10 patients had renal insufficiency. Eight patients received renal biopsy. Pathological findings consisted of artery thickening and stenosis with needle-shaped clefts in the occluded vessels, and moderate to severe infiltration of lymphomonocytes and some eosinophils. Ten patients were followed up; renal function was normal in one patient and was insufficient in 9 patients, in which one died, and 8 patients showed no improvement in renal function. At the end of follow-up, 4 patients were dialysis-dependent. Conclusion The clinical manifestation of cholesterol crystal embolism varied. Renal biopsy and pathological examination are required in unexplained acute or subacute renal insufficiency patients complicated with atherosclerosis, interventional therapy, and/or anticoagulant treatment. Related Articles | Metrics

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A multicenter randomized controlled study of nafamostat mesylate for anticoagulation therapy on hemodialysis ZHUANG Bing, YE Hong, CAO Hong-di, BIAN Xue-qin, ZHONG Hua, LUO Yuan, PENG Kan-fu, SHI Hui, YANG Jun-wei Chinese Journal of Blood Purification    2022, 21 (10): 739-743.   DOI: 10.3969/j.issn.1671-4091.2022.10.008 Abstract （1829）      PDF（pc） （499KB）（772）       Knowledge map    Objective To observe the safety and efficacy of nafamostat mesylate for anticoagulation in maintenance hemodialysis patients. Methods Patients on hemodialysis were randomly divided into two groups, nafamostat mesylate for injection group and sodium heparin injection group, respectively. The safety and efficacy of nafamostat were evaluated.Results The anticoagulation efficiency of nafamostat mesylate for injection group and sodium heparin injection group was 97.2% and 98.2%, respectively (χ2=0.000，P=0.992); The effect of nafamostat mesylate for injection group on activated clotting time (ACT) during dialysis was less than that of sodium heparin injection group.The ACT values at the arterial side of the two groups were significantly different (1h, t=-15.333, P＜0.001; 2h, Z=-10.317, P＜0.001; 3h,t=-12.733, P＜0.001; the end of dialysis, Z=-6.796, P＜0.001),the venous side of the two groups were significant statistical differences in ACT values(1h, t=-17.833, P<0.001; 2h, t=-15.604, P＜0.001; 3h, Z=-10.066, P＜0.001; the end of dialysis,Z=-4.399, P＜0.001);After the end of hemodialysis, the nafamostat mesylate group for injection had less effect on activated partial thromboplastin time (Z=-4.971, P＜0.001) and thrombin time (Z =5.770, P＜0.001) than the heparin sodium injection group ; The incidence of adverse reactions in nafamostat mesylate for injection group was lower than heparin sodium injection group (χ2=15.239，P＜0.001). Conclusion The anticoagulant effect of nafamostat mesylate is non-inferior to sodium heparin , and the incidence of adverse reactions is lower.It could be used safely and effectively in the anticoagulation of hemodialysis. Reference | Related Articles | Metrics

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Sacubitril/valsartan improves cardiac systolic function independently from blood volume management in hemodialysis patients with heart failure Chinese Journal of Blood Purification    2022, 21 (01): 10-14.   DOI: 10.3969/j.issn.1671-4091.2022.01.003 Abstract （1779）      PDF（pc） （499KB）（272）       Knowledge map    【Abstract】Objective To observe the efficacy and safety of sacubitril/valsartan for the treatment of heart failure in maintenance hemodialysis patients. Methods Patients on hemodialysis complicated with chronic cardiac insufficiency and with stably controlled volume status were enrolled. They were treated with sacubitril/valsartan and followed up for 3 months. Before treatment with sacubitril/valsartan (baseline) and during follow- up, biomarkers of heart failure were tested, and volume status was assessed by body composition monitor (BCM). Changes of cardiac structure and function were examined by echocardiography. Results A total of 17 patients were included, while 4 patients withdrew due to drug-related adverse reactions and one due to renal transplantation during follow-up. Left ventricular ejection fraction (LVEF) increased from baseline 54.2±15.8% to endpoint 62.7±10.1% (t=-4.429, P=0.001) and greater improvement was found in patients with declined baseline LVEF (≤55%; t=-6.204, P=0.003), in line with a significant reduction in left ventricular end systolic volume (baseline 109.0±62.7ml vs. endpoint 79.4±52.1ml; t=4.725, P=0.009). In patients with normal LVEF, left ventricular posterior wall thickness decreased significantly (baseline 1.08 ± 0.27cm vs. endpoint 0.99 ± 0.16cm; t=3.176, P=0.025). The endpoints of serum creatinine (t=- 2.856, P=0.016), urea (t=- 3.149, P=0.009) and parathyroid hormone (baseline 328±161pg/ml vs. endpoint 409±191pg/ml; t=-2.230, P=0.048) elevated significantly as compared with the baseline values. Conclusion Sacubitril/valsartan significantly improves cardiac systolic function in hemodialysis patients with heart failure and reduces ventricular wall thickness in patients with normal LVEF. However, this treatment may also induce the increase of creatinine, urea and parathyroid hormone levels. Reference | Related Articles | Metrics

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Progresses in the application of nafamostat mesylate for anticoagulation during continuous renal replacement therapy  SUN Xian-kun WANG Fang, CHEN Zhi-wen, ZHANG Ling Chinese Journal of Blood Purification    2022, 21 (11): 827-830.   DOI: 10.3969/j.issn.1671-4091.2022.11.009 Abstract （1556）      PDF（pc） （351KB）（726）       Knowledge map    The anticoagulants currently used may have contraindications and side effects, therefore continuous renal replacement therapy without anticoagulation is still common. Nafamostat mesylate has a short half-life, which may help critically ill patients avoid bleeding during blood purification. In Korea and Japan, Nafamostat mesylate is frequently utilized for anticoagulation in extracorporeal circulation line. However, there are no consensuses about the fundamental anticoagulant prescription, effective dose and monitoring strategy of the drug. Here we review the anticoagulation mechanism of nafamostat mesylate in patients on continuous renal replacement therapy, method of use, anticoagulation effect and limitations, so as to give a reference for future studies. Reference | Related Articles | Metrics

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Interpretation of the KDOQI Clinical Practice Guideline for Vascular Access, 2019 version Chinese Journal of Blood Purification    2020, 19 (07): 482-491.   DOI: 10.3969/j.issn.1671-4091.2020.07.013 Abstract （1437）      PDF（pc） （468KB）（2490）       Knowledge map    【Abstract】In April 2020, the American National Kidney Foundation made a major update to the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Vascular Access, and carried out various treatments for the survival plan of end-stage renal disease patients, including the life plan of end-stage renal disease patients, the selection of vascular access, and the new methods for handling specific complications. This article interprets this guideline according to the conditions of our country, helps doctors and patients make decisions on the treatment mode and vascular access for end-stage renal disease, and brings directional suggestions for subsequent research. Reference | Related Articles | Metrics

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The cause of death and its related information in hemodialysis patients in China - enlightenment from the DOPPS study Chinese Journal of Blood Purification    2022, 21 (02): 89-93.   DOI: 10.3969/j.issn.1671-4091.2022.02.005 Abstract （1355）      PDF（pc） （430KB）（1238）       Knowledge map    【Abstract】Although hemodialysis (HD) can improve the life expectancy of end stage renal disease (ESRD) patients, the risk of death is still significantly higher in HD patients than in general population. The purpose of this study was to explore the cause of death and its related information in HD patients in the China Dialysis Outcomes and Practice Patterns Study (DOPPS). Methods DOPPS is an international, prospective and observational study. China participated in the DOPPS 5 study (2012～2015) and has completed the follow-up of the cohort. A total of 1,427 patients were enrolled in the China DOPPS 5 study. Their demographics, primary cause of ESKD, comorbidities, dialysis prescription, laboratory examination results, and date, cause and other related information of death were recruited. The primary cause, date and place of death were then defined. Results A total of 1,427 HD patients were enrolled in the China DOPPS 5 study, including 473 cases in Beijing, 454 cases in Guangzhou and 500 cases in Shanghai. The average age of the patients was 59.4+14.9 years old, 55% were males, and 25.1% had diabetes. The mean follow-up period was 1.9 years (1.1, 2.1 years). During the follow-up period, 205 patients died, with the overall mortality of 14.4% and the annual average mortality of 8.8%. In the death patients, the median age was 70 (59, 79) years old, 56.1% were males, and the median dialysis vintage was 2.5 (1.0～5.0) years. The number of death patients in Beijing, Guangzhou and Shanghai were 67, 67 and 71 cases respectively, with the annual average mortality of 7.9%,10.0% and 8.6% respectively. The top three causes of death in HD patients were cerebrovascular events (19.3%, including ischemic stroke), congestive heart failure (18.2%) and pulmonary infection (11.6%); 105 cases died of cardiovascular diseases, accounting for 51.2% of the death patients. There were gender differences in the ranking of the main causes of death. In the died patients, 70.8% died in hospital and 27.0% died at home; HD treatment continued before death in 79.8% patients, and discontinued before death in 20.2%; 62.9% cases received hospice care before death; the risk time of death in a day was within 10pm～6am. Conclusion In the China DOPPS 5 study, the average annual mortality was 8.8%. The main cause of death was cardiovascular events. Among the single cause of death, cerebrovascular events (including ischemic stroke), congestive heart failure and pulmonary infection were the most common causes of death, and the causes of death seemed to be gender different. The terminal stage was present in most death patients, and 1/4 of death happened at home. Without medical intervention, the risk time of death in a day was from late night to early morning. Reference | Related Articles | Metrics

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Effect of lanthanum carbonate on vascular calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: a prospective pilot study Chinese Journal of Blood Purification    2017, 16 (06): 378-382.   DOI: 10.3969/j.issn.1671-4091.2017.06.006 Abstract （1322）      PDF（pc） （439KB）（472）       Knowledge map    Objective To explore the effect of lanthanum carbonate on vascular calcification and bone mineral density in maintenance hemodialysis (MHD) patients with diabetes complicated with adynamic bone disease. Methods A total of 92 MHD cases were divided into calcium carbonate (CC) group and lanthanum carbonate (LC) group. We compared serum calcium, phosphate, FGF23, bone alkaline phosphate (BALP), procollagen I N-terminal peptide (PINP), C-terminal telopeptide (β-CTX), matrix gla protein (MGP) and hsCRP, coronary artery calcification score (CACS) and bone mineral density at baseline and after 12 months between the two groups. SPSS 17.0 for Windows was used for statistical analyses. Results After the treatment for 12 months, serum levels of phosphate, FGF23 and MGP decreased significantly and serum levels of iPTH, BALP, PINP and β-CTX, CACS, and bone mineral density increased significantly in LC group, as compared with those at baseline (P＜0.05). After the treatment for 12 months, serum levels of calcium, phosphate, FGF23 and MGP, and CACS were lower in LC group than in CC group, and serum levels of iPTH, BALP, PINP and β-CTX, and bone mineral density were higher in LC group than in CC group. Pearson’s correlation analyses revealed that bone mineral density in forearm correlated positively with iPTH and MGP and negatively with CACS, and that CACS correlated positively with serum calcium, phosphate and FGF23 and negatively with serum MGP. Multivariate linear regression revealed that the changes of bone mineral density in forearm and collum femoris and serum FGF23 were the independent influence factors for the change of CACS (P＜0.05). Conclusions Slower progression of coronary artery calcification, improved bone turnover and increased bone mineral density occurred in the LC group as compared with those in the CC group. These results may result from the effects that lanthanum carbonate improves phosphate and MGP metabolism and directly antagonizes vascular calcification. Related Articles | Metrics

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Discussion with the feasibility of accepting surgery and the periopreative management in patients with maintenance dialysis ZHAO Hui-ping;YAN Yu;CAI Mei-shun;LU Li-xia;WANG Mei null    2008, 7 (3): 141-144.   Abstract （1305）   HTML （0）    PDF（pc） （565KB）（470）       Knowledge map    Objective Discussion on maintenance dialysis patients with the feasibility of accepting surgery and perioperative management. Methods One-hundred-seventy-five maintenance dialysis patients (including hemodialysis and peritoneal dialysis) were selected into a retrospective study. Then we investigated their information related to the surgery, compared with the changes of hemoglobin、electrolyte、kidney function、 blood pressure between pre- and post-operation, record whether or not there were surgical complications, discuss the perioperative management and summarize the adjustment of dialysis programme during perioperative period. Results Among 175 cases of maintenance hemodialysis patients , 18 cases need surgical operation,accounting for 10.28% of dialysis patients.13 patients undergoing 18 cases of operations. Preoperative Hemoglobin (Hb) level were (97.35 t difference were found in the electrolytes、kidney functions and blood pressures between pre- and post-surgery. 2 cases of patients happened surgical complications which were hypotension and respiratory failure.1 patient died. The dialysis programmes need to be adjusted , different dialysis methods can be selected including continuous renal replacement therapy、without heparin hemodialysis、automatic peritoneal dialysis or continuous ambulatory peritoneal dialysis，according to the surgery conditions and the patientsConclusions Patients with maintenance dialysis have high risks of surgery. But after correct and appropriate perioperative management, most of them can tolerate surgery. Strengthen the perioperative management, especially the adjustment of dialysis modalities, will help to these patients to survive the perioperative period. Related Articles | Metrics

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Analysis of death causes and related factors in patients with maintenance hemodialysis GAO Ai-qin;ZOU Zuo-jun;LI Yang;SUI Xiao-ni;LIN Chun-hua null    2009, 8 (9): 486-489.   Abstract （1283）   HTML （0）    PDF（pc） （243KB）（245）       Knowledge map    【Abstract】 Objective To investigate the causes of death and their related factors in maintenance hemodialysis (MHD) patients. Methods We retrospectively analyzed 306 patients who had treated with MHD for more than 3 months during the period between January 2000 and January 2008. At the end of the observation period, 71 of the patients died, 134 remained to be treated with MHD, and 101 went out of the MHD treatment course for various reasons. Age, sex, primary diseases, blood pressure, inter-dialysis weight gain, Kt/V, hemoglobin (HGB), hematocrit (HCT), serum creatinine before hemodialysis (Scr.PHD), and serum albumin (ALB), total cholesterol (CHO), triglyceride (TG), calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) were compared between the death cases and the survival cases. Correlation analysis was also made for the risk factors relating to death. Results The causes of death were cardiac complications (25 cases, 35.21%), cerebrovascular diseases (23 cases, 32.39%), generalized failure (8 cases, 11.27%), serious infections (8 cases, 11.27%), and malignant tumors (6 cases, 8.45%). Older mean age (P＜0.01), lower values of HGB, HCT, ALB, Kt/V, Scr.PHD and PTH (P＜0.001 or P＜0.05) and higher serum CHO (P＜0.01) were found in the death cases than in the survival cases. Conclusions Cardiac complications, cerebrovascular diseases, generalized failure and serious infections are the common causes leading to death in HMD patients. The main risk factors relating to death include elder age, anemia, hypoalbuminemia, hypercholesterolemia, insufficient Kt/V and lower Scr. PHD. Related Articles | Metrics

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Prognosis of peritoneal dialysis and the effects of blood pressure and variability of blood pressure on mortality Chinese Journal of Blood Purification    2015, 14 (05): 271-276.   DOI: 10.3969/j.issn.1671-4091.2015.05.004 Abstract （1271）   HTML （0）    PDF（pc） （772KB）（308）       Knowledge map    Objective To analyze the prognosis of peritoneal dialysis (PD) patients and to investigate the association between blood pressure (BP), the variability of BP and mortality. Methods We included 482 PD patients who had regular visits in our PD center from 1999 to Jan. 1, 2015 for survival analysis and to identify the risk factors for mortality. Sixty-nine of the PD patients who had been on PD for more than 3 months before Jan. 31, 2008 were involved in the analysis of the relationship between BP variability and mortality. Consecutive 6 office BP measurements once a month during 2008 were collected from every patient, and the coefficient of variation (CV) for BP was used as an indicator of BP variability. Baseline clinical data and laboratory tests were also reviewed. Patients were followed up for 72 months. All-cause mortality and cardiovascular mortality were analyzed by Cox regression. Results Two hundred and twenty-four PD patients died in the follow-up period for 16 years. Diabetes (HR 2.245, 95% CI 1.718～2.932, P＜0.001) and advanced age (HR 2.840, 95% CI 2.065～3.906, P＜0.001)were the risk factors for mortality. Cardiovascular event (52.2%) and infection (25%) were the two major causes of death. The CV for systolic blood pressure was 9.8±4.7%. Among the 69 PD patients, 33 patients died. Systolic BP ≥153mmHg was an independent predictor for allcause mortality (HR 2.848, 95% CI 1.156～7.015, P=0.023) and cardiovascular mortality (HR 3.122, 95% CI 1.012～.635, P=0.048). BP variability was not a predictor for mortality in PD patients. Conclusion Hypertension was an independent predictor for all-cause and cardiovascular mortality for PD patients, but BP variability could not be proved to be a factor affecting the prognosis of PD patients. Related Articles | Metrics

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Effects of lanthanum carbonate on serum phosphorus in maintenance hemodialysis patients receiving calcitriol pulse therapy due to secondary hyperparathyroidism Chinese Journal of Blood Purification    2017, 16 (11): 728-731.   DOI: 10.3969/j.issn.1671-4091.2017.011.003 Abstract （1243）      PDF（pc） （417KB）（479）       Knowledge map    Objective To investigate the effect of lanthanum carbonate on calcium and phosphorus metabolism in maintenance hemodialysis (MHD) patients treated with calcitriol pulse therapy due to secondary hyperparathyroidism (SHPT). Methods Sixty MHD patients with SHPT were randomly divided into control group 1 and treatment group 1 (for patients with iPTH 300-600 pg/mL), and control group 2 and treatment group 2 (for patients with iPTH 600-1000 pg/mL). Patients in control group 1 were given oral calcitriol of 2μg 2 times/week and calcium carbonate 750mg 2 times/day; patients in control group 2 were given oral calcitriol of 2μg 3 times/week and calcium carbonate 750mg 2 times/day. Patients in treatment group 1 were given oral calcitriol of 2μg 2 times/week and lanthanum carbonate 500μg 3 times/day; those in treatment group 2 were given oral calcitriol of 2μg 3 times/week and lanthanum carbonate 500μg 3 times/day. Serum iPTH, calcium and phosphorus were examined in the treatment period at 4th, 8th and 12th weeks. Results Compared with the levels before treatment, serum iPTH decreased significantly (P＜0.05) and serum calcium increased significantly in the treatment period at 4th, 8th and 12th weeks in control and treatment groups. The increase of serum calcium was more in control groups using calcium carbonate than in treatment groups using lanthanum carbonate (P＜0.05). The decrease of serum phosphorus was more in treatment groups using lanthanum carbonate than in control groups using calcium carbonate, but without statistical significance (P>0.05). Conclusion Lanthanum carbonate can reduce serum phosphorus level in MHD patients treated with calcitriol pulse therapy due to SHPT. Related Articles | Metrics

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null    2003, 2 (7): 366-368.   Abstract （1228）   HTML （1）    PDF（pc） （1449KB）（386）       Knowledge map    Objective To Compare the effects of short-term, high-volume hemofiltration (STHVH) therapy and intermittent hemodialysis (IHD) on severe acute pancreatitis (SAP) patients with acute renal failure (ARF). Methods Of 15 SAP patients with ARF, 9 received STHVH and 6 underwent IHD. In all cases, acute physiology indexes and 28-day survival rates were recorded. Blood urea nitrogen (BUN), serum creatinine (Scr), serum potassium, hydrocarbonic, and artery blood pH were detected in all patients every morning before hemopurification. Serum inflammatory cytokines such as tumor necrosis factor-α(TNF-α), interleukin-1β(IL-β), interleukin-8(IL-8) and anti-inflammatory cytokines interleukin-10 (IL-10) were detected in all patients before and after hemopurification. Results There was on difference of APACHE II score between two groups before the treatments (24.4±4.3 vs 23.2±3.1, P >0.05). In STHVH group APACHEⅡscore was lower than IHD group after treatment vs 20.2±2.3 (P<0.05). Daily mornning BUN, Scr, hydrocarbonic and artery blood pH had on difference between the two groups (P<0.05). Serum inflammatory cytokines TNF-α, IL-1β and IL-8 decreased in STHVH group comparing with IHD group after hemopurification. Serum IL-10 level increase term in STHVH group after therapy. Conclusion STHVH is of benift to improve the prognosis of SAP patients.  Related Articles | Metrics

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Cardiovascular outcomes with Sacubitril- Valsartan in patients undergoing hemodialysis Chinese Journal of Blood Purification    2021, 20 (12): 809-813.   DOI: 10.3969/j.issn.1671-4091.2021.12.005 Abstract （1220）      PDF（pc） （498KB）（237）       Knowledge map    【Abstract】Objective To explore the cardiovascular outcomes with sacubitril-valsartan in patients undergoing hemodialysis. Methods 13 maintenance hemodialysis (MHD) patients from Peking University People's Hospital were selected, without obvious edema, severe infection or acute cardiovascular events recently. Blood pressure and echocardiography of the patients were recorded. Paired-Samples T test was used to identify the effects of sacubitril-valsartan in MHD patients. Results ①A total of 13 patients on MHD for 99 (14～155) months (8 males and 5 females) were included in this study. ②Compared with baseline levels, left ventricular ejection fractions (LVEF) (43.0 ± 10.2% vs. 60.0 ± 13.9%, t =- 4.769, P＜0.001) were markedly improved after treatment with sacubitril-valsartan. ③ Compared with baseline levels, NT-proBNP levels (25594pg/ml vs. 15325 pg/ml, t = 2.979, P = 0.012) were markedly decreased after treatment with sacubitril-valsartan. ④No serious adverse events occurred. Conclusions Sacubitril-valsartan is effective and safe for MHD patients. Related Articles | Metrics

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The effectiveness and safety of Jerry automated peritoneal dialysis machine for maintenance peritoneal dialysis patients: a multicenter, randomized, and two phase crossover trial Chinese Journal of Blood Purification    2017, 16 (03): 148-153.   DOI: 10.3969/j.issn.1671-4091.2017.03.002 Abstract （1220）      PDF（pc） （507KB）（665）       Knowledge map    Objective To evaluate the effectiveness and safety of Jerry automated peritoneal dialysis (APD) machine for maintenance peritoneal dialysis (PD) patients through a prospective, multicenter, randomized and controlled trial. Methods This study was carried out in 6 PD centers in China, and chronic renal failure patients treated with PD for more than 3 months were enrolled. Patients in the experimental group used JARI-APD-1AAPD machine, and those in the control group used Baxter HomeChoice APD machine. The calculated sample size should be 84 patients. A multicenter, randomized, two phase crossover, opened, and positive control trial was designed, and each phase lasted for one day. The primary effectiveness indices included consistency between displayed value and measured value of single cycle drainage volume and single cycle infusion volume. The secondary effectiveness indices included accuracy of temperature control, toxin removal, and correction of electrolyte and acid- base imbalance. Results from Jerry APD machine were compared to those from Baxter APD machine by non-inferiority test. The safety indices included clinical symptoms, vital signs, and occurrence of machine malfunction. SAS 9.4 software was used to analyze the results. Results ① A total of 84 patients (47 males and 37 females, average age 45.33±11.34 years old) were enrolled in this study. The predominant primary disease was chronic glomerulonephritis, accounting for 50% of the patients. The average dialysis duration was 37.70±27.67 months. ②As for primary effectiveness indices, the consistency between displayed value and measured value of single cycle drainage volume was 97.62% in experimental group, accurately controlling the single cycle drainage volume and not inferior to that (98.81%) in control group (Z=4.315, P＜0.001); the consistency between displayed value and measured value of single infusion volume reached the accuracy of volume control in both groups and showed no difference between the two groups by non-inferiority test (Z=9.456, P＜0.001). ③As for secondary effectiveness indices, the measured temperature was consistent with the required accuracy in both groups, and experimental group was not inferior to control group in this index; the changes of blood urea, creatinine and electrolytes before and after the treatment also had no differences between the two groups. ④As for safety indices, the presence of uncomfortable symptoms, adverse events, and vital sign changes had no differences between the two groups. No machine malfunction was seen in both groups. Conclusions The multicenter randomized, opened, and two phase crossover clinical trial showed that the Jerry APD machine conformed to the standards of primary effectiveness indices, secondary effectiveness indices, and safety indices. Jerry APD machine is not inferior to Baxter APD machine in the effectiveness and safety indices. Related Articles | Metrics

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Research advances on portable artificial kidney devices  CHEN Li-ting, SONG Ming-yang, ZHAO Jian-cheng, LI Xue-mei Chinese Journal of Blood Purification    2022, 21 (06): 385-388.   DOI: 10.3969/j.issn.1671-4091.2022.06.001 Abstract （1215）      PDF（pc） （1798KB）（599）       Knowledge map    The global burden of chronic kidney disease is increasing. In China, the number of dialysis patients is increasing rapidly. Hemodialysis is the most prevalent renal replacement therapy worldwide. Due to the intermittence of hemodialysis and the need for patients to go to the hospital frequently, experts and scholars have been committed to finding more suitable kidney replacement therapy for patients. Portable artificial kidney device is a promising method. This review aims to summarize the research progress of portable artificial kidney devices with mature technology and new artificial kidney devices under development. Related Articles | Metrics

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Epidemiology and treatment pattern of hyperkalemia among outpatients in China: a descriptive study using an administrative database in China  Chinese Journal of Blood Purification    2020, 19 (11): 726-729.   DOI: 10.3969/j.issn.1671-4091.2020.11.002 Abstract （1210）      PDF（pc） （392KB）（1873）       Knowledge map    【Abstract】Objectives The aim of this study was to evaluate the proportion of hyperkalemia, rates of the diagnosis and treatment, and rate of retesting for hyperkalemia among outpatients in China. Methods Data were derived from Beijing Data Center for Rational Use of Drugs. Patients who accessed outpatient services (aged ≥18 years old) with record(s) of serum potassium (S-K) between Jan. 1st, 2015 and Dec. 31st, 2017 were included. The data about laboratory test, diagnosis and treatment were analyzed. The main outcomes including proportion of hyperkalemia patients, diagnosis rate, treatment rate and S-K retesting rate were analyzed. The geographic and seasonal distributions of the outcomes were examined. Results A total of 2,997,634 patients with at least one S-K record were analyzed. Among these patients, 115,826 (3.86%) experienced hyperkalemia (S-K＞5.0mmol/L). In patients with chronic kidney disease, heart failure, diabetes mellitus and hypertension, the rates of patients who experienced hyperkalemia were 22.89%, 12.54%, 7.11% and 6.51%, respectively. In outpatients, the overall rate of hyperkalemia was 2.53%. In patients with hyperkalemia, the overall hyperkalemia treatment rate was 8.69%, and the overall retesting rate within 7 days was 11.41%. Conclusions Hyperkalemia is an abnormality not rare in adult outpatients in China. The rate and severity of hyperkalemia were higher in patients with chronic kidney disease, heart failure, hypertension and diabetes compared to those in the overall outpatients. However, the rates of diagnosis, treatment and retesting for hyperkalemia in outpatients were insufficient, suggesting that the recognition and management of hyperkalemia in outpatients should be emphasized. Reference | Related Articles | Metrics

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Causes of discontinuing hemodialysis therapy in 125 patients with maintenance hemodialysis Xiao-ni;YU Long-li;GAO Ai-qin;ZOU Zuo-jun null    2008, 7 (6): 296-299.   Abstract （1190）   HTML （1）    PDF（pc） （568KB）（431）       Knowledge map    【Abstract】 Objective To analyze the causes of discontinuing hemodialysis therapy and the factors relating to their survival rate and living quality in patients with maintenance hemodialyis. Methods We retrospectively analyzed 235 maintenance hemodialysis patients in this hospital during the period from Jan. 2002 through Jan. 2007. Results In these patients, 125 cases (53.19%) discontinued hemodialysis therapy, of which the main causes were death (38.40%), renal transplantation (21.60%) and economic problems (20.80%). The main cause of death was cerebrovascular diseases (31.25%), which were resulted from nephropathic hypertension in 80.0% of these death cases. The next cause of death was cardiovascular diseases (25.0%), which were the end stage of diabetic nephropathy in 75.0% of these death cases. The death cases had older age, and had deterioration of general condition and malignant tumors in more cases (P<0.01, as comparison with those of the living cases). In addition, patients died of cardiovascular diseases, serious infections and deterioration of general condition experienced shorter period of hemodialysis (P<0.05 and P<0.001). Conclusion In patients with maintenance hemodialysis, death and economic problems were the major causes leading to discontinuation of this therapy. Cerebrovascular diseases were the main cause of death. Hypertension, diabetes and older age were the factors relating to the higher mortality rate. Deterioration of general condition and malignant tumor often happened in elder cases. Appropriate dialysis method and dosage will improve their life expectation and living quality. Related Articles | Metrics

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Active charcoal combined with zhubarb containing preparation as an adjuvant measure to control hyperphosphatemia in patients on dialysis CHENG Xu-yang;CAI Mei-shun;CUI Tai-gen;HE Lian;BAI Xia-feng;WU Lei-yun;DONG Jie;WANG Mi;LIU Jing;ZHU Ning;GUO Wei-ya;QIAO Song;ZHAO Hui-ping;XU Rong;ZUO Li;WANG Mei null    2011, 10 (3): 119-124.   DOI: 10.3969/j.issn.1671-4091.2011.03.00 Abstract （1189）   HTML （0）    PDF（pc） （261KB）（933）       Knowledge map    Objectives To evaluate the efficacy of active charcoal combined with rhubarb containing preparation in refractory hyperphosphatemia in patients on dialysis. Methods This was a multi-center, prospective and cross-over study. Patients on hemodialysis or peritoneal dialysis with stable disease condition but with hyperphosphatemia (serum phosphate > 1.78mmol/L) that could not be successfully controlled by conventional methods were selected. Patients were randomly assigned into 2 groups. Patients in therapy group received Aixite 1.5g with meal three times per day, and Shenshuaining, a composite preparation containing rhubarb, 4 pills three times per day. Dose of Shenshuaining was increased or decreased depending on patients’ gastrointestinal symptoms. Patients’ diet habit and other therapies remained unchanged. After 1 month, patients in treatment group were changed to control group, and those in control group to treatment group. Patients were then followed up for another 1 month. Changes of serum phosphate, albumin and hemoglobin between treatment group and control group were compared using paired t test. Results Fifty patients from 6 dialysis facilities were selected, of whom 24 patients were males, and 15 patients were on peritoneal dialysis. The average age and vintage were 56±13 and 4.9±3.1 years, respectively. Three patients were not included in the final analysis: one lost our follow-up, one had diarrhea before the treatment, and one took food unstably. The treatment decreased serum phosphate by about 0.35±0.67mmol/L (P=0.0010, compared with that of control group). Serum phosphate level lowered to <1.78mmol/L in 36.2% patients. Serum calcium and iPTH levels did not alter during the treatment period. Diarrhea happened in 3 patients and constipation in 3 patients, and the symptoms released after adjustment of Shenshuaining dose. Conclusions Active charcoal combined with rhubarb containing preparation is effective as an adjuvant measure in control of hyperphosphatemia in patients on dialysis, and provides a new approach for the treatment of hyperphosphatemia. Because the short observation period and small sample size, further study is needed to find out the long term benefits and risks of this regimen. Related Articles | Metrics

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The research of effectiveness of hybrid renal replacement on severe snake bite patients CHENG Jun-zhang;HU Shou-liang;LU Hong-zhu;LIU Jun-cheng;YUAN Fan-li. null    2011, 10 (1): 15-17.   DOI: 10.3969/j.issn.1671-4091.2011..00 Abstract （1186）   HTML （0）    PDF（pc） （206KB）（643）       Knowledge map    Objective The aim of this study is to investigate the effect of hybrid renal replacement treatment (HRRT) on acute pulmonary edema (APE) with acute kidney injury (AKI) following multiple wasp stings. Methods We designed a prospective study which enrolled nine patients who developed APE with AKI after multiple wasp stings between 2007 and 2010 in West China Hospital. HRRT included continuous venous-venous hemofiltration (CVVH), plasmapheresis (PE) and sustained low-efficiency dialysis (SLED). CVVH was performed for at least 72h with Baxter Accura or B. Braun Diapact CRRT machine and B. Braun Diacap Acute M hemofilter. Hemofiltration was accomplished using predilution bicarbonate replacement fluid at the rate of 3000ml/h and citrate or low-molecular-weight heparin (LMWH) for anticoagulation, with blood flow rates of 180 to 250 ml/min. PE was performed on the 1st and 2nd day after admission to hospital respectively (dose: fresh frozen plasma 2000 to 2500ml each time), then was replaced with SLED as patients in stable condition (dose: 150ml/min, for 10 to 12 hours every other day). Meanwhile, other therapeutic measures, such as regional wash and wet compress with normal saline around wounds, glucocorticoids therapy, hepatic function protection and nutritional support, were applied. Erythropoietin injection, as well as albumin and blood transfusion, were also carried out when necessary. Results One patient died unexpectedly 2h after admission to hospital. Autopsy, done 8h after sudden death, showed that the main cause of death was multiple organ failure due to the massive wasp envenomation. The other eight patients had a sharp improvement in oxygenation index after HRRT therapy, with obvious amelioration of APE as CT scan showed after an average span of 5.3±2.6 days. Among them, five ventilator dependent patients successfully weaned from mechanical ventilation 2 to 7 days after that. All the patients had distinct decrease in BNP, CK, myoglobin (Myo) and LDH after initiation of HRRT. They progressed to the commence of diuretic phase, renal function recovery and Myo decreasing to normal at 18±7d, 29±12d and 37±21d after admission to hospital, respectively. No organ dysfunction was found after an average follow-up span of 92±68 days. Conclusion We conclude that the coalition of APE and AKI is a severe complication of multiple wasp stings, and active HRRT therapy (CVVH+PE+SLED) as early intervention can bring significant benefits. Related Articles | Metrics

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Clinical practice guideline for use of iron on anemia in chronic kidney disease Committee of clinical practice guideline for use of iron on anemia in chronic kidney disease Chinese Journal of Blood Purification    2022, 21 (增刊): 17-40.   DOI: 10.3969/j.issn.1671-4091.2022.S.002 Abstract （1170）      PDF（pc） （1508KB）（3057）       Knowledge map    Related Articles | Metrics

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null    2002, 1 (8): 14-17.   Abstract （1167）   HTML （0）    PDF（pc） （2721KB）（429）       Knowledge map    【Abstract】 Objective To observe plasma level of TNFα in uremia and the influence of Cuprophane (Cup) and Hemophane (Hp) on production of tumor necrosis fact or alpha (TNFα) in maintenance hemodialysis (MHD) patients. Methods by in vitro incubation of peripheral blood monoe uclear cell (PBMC, LPS 10mg/L, 24h), ELISA and dot blot hybrodization to detect plasma TNFα levels, production and gene expression of TNFα by PBMC in 11 non-dialysis uremia patients, 14 MHD ones and 15 normal individuals. Results compared with normal control group, plasma TNFα level in uremic patients was higher, but was without significance (P>0.05). In MHD group equipped with Cup membrane, plasma TNFα level was elevated evidently with significance (P<0.05); after in vitro incubation of PBMC (LPS 10mg/L, 24h), the protein and gene expression of TNFα were higher than normal control either in non-dialysis patients or in MHD ones (P<0.05); During a hemodialysis(HD) session, the maximal amount of TNFα mRNA was detected at five minutes after the beginning of HD in group equipped with Cup (1.61±0.17 vs 0.84±0.06, and 1.61±0.17 rs 1.10±0.04 P<0.05), Simultaneously companion the increasing of protein levels of TNFα with significance. Conclusion Uremia and Cuprophane dialyer can stimulate PBMC to product TNFα. Related Articles | Metrics

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Analysis and treatment of concentrate related failures of Baxter Gambro AK96 hemodialysis machine Chinese Journal of Blood Purification    2017, 16 (05): 350-352.   DOI: 10.3969/j.issn.1671-4091.2017.05.018 Abstract （1166）      PDF（pc） （402KB）（535）       Knowledge map    This article briefly describes the fault of“Incorrect bicarbonate concentrate, check concentrate” demonstrated on Baxter Gambro AK96 Hemodialysis Machine, analyzes the operation principle of the equipment in details, and then proposes the treatment schemes about this fault, which have practical operability, and can provide reference for technologists and operators working in dialysis department. Related Articles | Metrics

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Analysis of psychological factors in patients with uremic encephalopathy DENG Ying-hui;JIA Qiang null    2008, 7 (7): 357-360.   Abstract （1154）   HTML （2）    PDF（pc） （598KB）（385）       Knowledge map    【Abstract】 Objective To evaluate psychological factors in the pathogenesis of uremic encephalopathy. Methods We recruited 23 chronic kidney disease patients with uremic encephalopathy (CKD at 5th stage) as the illness group (group A), and 23 CKD patients without uremic encephalopathy as the control group (group B). Their psychological problems were evaluated by using the symptom checklist 90 (SCL-90), self-rating depression scale (SDS) and self-rating anxiousness scale (SAS) before the presence of uremic encephalopathy. Results The illness group had significant higher scores of SCL-90 in global indices and every symptom scales, SDS and SAS evaluations (P＜0.01 or P＜0.05, as compared with those of the control group). Patients in the illness group had higher positive rates in SCL-90 scores of global indices and symptom scales of somatization, obsession, interpersonal sensitivity, depression, anxiety and phobia, as well as higher scores of SDS and SAS (OR 3.56～7.39; P＜0.01 or P＜0.05, as compared with those of the control group). Conclusion Negative emotional changes such as depression and anxiety may be the risk factors for the presence of uremic encephalopathy in CKD patients Related Articles | Metrics

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Study on the occurrence and influencing factors of pruritus in patients with maintenance peritoneal dialysis#br# Chinese Journal of Blood Purification    2019, 18 (09): 653-657.   DOI: 10.3969/j.issn.1671-4091.2019.09.019 Abstract （1148）      PDF（pc） （428KB）（907）       Knowledge map    【Abstract】Objectives To investigate the incidence of pruritus and its influencing factors in patients with peritoneal dialysis (PD). Methods According to the improved DUO scoring method, the pruritus questionnaire survey was conducted among PD patients who were regularly followed up in the PD Center of Peking University People's Hospital. Clinical data and laboratory results were collected. Logistic regression was used to analyze the influencing factors for pruritus, and multivariate linear regression was used to analyze the influencing factors for the severity of pruritus. Results ①A total of 123 PD patients were enrolled in this study, including 53 males (43.1%) with an average age of 60.15±12.46 years and a dialysis duration of 37.14±27.79 months. The main primary disease was diabetic nephropathy (35.8%). ②Eight-two PD patients had skin pruritus, with an incidence of 66.7% . Logistic regression analysis showed that dry skin (OR=4.956, 95% CI 2.364～10.388, P<0.001), high serum CRP (OR=1.251, 95% CI 1.075～1.456, P=0.005), high serum phosphorus (OR=5.029, 95% CI 1.030～24.560, P=0.046) and high serum magnesium (OR=3.533, 95% CI 0.390～6.124, P=0.023) were the independent risk factors for pruritus in PD patients. ③Of the 82 patients with pruritus, 40.2% had mild pruritus, 46.3% had moderate pruritus, and 13.4% had severe pruritus. Multivariate linear regression analysis showed that dry skin (β =0.674, P＜0.001), serum phosphorus (β =0.631, P=0.004) and serum iPTH level (β=0.001, P=0.040) were the independent risk factors for the severity of pruritus in PD patients. Conclusions The incidence of skin pruritus is higher in PD patients. PD patients with dry skin, higher serum levels of CRP, magnesium and phosphorus are more likely to suffer from pruritus. PD patients with dry skin, higher serum levels of phosphorus and iPTH had more severe pruritus. Reference | Related Articles | Metrics

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Etiology analysis of incident hemodialysis patients in Beijing in 2007 CHEN Hong;ZHOU Chun-hua null    2009, 8 (10): 572-575.   Abstract （1147）   HTML （0）    PDF（pc） （246KB）（222）       Knowledge map    【Abstract】　Objective　To investigate age, sex and primary disease of incident hemodialysis patients with end stage renal disease (ESRD) in Beijing in 2007. Methods Based on the information from the database issued by Beijing Hemodialysis Quality Control Improvement Center (BJHDQCIC), we analyzed age, sex and primary disease in 1732 ESRD patients newly treated with hemodialysis in Beijing in 2007. 　Results In 2007 in Beijing, 1732 cases began to treated with hemodialysis. The male/female ratio was 1.35:1, and 73.6% patients were in the age range of 41～80 years. The most frequent primary diseases were primary glomerulonephritis 27.97%, diabetic nephropathy 23.19%, and hypertensive nephropathy 13.21%. Conclusion In this study, the major primary disease leading to ESRD and hemodialysis was primary glomerulonephritis. In the recent 5 years, however, the ratio of primary glomerulonephritis in the hemodialysis patients is decreasing, and that of diabetic nephropathy is increasing. Related Articles | Metrics

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Experimental study of hybrid bioartificial liver therapy for animal model with acute hepatic failure WANG Kai;ZHAO Xian-guo;DUAN Zhong-ping;WANG Xin-fang;LI Su-zhen null    2010, 9 (7): 389-392.   DOI: 10.3969/j.issn. 1671-4091.2010.07.011 Abstract （1145）   HTML （0）    PDF（pc） （255KB）（250）       Knowledge map    【Abstract】 Objective To evaluate the therapeutic effects of hybrid bioartificial liver (HBL) on animal acute hepatic failure model. Methods HBL consisted of plasma exchange, hemofiltration and porcine hepatocyte-based bioartificial liver. Six experimental minipigs were induced to have acute hepatic failure by administration of D-galactosamine. After 48 hours the animals were treated with plasma exchange plus hemofiltration then followed by porcine hepatocyte-based bioartificial liver. Clinical manifestations and serum indexes of the animals were observed and compared with those at different treatment stages. Results No significant changes in vital signs were found, and the adverse effects did not occur in these animals during the treatment. Compared with those before HBL treatment, the concentrations of blood total bilirubin, NH3, alanine transferase, endotoxin and creatinine were much lower (P>0.01), and levels of fibrinogen, prothrombin activity and alpha-fetoprotein were much higher (P＜0.01) after HBL treatment. Compared with those after plasma exchange plus hemofiltration, serum fibrinogen and prothrombin activity were higher (P＜0.05), and serum NH3 and total bilirubin were lower after the porcine hepatocyte-based bioartificial liver treatment. Conclusions The treatment of HBL for acute hepatic failure is safe and effective, and is superior to the efficacy of plasma exchange plus hemofiltration. Related Articles | Metrics

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The reliability and validity of Kidney Disease Questionnaire (KDQ) on measuring life quality in patients on maintenance hemodialysis WANG Ying;LIN Ke-ke null    2008, 7 (10): 549-551.   Abstract （1143）   HTML （7）    PDF（pc） （330KB）（775）       Knowledge map    Objective To explore the reliability and validity of Kidney Disease Questionnaire (KDQ) on measuring life quality in patients on maintenance hemodialysis. Method Convenient sampling was used. A total of 100 patients on maintenance hemodialysis from the Hemodialysis Center of People’s Hospital were tested. The self-designed questionnaire includes three parts, namely the demographical data, SF-36 short form, and KDQ. Data regarding life quality of the patients were calculated to assess the reliability and validity of KDQ. Results The test-retest reliability of KDQ was 0.706, and the split-half reliability was 0.821. Except for the subscale of physical symptoms, Cronbach’s a coefficient of subscales ranged from 0.508～0.852. The questionnaire also showed good construction validity and criterion-related validity. Conclusion KDQ can be served as a proper scale to measure life quality in patients on hemodialysis. Related Articles | Metrics

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Therapeutic effect of two inoculation methods for hepatitis B vaccination in hemodialysis patients SU Wei;ZHANG Huan-qiao;SHANG You-quan;ZHANG Yan-zhi. null    2010, 9 (5): 261-264.   Abstract （1140）   HTML （0）    PDF（pc） （250KB）（347）       Knowledge map    【Abstract】Objective Effective immunoprotection has great benefits for hemodialysis(HD) patients who have the high risk of infection with hepatitis B virus (HBV).However, the lower response to hepatitis B vaccination is observed in HD patients. The aim of this study was to research the effects of vaccination by two ways. Methods 50 chronic HD patients with normal aminotransferase levels, seronegative for HBsAg, anti-HBc, and anti-HBs antibodies were divided into two groups.:patients of group A (32 HD patients) received 4 doses of 20ug recombinant hepatitis B vaccine by i.m route in the deltoid region at 0, 1, 6 and 9 months,;patients of group B (18 chronic HD patients)received 6 doses of 5ug recombinant hepatitis B vaccine at 2 every two weeks by i.d route on the volar surface of the forearm. Protective seroconversion is indicated by the serum levels of hepatitis B surface antibody (anti-HBs) equal to or higher than 10 mIU/ml. Serum anti-HBs were tested 1-3 months after completion of vaccination.The differences of protective antibody seroconversion rate between the two groups were analyzed. Results 25 patients in group A have had the protective antibody (protective seroconversion rate was 78.12%) while 16 patients in group B have had the protective antibody (protective seroconversion rate was 88.89%),there are difference between the two groups.The level of antibody titers in group A is higher than group B,there is significant difference between two groups .There are no differences among two groups for the sex, age, course, creatinine level, albumin level, hemoglobin level(P>0.05). Conclusion Compared with the traditional methods of hepatitis B vaccination, Long course of intramuscular injection as well as repeated low-dose intradermal injection of recombinant hepatitis B vaccine may produce a higher percentage of protective antibodies,while the latter was more higher. The level of antibody titers in group of long period、routine doses with i.m route is higher than in group of multiple low doses with i.d route .The sample is small in this study,,it need further study . Related Articles | Metrics

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History of hemodialysis in China Chinese Journal of Blood Purification    2019, 18 (11): 735-737.   DOI: 10.3969/j.issn.1671-4091.2019.11.001 Abstract （1134）      PDF（pc） （400KB）（1458）       Knowledge map    【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. Reference | Related Articles | Metrics

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null    2003, 2 (8): 419-423.   Abstract （1127）   HTML （0）    PDF（pc） （2185KB）（287）       Knowledge map    Objective To explore the changes and clinical significance of the plasmic angiotensinⅡ (AngⅡ), neuropeptide Y (NPY), neurotensin (NT) and intact parathyroid hormone (iPTH) in patients with chronic renal insufficiency. Methods The plasmic AngⅡ、NPY and NT were measured by radioim-munoassay (RIA). The serum iPTH were measured by immunoradiometric assay (IRMA).There were four groups and twenty cases of each as group, A,B, C and D. They were normal controls, chronic renal insufficiency compensated stage, azotemia stage and uremia stage respectively. Results With the severity of renal failure,the level of AngⅡ showed an ascending tendency. Groups C and D were higher than normal control group (P<0.001); The concentration of NPY (groups B.C and D) were higher than group A (P<0.05); The level of NT showed a decending tendency, group D were lower than group A( P<0.001); The iPTH (group D) were significant higher than group A (P<0.001). In addition to the negative correlation between AngⅡ or NPY or iPTH and Ccr, the negative correlation between NT and Ccr, negative correlation between AngⅡ and NT were found. Conclusion The increased AngⅡ、NPY、iPTH and decreased NT play important roles in the further decrease of renal function and also provide theoretical bases for chronic renal failure's preventions and treatments. Related Articles | Metrics

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Effect of sodium thiosulfate combined with hemoperfusion on uremic pruritus and oxidative stress in maintenance hemodialysis patients  Chinese Journal of Blood Purification    2022, 21 (01): 33-37.   DOI: 10.3969/j.issn.1671-4091.2022.01.008 Abstract （1110）      PDF（pc） （508KB）（328）       Knowledge map    【Abstract】Objective To observe the effect of sodium thiosulfate combined with hemoperfusion on refractory pruritus and oxidative stress in maintenance hemodialysis (MHD) patients. Methods A total of 70 MHD patients with refractory pruritus treated in the Hemodialysis Center, Shanghai Jing’an District Zhabei Central Hospital during January 2019 to December 2020 were enrolled in this study. They were randomly divided into three groups: group A (sodium thiosulfate group), group B (hemoperfusion group) and group C (sodium thiosulfate combined with hemoperfusion group). Patients in group A received hemodialysis three times a week, and 3.2g sodium thiosulfate was intravenously injected before every dialysis; those in group B received hemodialysis twice a week and hemodialysis combined with hemoperfusion once a week; those in group C used the dialysis protocols in group B as well as intravenous 3.2g sodium thiosulfate before every dialysis for 3 months. Serum creatinine (SCR), urea nitrogen (BUN), calcium (Ca), phosphorus (P), β2-micro-globulin (β2-MG), parathyroid hormone (PTH), C-reactive protein (CRP), glutathione peroxidase (GSHPx), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before and after 3 months treatment. Pittsburgh sleep quality index (PSQI) and visual analogue scale (VAS) were used before and after 3 months treatment to evaluate the efficacy and safety of the treatment. Results Serum P, β2-MG and PTH in group B and group C were lower after the treatment than those before the treatment, and were lower than those in group A after the treatment (Serum P, in group B and group C: t=2.829 and 4.226, P=0.010 and <0.001; between group B and group C: F=3.191 and P=0.041. Serum β2-MG, in group B and group C: t=2.363 and 2.575, P=0.027 and 0.017; between group B and group C: F=4.658 and P=0.013. Serum PTH, in group B and group C: t=2.715 and 5.856, P=0.008 and <0.001; between group B and group C: F=13.738 and P<0.001). Serum GSHPx and SOD in group A and group C were higher after the treatment than those before the treatment, and were higher than those in group B during the same period (Serum GSHPx, in group A and group C: t=-2.247 and - 5.387, P=0.035 and <0.001; between group A and group C: F=15.577 and P<0.001. Serum SOD, in group A and group C: t=-2.300 and -5.122, P=0.031 and <0.001; between group A and group C: F=8.308 and P=0.001). Serum MDA decreased significantly (in group A and group C: t=5.630 and 7.904, P<0.001; between group A and group C: F=26.116 and P<0.001). PSQI score and VAS score lowered after 3 months treatment compared to those before treatment in the three groups (PSQI score in groups A, B and C: t=4.739, 4.761 and 8.803 respectively, P<0.001; VAS score in groups A, B and C: t=15.087, 11.682 and 17.310 respectively, P<0. 001). PSQI and VAS scores lowered more in group C than in group A and group B during the same period (For PSQI score and VAS score: F=15.049 and 8.670, P<0.001). After 3 months treatment, the effective rates were 54.2%, 47.8% and 78.3% in group A, group B and group C, respectively, higher in group C than in groups A and B (χ2=4.956, P=0.026). Conclusions Sodium thiosulfate combined with hemoperfusion was safe and effective for MHD patients with refractory pruritus. Sodium thiosulfate has antioxidant effect, which may alleviate uremic pruritus. Reference | Related Articles | Metrics

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Pulse pressure directly correlating with the stiffness of large arteries in maintenance hemodialysis patients GAN Liang-ying;WANG Mei;YANG Jing-hua;TAN Min;TAN Yi-yi;ZHANG Da-wei null    2008, 7 (6): 300-302.   Abstract （1107）   HTML （0）    PDF（pc） （597KB）（304）       Knowledge map    【Abstract】 Objective Pulse pressure (PP) has been shown as a risk factor for mortality and cardiovascular events in maintenance hemodialysis (MHD) patients. However, the impact of clinical factors on PP and it correlation with pulse wave velocity (PWV) in these patients has not been sufficiently studied. The objective of this study was to investigate PP in MHD patients and it correlation with clinical factors. Methods Ninety MHD patients were enrolled, and 36 sex and age matched healthy people were used as controls. Demographic data were collected. Blood pressure and biochemical parameters were measured. Automatic PWV measuring system was applied to examine carotid-femoral PWV (CFPWV) as the parameter reflecting elasticity and stiffness of large central arteries. Backward multiple linear regression analysis was used to assess the influencing factors of PP. A value of P<0.05 was regarded as significant. Results PP, systolic blood pressure (SBP), mean arterial pressure (MAP) and CFPWV in MHD patients were greater than those in healthy controls (59.8+16.8 mmHg vs 47.5+14.7 mmHg; 140.9+20.4 mmHg vs 124.9+15.1 mmHg; 101.1+14.7 mmHg vs 93.3+10.5 mmHg and 13.22+3.23 m/s vs10.67+2.11 m/s, respectively, P<0.05). A backward multiple regression analysis demonstrated that age, diabetes mellitus and CFPWV were positively related to PP. The SBP, PP and CFPWV in diabetic MHD patients were significantly higher than those in non-diabetic MHD patients (P<0.05). Conclusions This study demonstrates that PP is elevated in MHD patients due to increased SBP. Age, DM and CFPWV are major determinants of PP. PP in MHD patients correlates significantly with CFPWV which is an aortic stiffness marker. Related Articles | Metrics

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Low birth weight influences glomerular filtration rate: a meta analysis XU Rong;ZUO Li;WANG Hai-yan null    2008, 7 (5): 243-247.   Abstract （1096）   HTML （0）    PDF（pc） （622KB）（209）       Knowledge map    【Abstract】 Objective To study the effect of low birth weight on glomerular filtration rate (GFR) in adulthood. Methods We searched the database PubMed for related literature by using the keywords birth weight, creatinine clearance, glomerular filtration rate and renal function. According to our study purposes, 7 clinical study reports were included and analyzed. Revman 4.2 was used for data analysis. Results GFR of individuals with a low birth weight was normal, however, their GFR was 4ml/min/1.73m2 lower than that of those with a normal birth weight. This finding is still evident after we exclude 2 studies measured in childhood. Conclusion GFR of adult individuals with a low birth weight is in the normal range, but is lower than that of those with a normal birth weight. Related Articles | Metrics

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MMP-9 and TIMP-1 are associated with vascular medial calcification in uremic patients WANG Lu;LIN Hong-li;WANG Ke-ping;XIE Hua;HUANG Lin null    2008, 7 (8): 420-423.   Abstract （1094）   HTML （0）    PDF（pc） （706KB）（303）       Knowledge map    Objective To study the relationship between the medial calcification of arteries and the expressions of matrix metallopeptidase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in uremic patients. Methods Pieces of radial arteries were taken from 80 uremic patients at the time of arteriovenous fistula operation. The control radial arteries were taken from trauma patients with normal kidney function at the time of amputation operation. Vascular calcification was evaluated histomorphometrically on Von Kossa-stained sections, and the expressions of MMP-9, TIMP-1, osteopontin (OPN), collagen I, core binding factor a-1 (Cbfa-1) were determined immunohistochemically. Other related factors including serum calcium, phosphate, cholesterol, triglyceride (TG), low-density lipoproteins (LDL), albumin (ALB), hemoglobin, intact parathyroid hormone (iPTH) and C-reactive protein (CRP) were also detected. Results Vascular calcification was found in 36 uremic patients (45%), while no vascular calcification in the control group. Mild to moderate calcification was found in 25 uremic patients, and severe calcification in 11 cases. All of the radial arteries with calcification showed positive immunostaining of MMP-9, TIMP-1, OPN, collagen I and Cbfa1 (p<0.01). In some uremic radial arteries without morphologically obvious calcification, immunostaining of OPN and collagen I were also positive, but immunostaining of Cbfa1 was negative. Mean arterial blood pressure, serum phosphate, serum calcium-phosphate product, serum iPTH and CRP were significantly higher in uremic patients than in controls (p＜0.01), but body mass index, serum calcium, TG, total cholesterol, LDL and ALB had no differences between the two groups. Conclusion We have demonstrated, for the first time, that expressions of MMP-9 and TIMP-1 in arteries are correlated to vascular calcification in uremic patients. Our results suggest that the imbalance expression of MMP-9/TIMP-1 may cause, at least partially, vascular medial calcification in uremic patients. Related Articles | Metrics

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The comparison study on different immunoadsorption methods for the treatment of systemic lupus erythematosus HAN Zhi-wu;YAO Guo-qian;LI Jing;XIAO Qiong;WANG Jing;XU You-ping null    2010, 9 (7): 380-384.   DOI: 10.3969/j.issn. 1671-4091.2010.07.001 Abstract （1094）   HTML （1）    PDF（pc） （313KB）（366）       Knowledge map    【Abstract】Objective To investigate the clinically curative effects of different therapeutic methods of immunoadsorption (protein A immunoadsorption, PH350 immunoadsorption, DNA immunoadsorption) for systemic lupus erythematosus (SLE). Methods A total of 98 SLE patients were divided into three groups according to the immunoadsorption method used. Before and after the therapy, 24-hour urinary protein, serum creatinine (Cr), urea nitrogen (UN), albumin, immunoglobulin level, complement C3 and C4, autoantibodies (ANA and anti-dsDNA autoantibody) and SLEDAI score were measured. Results There were significant changes in 24-hour urinary protein, serum creatinine (Cr), urea nitrogen (UN), albumin, immunoglobulin level, autoantibodies (anti-dsDNA autoantibody), and SLEDAI score before and after the therapy (all P<0.05). Furthermore, the clearance of immunoglobulin was more efficient in protein A group than in PH350 group and DNA group (P<0.05). However, there were no differences in lupus activity control among patients using different immunoadsorption methods after longer period of observation. Conclusion The curative effects of immunoadsorption methods on SLE were significant. Among the immunoadsorption methods we used, protein A was more effective in autoantibody clearance. In clinical practice, a variety of factors should be considered in choosing the best immunoadsorption methods. Related Articles | Metrics

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Clinical observation of sodium thiosulfate in the treatment of intractable uremic pruritus Chinese Journal of Blood Purification    2020, 19 (02): 92-94.   DOI: 10.3969/j.issn.1671-4091.2020.02.006 Abstract （1086）      PDF（pc） （434KB）（1258）       Knowledge map    【Abstract】Objective To observe the efficacy and safety of sodium thiosulfate (STS) in the treatment of uremic pruritus. Methods Sixty patients with uremic pruritus were randomly divided into observation group (n=30) and control group (n=30). The control group was given loratadine 10mg orally once daily, and the observation group was given STS 3.2g intravenously three times a week after dialysis in addition to the loratadine treatment in control group. They were observed for 3 months. The changes of inflammatory index, modified Duo's pruritus score, Pittsburgh sleep quality index (PSQI) score and the incidence of adverse reactions were compared before and after the treatment. Results The total clinical effective rate was 96.70% in the observation group, significantly higher than that (63.30%) in the control group (χ2=10.892, P=0.001). The changes of C- reactive protein (t=15.170, P<0.010), ferritin (t=7.330, P<0.010) and albumin (t=- 9.030, P<0.010) before and after treatment were statistically significant in the observation group; however, the changes of C-reactive protein (t=1.170, P=0.055) and ferritin (t=1.731, P=0.086) before and after treatment did not have statistical significances in the control group. Modified Duo score (intra-group: t=14.480, P<0.001; intergroup: t=- 11.220, P<0.001) and PSQI score (intra- group: t=33.240, P< 0.001; inter- group: t=- 14.480, P<0.001) after the treatment were significantly lower than those before the treatment in the observation group and were also lower than those before treatment in the control group. There was no significant difference in the incidence of adverse reactions between the two groups (χ22=0.218, P=0.640). Conclusions STS combined with anti-allergic therapy is more effective in the treatment of uremic pruritus without serious adverse reactions. Reference | Related Articles | Metrics