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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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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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Investigation on anemia risk of non dialysis chronic kidney disease patients in China (INSIGHT study) National anemia investigation working group of chronic non dialysis renal disease patients Chinese Journal of Blood Purification    2022, 21 (增刊): 53-69.   DOI: 10.3969/j.issn.1671-4091.2022.S.004 Abstract （319）      PDF（pc） （609KB）（1206）       Knowledge map    Related Articles | Metrics

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Diagnosis and teatment of hyperphosphatemia in non-dialysis patients with chronic kidney disease in China SUI Zhun ZUO Li Chinese Journal of Blood Purification    2022, 21 (增刊): 41-52.   DOI: 10.3969/j.issn.1671-4091.2022.S.003 Abstract （227）      PDF（pc） （1025KB）（1010）       Knowledge map    Reference | Related Articles | Metrics

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Expert consensus on the specialized nursing operation of hemoperfusion combined with hemodialysis Blood Purification Committee of Chinese Nursing Association (This consensus was written by MA Zhi-fang, XIANG Jing, XIA Jing-hua, XIAO Guang-hui, FU Xia, SHEN Hua-juan, HE Shan, CHEN Jing, TONG Hui, GAO Ju-lin, YUE Xiao-hong, JIAO Jian-mei, ZHU Han-yu) Chinese Journal of Blood Purification    2023, 22 (05): 364-368,380.   DOI: 10.3969/j.issn.1671-4091.2023.05.010 Abstract （651）      PDF（pc） （556KB）（952）       Knowledge map    Combined hemoperfusion (HP) and hemodialysis (HD) (combined artificial kidney) is increasingly used for the treatment of end-stage renal disease (ESRD). Clinical nursing staff have an urgent need for the specialized nursing operation of combined artificial kidney. The expert group of the Blood Purification Professional Committee of the Chinese Nursing Association, referring to the domestic and foreign literature and combining the clinical application experience, has formulated the “Expert Consensus on Specialized Nursing Operation of Hemoperfusion Combined with Hemodialysis” that contains seven aspects: pipeline selection, heparinization of hemoperfusion, pre-flushing process, blood transfusion operation, blood return operation, observation and treatment, and pressure monitoring. This is the first expert consensus to guide the combined artificial kidney treatment and nursing operation in China, in order to provide a valuable reference for clinical nursing staff to implement the nursing operation of combined artificial kidney treatment. Reference | Related Articles | Metrics

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Measurement method of renal uric acid excretion ability in patients with hyperuricemia  LIU Yue, WANG Yue Chinese Journal of Blood Purification    2023, 22 (05): 381-383.   DOI: 10.3969/j.issn.1671-4091.2023.05.014 Abstract （139）      PDF（pc） （341KB）（876）       Knowledge map    About 90% of the hyperuricemia patients are found to have renal dysfunction of uric acid excretion. Guidelines and consensus from China and foreign countries have recommend that the 24-hour uric acid excretion fraction and/or 24-hour uric acid excretion can be used for assay of renal uric acid excretion ability, clinical classification and drug selection. However, collection of a 24-hour urine sample takes a long time, and the result may not be accurate due to the possible contamination and incomplete sampling during collection and limited urine storage condition. Previous studies have found that uric acid excretion fraction in random urine sample, especially in morning urine sample, is a simple and efficient method, which may replace the 24-hour uric acid excretion method to evaluate renal uric acid excretion function and to guide clinical classification and treatment in hyperuricemia patients. Reference | Related Articles | Metrics

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Research and Application Progress of Long acting Erythropoietin LIU Ai-chun, WEI Tao Chinese Journal of Blood Purification    2023, 22 (03): 161-163.   DOI: 10.3969/j.issn.1671-4091.2023.03.001 Abstract （327）      PDF（pc） （342KB）（789）       Knowledge map    China has a large number of patients with renal anemia and tumor anemia after radiotherapy and chemotherapy. Long acting erythropoietin (EPO) has the advantages of long half-life and high biological activity. It can reduce the frequency and dose of administration, improve patient compliance and improve the effect of anemia treatment. This paper summarizes the design scheme, advantages and application prospects of long-acting EPO in order to provide a theoretical basis for promoting the wide application of long-acting EPO in China. Related Articles | Metrics

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Evidence-based practice of exercise rehabilitation in maintenance hemodialysis patients ZHAN Xuan, GUO Yue-yue, ZHOU Kou-xiang, CHEN Ting-ting, BO Xiang-min, LIU Sheng-feng Chinese Journal of Blood Purification    2023, 22 (06): 472-476.   DOI: 10.3969/j.issn.1671-4091.2023.06.016 Abstract （242）      PDF（pc） （449KB）（788）       Knowledge map    Objective   To implement evidence-based practice based on the evidences from exercise rehabilitation in maintenance hemodialysis (MHD) patients, and to validate the role of exercise rehabilitation in improving physical function, exercise tolerance, and quality of life in MHD patients.  Methods  The evidence-based continuous quality improvement model was used as the research framework, and an evidence-based program for exercise rehabilitation in MHD patients was conducted from January to December 2021 through evidence acquisition, status review and evidence introduction. A total of 80 MHD patients hospitalized in the Department of Nephrology, Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to March 2022 were then recruited and randomly divided into experimental group (n=40) and control group (n=40). After the exercise intervention, the muscle mass, muscle strength, 6-minute walking test, and quality of life were compared between the two groups. The awareness of sport rehabilitation evidence in medical staff was also compared before and after the evidence-based practice.  Results   Nine pieces of evidences were finally included, with a total of seven reviewed indicators. After exercise intervention, muscle mass (t=-3.302, P<0.01), muscle strength (t=-2.825, P<0.001), and 6-minute walking (t=-5.529, P<0.001) increased more in experimental group than in control group. The total scores of each dimension in the Health Survey Short Form increased more in experimental group than in control group (P<0.05). The awareness rate of sport rehabilitation evidence among medical staff increased by 40.74% before and after evidence-based practice, which has a statistical significance (P<0.001).  Conclusion  The evidence-based exercise rehabilitation practice can improve the body function, exercise endurance and quality of life in MHD patients. Reference | 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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Recent progresses in the application of new techniques relating to arteriovenous fistuloplasty            LI Jie, HOU Guo-cun Chinese Journal of Blood Purification    2023, 22 (04): 287-291.   DOI: 10.3969/j.issn.1671-4091.2023.04.009 Abstract （318）      PDF（pc） （763KB）（768）       Knowledge map    Arteriovenous fistula is the preferable vascular access method for renal failure patient to initiate hemodialysis, and becomes a lifeline of these patients. Since the first successful anastomosis of radial artery-cephalic vein in 1962, many surgical methods, auxiliary devices and methods to promote the maturation of arteriovenous fistula have been developed and widely used. This article reviews the progresses of arteriovenous fistulaplasty to facilitate clinicians with more options for vascular access surgery. Reference | Related Articles | Metrics

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Research progresses in the prediction model of intradialytic hypotension WANG Ze-min, SHAO Guo-jian, ZHENG Yue-nan, PAN Lu-lu, ZHENG Yi-yi Chinese Journal of Blood Purification    2023, 22 (03): 202-205,220.   DOI: 10.3969/j.issn.1671-4091.2023.03.010 Abstract （272）      PDF（pc） （413KB）（746）       Knowledge map    Maintenance hemodialysis (MHD) is an important renal replacement therapy for end-stage renal disease. Intradialytic hypotension (IDH) is a common complication in MDH patients. IDH may cause many adverse events and affect the quality of life and the prognosis of the patients. The discovery of high-risk factors for IDH is essential to the early identification of IDH. The IDH prediction models integrate multiple risk factors, can better predict the occurrence of IDH, and thereby improve the prognosis of MHD patients. This article discusses and summarizes the definition of IDH, risk factors for IDH, the types of prediction models, and the prediction models of IDH in China and foreign countries, in order to provide references for the construction of suitable prediction models for IDH. Reference | Related Articles | Metrics

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Research progress of cardiorenal anemia syndrome ZHONG Zhong, CHEN Wei Chinese Journal of Blood Purification    2023, 22 (03): 164-167,172.   DOI: 10.3969/j.issn.1671-4091.2023.03.002 Abstract （346）      PDF（pc） （378KB）（731）       Knowledge map    There is a close interaction between the heart and the kidney. Cardiorenal syndrome encompasses a spectrum of disorders involving both the heart and kidney in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Anemia is very common in patients with both chronic kidney disease and heart failure. They interact and promote each other, forming a vicious circle, so they called the term cardiorenal anemia syndrome (CRAS). The occurrence of CRAS is mainly related to erythropoietin deficiency, iron deficiency, oxidative stress, inflammation response, and abnormal bone mineral metabolism. Patients with CRAS require comprehensive management, not only to control anemia, but also to actively treat heart failure, kidney injury and other comorbidities. Currently, the treatment of CRAS mainly focuses on erythropoietin and iron supplementation and the use of new hypoxia-inducible factor prolyl hydroxylase inhibitors. However, there are still many unresolved problems regarding the treatment of CRAS, and more randomized controlled studies with large samples are needed to provide evidence-based medicine results in the future. Related Articles | Metrics

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Clinical Practice Recommendation for Arteriovenous Access Thrombosis Treatment WANG Yu-zhu, ZHANG Li-hong, ZHAN Shen Chinese Journal of Blood Purification    2022, 21 (08): 545-459,568.   DOI: 10.3969/j.issn.1671-4091.2022.08.001 Abstract （550）      PDF（pc） （476KB）（730）       Knowledge map    Vascular access is the lifeline of maintenance hemodialysis patients. Arteriovenous fistula is the preferred vascular access, but it is prone to thrombosis which resulting in loss of fistula. Also, thrombosis is associated with hospitalization and all-cause mortality in maintenance hemodialysis patients. The establishment of vascular access and the treatment of complications in our country have made great progress in recent years, but there is a lack of systematic and standardized understanding of preoperative assessment, indications, method selection, technical points, and complication prevention for arteriovenous fistula thrombosis treatment. In view of this, the Department of Nephrology of Beijing Haidian Hospital drafted this recommendation with reference to relevant domestic and foreign literatures and a large amount of practical experience in our center, aiming to provide reference for nephrologists to standardize thrombosis treatment. 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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Application of Angiotensin Receptor-Neprilysin Inhibitor in Chronic Kidney Disease Patients: Chinese Expert Consensus Chinese Expert Group Consensus on Application of Angiotensin Receptor-Neprilysin Inhibitor in Chronic Kidney Disease Patients Chinese Journal of Blood Purification    2023, 22 (04): 241-253.   DOI: 10.3969/j.issn.1671-4091.2023.04.001 Abstract （631）      PDF（pc） （572KB）（726）       Knowledge map    Chronic kidney disease (CKD) is a global public health problem, and cardiovascular disease is the most common cause of death in patients with CKD. The incidence and prevalence of cardiovascular events during the early stages of CKD increases significantly with a decline in renal function. More than 50% of dialysis patients die from cardiovascular disease. Therefore, developing effective methods to control risk factors and improve prognosis of cardiovascular disease is the primary focus during the diagnosis and treatment of CKD. For example, the Systolic blood pressure intervention trial (SPRINT) study demonstrated that CKD drugs are effective in reducing cardiovascular and cerebrovascular events by controlling blood pressure. Uncontrolled blood pressure not only increases the risk of these events but also accelerates the progression of CKD. Recent studies have repeatedly confirmed that the first and so far the only angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan can reduce blood pressure more effectively than renin–angiotensin system inhibitors and improve the prognosis of heart failure in patients with CKD. Here, to better guide the application of ARNI in patients with CKD, and reduce the occurrence of cardiovascular events，we formulate a consensus based on clinical evidence and experience. Reference | Related Articles | Metrics

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Expert consensus on anticoagulation management in chronic kidney disease patients complicated with non-valvular atrial fibrillation The Working Group on Anticoagulation Management of Non-valvular Atrial Fibrillation in Chronic Kidney Disease Patients Chinese Journal of Blood Purification    2023, 22 (08): 561-573.   DOI: 10.3969/j.issn.1671-4091.2023.08.001 Abstract （673）      PDF（pc） （782KB）（708）       Knowledge map    The incidence of thromboembolic diseases and hemorrhage is high in chronic kidney disease (CKD) patients complicated with non-valvular atrial fibrillation. Nephrologists and cardiologists are facing problems in anticoagulation treatment for these patients. A committee composed of nephrologists, cardiologists and pharmaceutical experts compiled the consensus based on current status of clinical diagnosis and treatment of the disease. According to the data of evidence-based medicine and clinical experiences, this consensus systematically introduces the risk assessment of thromboembolism and bleeding, the timing of starting anticoagulant therapy and the drug of choice, in order to guide and standardize the anticoagulant treatment and to improve clinical diagnosis and treatment of non-valvular atrial fibrillation in CKD patients. Reference | Related Articles | Metrics

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The new classification of uremic toxins LI Chao, WEI Tao Chinese Journal of Blood Purification    2023, 22 (11): 801-805,815.   DOI: 10.3969/j.issn.1671-4091.2023.11.001 Abstract （362）      PDF（pc） （521KB）（697）       Knowledge map    ?The retention and increase of uremic toxin will lead to a series of uremic symptoms, which will affect many systems of the whole body, and lead to the decline of patients' quality of life and high mortality. In 2003, the European Uremic Working Group classified uremic toxins into three groups according to their physical chemistry properties: water-soluble small molecule compounds, protein-binding compounds, and middle molecule compounds. With the new understanding of uremic solutes, the new data of sources and the development of hemodialysis methods and membrane materials, the previous classification can not fully adapt to the new progress in the field of blood purification. Accordingly, in november-december 2020, Claudio R, as president of the General Assembly, convened an expert meeting and prepared an expert consensus that provided new insights into the definition and classification of uremic toxin  tails the expert group's consensus recommendations for new definitions and more clinically oriented new classifications of uremic toxins. Related Articles | Metrics

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Research trends in artificial intelligence applied to hemodialysis: visualization analysis based on VOSviewer LIU Jia-li, HU Shen-ling, ZHOU Pei-ru, MO Hong-qiang, HUANG Jie-wei, HU Bo Chinese Journal of Blood Purification    2023, 22 (08): 633-637.   DOI: 10.3969/j.issn.1671-4091.2023.08.015 Abstract （299）      PDF（pc） （907KB）（678）       Knowledge map    Objective To investigate the current research status and development trend of artificial intelligence (AI) applied to hemodialysis.  Methods  We searched the literature in the field of AI applied to hemodialysis indexed by SCI-EXPANDED and SSCI in the Web of Science Core Collection database from the establishment of the database to March 29, 2023. We applied the bibliometric research method and VOSviewer software to visualize and present the countries, research institutions, journals, authors, and keywords.  Results  A total of 98 articles and 5 reviews were enrolled in the analysis. In the past 20 years, the application of AI to the field of hemodialysis has shown an overall and rising trend. The country with the most publications was China (n=37), and the institution with the most publications was Fresenius Medical Care (n=16). Hemodialysis outcomes, influencing factors, and complication prediction models are the current and future frontier of research trends in this field.  Conclusion Using bibliometrics and VOSviewer software for analysis can visualize the current status of research and cutting-edge hotspots in the field and provide a reference basis for further research in the future. Reference | Related Articles | Metrics

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Application of the risk assessment tool for grading management of hyperkalemia in hemodialysis patients  GAO Yu-mei, WU Tao-feng, LIN Li-hua, CAI Hui-lan, QIU Hong, JIN Dong-hua Chinese Journal of Blood Purification    2022, 21 (09): 692-696.   DOI: 10.3969/j.issn.1671-4091.2022.09.015 Abstract （248）      PDF（pc） （564KB）（648）       Knowledge map    Objective  The aim of this study was to observe the effect of the Chinese hyperkalemia risk assessment tool in maintenance hemodialysis (MHD) patients.   Methods   A total of 280 MHD patients from the three hospitals in the Suzhou New District were enrolled in this study. The control group (n=142) was given routine prevention and treatment methods for hyperkalemia. The experimental group (n=138) used Find, Organize, Clarify, Understand, Select, –Plan, Do, Check, Act (FOCUS-PDCA) model for graded intervention based on the risk level of hyperkalemia. The hyperkalemia related indexes were compared before and after the intervention.  Results  After 24 weeks of intervention, the prevalence of hyperkalemia (13.8% vs. 23.9%, c2=4.722, P=0.030) and blood potassium level (4.44±0.35 vs. 4.58±0.47mmol/l, t=2.850, P=0.005) were significantly lower in the experimental group than in the control group; the dialysis adequacy [1.32(1.22～1.54) vs. 1.24(1.20～1.30), Z=-5.360, P<0.001] and quality of life (63.79±14.59 vs. 56.30±16.29, t=-4.004, P<0.001) were significantly higher in the experimental group than in the control group. After 12, 18 and 24 weeks of intervention, the prevalence of hyperkalemia (36.2% vs. 31.2% vs. 27.5% vs. 13.8%, x2=19.37, P<0.001) and blood potassium level (5.02±0.43 vs. 4.81±0.42 vs. 4.68±0.39 vs. 4.44±0.35 mmol/L, F=51.52, P<0.001) in the experimental group decreased gradually along with the intervention duration. After 24 weeks of intervention, 31 extreme-risk or high-risk patients (22.4%) turned to moderate-risk level (Z=16.326, P=0.001).  Conclusion  Based on the hyperkalemia risk assessment tool, the hierarchical management of MHD patients through FOCUS-PDCA model can significantly reduce potassium level and risk of hyperkalemia, and improve dialysis adequacy and quality of life. This method is worthy of promotion for clinical application. Related Articles | Metrics

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The present status of the clinical prediction models for autologous arteriovenous fistula in hemodialysis patients ZHANG Yi-ye, YAN Yan Chinese Journal of Blood Purification    2023, 22 (03): 198-201.   DOI: 10.3969/j.issn.1671-4091.2023.03.009 Abstract （235）      PDF（pc） （360KB）（646）       Knowledge map    Autologous arteriovenous fistula (AVF) is the first choice of vascular access for maintenance hemodialysis (MHD) patients. However, the rates of AVF immaturity and dysfunction are very high. Therefore, accurate evaluation of the prognosis of AVF after operation is helpful to optimize the treatment and improve the prognosis of MHD patients. In recent years, the clinical prediction models (CPMs) have been widely used for the evaluation of AVF. In the current review, we summarize the current research status of CPMs for AVF in MHD patients. Related Articles | Metrics

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Construction and validation of a prediction model for the risk of intradialytic hypotension in maintenance hemodialysis patients GUO Xue-mei, ZHU Zhen-nan, LUO Jia-yi, ZHANG He-ping, JING Jian-ying Chinese Journal of Blood Purification    2022, 21 (06): 408-412.   DOI: 10.3969/j.issn.1671-4091.2022.06.006 Abstract （438）      PDF（pc） （511KB）（629）       Knowledge map    Objective  To investigate the influencing factors for intradialytic hypotension (IDH) in maintenance hemodialysis (MHD) patients, then to construct a risk prediction model and to evaluate the prediction effect of this model.  Methods  A total of 222 MHD patients in the Blood Purification Center of The Affiliated Hospital of North Sichuan Medical College from September 2020 to August 2021 were enrolled in this study as the study subjects. They were randomly divided into modeling group and modeling validation group in the patient number ratio of 6:4. Patients in the modeling group were further divided into IDH group and non-IDH group based on the definition of IDH in the National Kidney Foundation Kidney Disease Prognostic Quality Guidelines. Univariate analysis was used to analyze the risk factors for IDH. Multivariate logistic regression analysis was performed to obtain the factors with P<0.05 for construction of the risk prediction model. Hosmer-Lemeshow test model was used to test the goodness of fit of the model. ROC curve was used to examine the predictive value of the model. The effectiveness of the constructed model was then evaluated in the modeling validation group.  Results  The incidence of IDH was 40.09% in the MDH patients. Predialysis systolic blood pressure (OR=0.959, 95% CI=0.932~0.988, P=0.005), hemoglobin (OR=0.962, 95% CI=0.929~0.996, P=0.030), magnesium (OR=79.558, 95% CI=2.644~2393.594, P=0.012), diabetes (OR=16.066, 95% CI=4.914~52.530, P<0.001), and hypertension (OR=5.221, 95% CI=1.661~16.409, P=0.005) were the influencing factors for IDH. Hosmer-Lemeshow test gave the result of P=0.718. When the optimal cut-off value was set at 0.436, the area under the ROC curve (AUC) was 0.922, the sensitivity was 0.83 and the specificity was 0.887. The Youden index was 0.717, and the correct rate of practical application was 83.15%.  Conclusion The model we constructed can better predict the risk of IDH in MDH patients and provides a reference for clinicians to evaluate IDH in MHD patients. Reference | Related Articles | Metrics

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The factors affecting the duration of continuous renal replacement therapy in acute kidney injury patients and the construction of a model for prediction of the duration EN Si-fang, LIU Ying, WANG Yun Chinese Journal of Blood Purification    2022, 21 (06): 413-417.   DOI: 10.3969/j.issn.1671-4091.2022.06.007 Abstract （216）      PDF（pc） （577KB）（606）       Knowledge map    To analyze the influencing factors for the duration of continuous renal replacement therapy (CRRT) in the treatment of acute kidney injury (AKI) patients, and to establish a model to predict the duration of CRRT in AKI patients.  Methods  A total of 102 AKI patients treated in the Intensive Care Unit (ICU) of Jiangsu Province Hospital from April 2018 to January 2020 were retrospectively analyzed. They were divided into <6 days group and ≥6 days group based on the median duration of CRRT [6.0 (2.3, 10.4) d]. Univariate analysis and binary logistic regression were used to find out the independent influencing factors for CRRT duration. The R software was then used to construct a prediction nomogram model, and the prediction value of this model was evaluated.  Results  Among the 102 AKI patients, 53 cases were in the <6 days group and 49 cases were in the ≥6 days group. Univariate analysis indicated that α1-MG (t=2.009,          P=0.047), β2-MG (t=2.402, P=0.018), Scr (t=2.395, P=0.019) and neutrophil gelatinase-associated lipocalin (NGAL; t=2.030, P=0.045) were lower in the <6 days group than in the ≥6 days, while mean arterial pressure (MAP; t=2.425, P=0.017) and urine volume (t=2.058, P=0.042) were higher in the <6 days group than in the ≥6 days. Binary logistic regression showed that urine volume (OR=1.131, 95% CI: 1.017~1.024), NGAL (OR=0.987, 95% CI: 0.982~0.993), α1-MG (OR=0.860, 95% CI: 0.767~0.976) and β2-MG (OR=0.755, 95% CI: 0.572~0.996) were the independent predictors for CRRT duration in AKI patients (P<0.05). The C-index of the nomogram model was 0.894 (95% CI: 0.723~0.896). The calibration curve showed that the average absolute error of prediction possibility was 0.029, indicating a better discrimination and accuracy of the prediction model.  Conclusion  The nomogram model constructed on the differences of urine volume, NGAL, α1-MG and β2-MG can better predict the duration of CRRT in AKI patients, and provide useful references for CRRT treatment in AKI patients. 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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Research progress in the effects of indoxyl sulfate on chronic kidney disease and its complications    YANG Jing-yu, FANG Jing-ai, ZHANG Xiao-dong, LIU Wen-yuan, ZHANG Zi-yuan, HU Ya-ling Chinese Journal of Blood Purification    2022, 21 (10): 754-757.   DOI: 10.3969/j.issn.1671-4091.2022.10.011 Abstract （334）      PDF（pc） （388KB）（599）       Knowledge map    Indoxyl sulfate (IS) is a uremic toxin of intestinal origin. Recent studies have shown that the accumulation of IS in the body will not only lead to the progression of chronic kidney disease (CKD), but also participate in the progression of cardiovascular disease, sarcopenia, cognitive impairment, osteopathy and anemia in CKD patients, thus reducing the quality of life and survival rate of CKD patients. This paper reviews the studies relating to the effects of IS on CKD and its complications in recent years, in order to provide new ideas for the prevention and intervention of CKD. Reference | Related Articles | Metrics

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Advantages and prospects of home hemodialysis GU Wen, ZHOU Yi-jun, NI Zhao-hui Chinese Journal of Blood Purification    2022, 21 (06): 389-392.   DOI: 10.3969/j.issn.1671-4091.2022.06.002 Abstract （710）      PDF（pc） （504KB）（589）       Knowledge map    Home Hemodialysis (HHD) is one of the methods of renal replacement therapy for patients with end-stage renal disease (ESRD), which is performed in a home environment by patients themselves or with the assistance of others. Although HHD has appeared and is widely used abroad as early as the 1960s, the proportion of HHD fell sharply due to the establishment of a large number of dialysis centers, the emergence of peritoneal dialysis, as well as the changes in reimbursement policies. In recent years, HHD has risen again because of its unique advantages. HHD can not only increase the survival rate of patients and improve the quality of life of patients, but also is of great significance in the context of the COVID-19 epidemic. In April 2020, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine carried out the first case of home hemodialysis in mainland China, filling the gap of HHD in mainland China. With the burgeoning development of the Internet, the establishment of a standardized HHD training system and the continuous enrichment of experience, HHD is supposed to have broader prospects.  Reference | Related Articles | Metrics

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Progress in the study of complications of renal anemia WANG Zeng, ZHANG Yang, WANG Qin, ZHU Qi- fan, CHEN Hong- yu Chinese Journal of Blood Purification    2022, 21 (07): 469-472.   DOI: doi:10.3969/j.issn.1671-4091.2022.07.002 Abstract （104）      PDF（pc） （400KB）（581）       Knowledge map    Renal anemia is one of the common symptoms of most patients with chronic kidney disease (CKD). Renal anemia will bring many complications, including cardiovascular disease, inflammatory state, and gastrointestinal bleeding, etc. In clinical correction of renal anemia, the treatment of complications should also be taken into account. This article reviews the literature on the mechanism and treatment of renal anemia complications for clinical reference. Reference | Related Articles | Metrics

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Research progress in vascular calcification of arteriovenous fistula HU Meng-hong, ZHAO Guang-ben, YU Chang-qing, CHEN Ji-lin, LIN Hong-li Chinese Journal of Blood Purification    2022, 21 (11): 823-826.   DOI: 10.3969/j.issn.1671-4091.2022.11.008 Abstract （471）      PDF（pc） （336KB）（581）       Knowledge map    Arteriovenous fistula (AVF) is the optimal vascular access for maintenance hemodialysis (MHD) patients. Vascular calcification (VC) is one of the important causes of AVF dysfunction, increasing the risks of dialysis inadequacy and death in the patients. Vascular calcification of AFV is a complicated process, resulting from the combined effects of pro-calcification factors and calcification inhibition factors, such as hemodynamic changes, calcium and phosphorus metabolism dysfunction, inflammation, oxidative stress, and others. In this paper, the epidemiological characteristics, pathophysiology, pathogenesis, and prevention of AVF vascular calcification are summarized. Related Articles | Metrics

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Advances in early warning system for acute kidney injury based on artificial intelligence  ZHAO Dan, YU chen, ZHANG Ying-ying Chinese Journal of Blood Purification    2022, 21 (08): 599-602.   DOI: 10.3969/j.issn.1671-4091.2022.08.014 Abstract （298）      PDF（pc） （391KB）（577）       Knowledge map    Acute kidney injury (AKI) is a common complication in hospitalized patients, and is associated with poor outcomes and higher mortality. Early identifying AKI before function loss is crucial to reverse the injury. Therefore, establishing an early-warning system for AKI is essential for clinicians to make the diagnosis and treatment decisions earlier. With the development of artificial intelligence, a variety of electronic alerts and machine learning-based predictive models to predict the risks of AKI have been developed. In the current review, we summarize the advances in the electronic systems based on artificial intelligence for predicting AKI.  Reference | Related Articles | Metrics

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A study on the status of anorexia and its influencing factors in maintenance hemodialysis patients BU Zhao-wen, ZHONG Yue-huan, LI Na, ZHOU Bin, DING Yi-mei Chinese Journal of Blood Purification    2022, 21 (11): 858-861.   DOI: 10.3969/j.issn.1671-4091.2022.11.015 Abstract （541）      PDF（pc） （485KB）（574）       Knowledge map    Objective To investigate the status of anorexia and its influencing factors in maintenance hemodialysis (MHD) patients.  Methods  A total of 168 MHD patients were recruited from the Blood Purification Center, Gansu Provincial Hospital from November 2021 to January 2022. The self-designed general condition questionnaire, visual analog score of appetite (VAS), self-rating sleep status scale (SPSS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and international physical activity questionnaire (short volume in Chinese version, IPAQ) were used for the investigation. Univariate analysis and binary logistic regression were performed to analyze the influencing factors.  Results  The incidence of anorexia was 32.1% in the 168 MHD patients. Binary logistics regression showed that gender (OR=0.323, 95% CI 0.119~0.879, P=0.027), constipation (OR=2.929, 95% CI 1.204~7.125, P=0.018), urea clearance index (OR=0.027, 95% CI 0.002~0.435, P=0.011), SPSS score (OR=1.081, 95% CI 1.01~1.156, P=0.024), and physical activity level (OR=0.134, 95% CI 0.049~0.0.364, P＜0.001) were the influencing factors for the diminished appetite in MHD patients.  Conclusion   Anorexia was found in about one third of the MHD patients. Patients’ constipation, urea clearance index, physical activity level and SPSS score were the influencing factors for anorexia. Reference | Related Articles | Metrics

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Research progresses in the mechanism of high-flux hemodialysis for the correction of renal anemia    WANG Hong-ye, YANG Jie, ZHANG Rui Chinese Journal of Blood Purification    2022, 21 (12): 869-872.   DOI: 10.3969/j.issn.1671-4091.2022.12.002 Abstract （200）      PDF（pc） （386KB）（569）       Knowledge map    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. Reference | Related Articles | Metrics

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Iron therapy for iron deficiency anemia in chronic kidney disease TANG Wen-jiao, LIAO Ruo-xi Chinese Journal of Blood Purification    2023, 22 (06): 438-441.   DOI: 10.3969/j.issn.1671-4091.2023.06.008 Abstract （245）      PDF（pc） （366KB）（569）       Knowledge map    Renal anemia is a common complication of chronic kidney disease (CKD). Iron deficiency is highly prevalent in patients with CKD. On the other hand, CKD patients are vulnerable to iron overload due to long-term iron supplement. Serum transferrin and transferrin saturation are traditionally used in the evaluation of iron status. However, due to the chronic inflammation in CKD patients, these biomarkers can not reflect iron status accurately. Oral and intravenous iron therapy both show advantages and disadvantages in anemia treatment. New iron agents bring new choices for iron therapy in renal anemia, while their efficacy needs further studies. Reference | Related Articles | Metrics

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Clinical study on the improvement of protein depletion in hemodialysis patients by the intervention of oral nutritional supplement  WANG Yu,  ZHAO Qing, LUO Yong-bing, FENG Xiao-ran,  ZHANG Feng-ping,  YU Xiao-yu, LIU Fei-yan, XU Jian-hua, WU Guo-qing, CHEN Qin-kai Chinese Journal of Blood Purification    2023, 22 (1): 11-16.   DOI: 10.3969/j.issn.1671-4091.2023.01.003 Abstract （493）      PDF（pc） （629KB）（565）       Knowledge map    Objectives: To investigate the improvement of protein-energy wasting (PEW) in hemodialysis patients after supplementation with Lexineng nutritional supplements. Methods: A total of 90 patients who had been on maintenance haemodialysis for more than 3 months and met the diagnosis of PEW in the hemodialysis units of 6 hospitals in Jiangxi Province were collected and randomly divided into a control group and a test group of 45 patients each. After the patients were given dietary instructions, the corresponding number of calories in the test group was replaced by one can of Lexineng supplement daily for 3 months. Changes in body mass index, laboratory parameters such as haemoglobin and albumin and assessment of safety effects were observed in both groups before and after 3 months of treatment with Lexineng supplementation.Results:A total of 90 patients were included in the study and 84 patients (41 in the control group and 43 in the trial group) eventually completed the trial as required, of whom 47 (55.95%) were male and the mean age was (61.6±11.39) years. The mean mineral intake levels were similar and the differences in the indicators between the two groups were not significant (p>0.05). After 3 months of the trial, the results showed that the changes in body measurements such as weight (Wt) and BMI in the control group were not significant compared to those before the trial (p>0.05), while the Wt、BMI increased significantly and the subjective global assessment (SGA) decreased significantly in the trial group (p<0.05). Serum albumin (Alb) and haemoglobin increased in both groups compared to the pre-test, with Alb and haemoglobin increasing more significantly in the test group (p<0.001), and albumin and haemoglobin were significantly higher compared to the control group (p<0.05); Leukodystrophy was also significant in reducing serum creatinine levels and increasing serum calcium concentrations (p<0.05), and was able to reduce blood glucose levels without increasing the fat burden.Conclusion: Sustained supplementation with Lexineng on maintenance hemodialysis is effective in improving PEW symptoms and other complications in haemodialysis patients in many ways. Reference | Related Articles | Metrics

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Recent progress in the diagnosis and treatment of central vein stenosis in hemodialysis patients LIU Ying-ting, ZHANG Jing, ZHANG Sheng-nan, JIAN Xun, HU Shi-de, LI Jing Chinese Journal of Blood Purification    2022, 21 (09): 672-675.   DOI: 10.3969/j.issn.1671-4091.2022.09.011 Abstract （376）      PDF（pc） （382KB）（557）       Knowledge map    Hemodialysis access is severely affected by central vein stenosis (CVS) in hemodialysis patients. Therefore, the diagnosis and treatment of CVS are of great importance. Early and accurate diagnosis of CVS is the premise of effective treatment that benefits the patients. This article gives a review about the diagnosis and treatment of CVS in hemodialysis patients for clinical reference. Reference | Related Articles | Metrics

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Recent advances in the diagnosis of renal osteodystrophy XIE Sheng, OUYANG Chun Chinese Journal of Blood Purification    2022, 21 (12): 903-906,916.   DOI: 10.3969/j.issn.1671-4091.2022.12.009 Abstract （205）      PDF（pc） （398KB）（549）       Knowledge map    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. Related Articles | Metrics

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Advances in strategies for diagnosis and treatment of anemia in peritoneal dialysis patients in various countries JIANG Hong , MA Xiao-xiao Chinese Journal of Blood Purification    2022, 21 (12): 865-868.   DOI: 10.3969/j.issn.1671-4091.2022.12.001 Abstract （400）      PDF（pc） （453KB）（532）       Knowledge map    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.  Reference | Related Articles | Metrics

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Effects and safety of Tenapanor in hemodialysis patients with hyperphosphatemia: a meta-analysis of randomized placebo-controlled trials  HUANG Bo, FENG Jian, ZHANG Yan-biao, LI Xian-hui, XUE Gang, LUO Hou-li Chinese Journal of Blood Purification    2022, 21 (11): 801-807.   DOI: 10.3969/j.issn.1671-4091.2022.11.004 Abstract （285）      PDF（pc） （1065KB）（526）       Knowledge map    Objective To evaluate the effects and safety of Tenapanor in hemodialysis patients with hyperphosphatemia by an updated meta-analysis.  Methods  All randomized controlled trials of Tenapanor were systematically searched in the Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wan fang and VIP databases. The primary endpoint was the mean difference (MD) of serum phosphorus changes using Tenapanor versus placebo control, and the secondary endpoint was the rate difference (RD) of the target serum phosphorus level (serum phosphorus level: ≤6 mg/dl). A subgroup analysis was also conducted based on whether phosphate binders were used. Drug-related adverse reactions and diarrhea were collected to determine the safety of Tenapanor.  Results  There were 4 eligible trials that enrolled 677 patients. The studies showed that Tenapanor significantly reduced serum phosphorus level by 2.345mg/dl (95% CI:-2.798～-1.892; P＜0.001) and the achievement of the target serum phosphorus level (RD=0.363; 95% CI:0.147～0.579; P＜0.001) was better than placebo. However, drug-related adverse events (RD=0.461; 95% CI:0.284～0.637; P＜0.001), and diarrhea (RD=0.429; 95% CI:0.354～0.505; P＜0.001) were more serious than placebo. Subgroup analysis found that there were no significant differences in the magnitude of serum phosphorus level with (MD=-2.070; 95% CI:-2.885～-1.255; P＜0.001) or without (MD=-2.468; 95% CI:-3.013～-1.923; P＜0.001) phosphate binders.  Conclusions The randomized placebo-controlled trials showed that Tenapanor significantly reduced serum phosphorus level in hemodialysis patients with hyperphosphatemia with or without use of phosphate binders. Diarrhea was present frequently but no serious drug-related adverse events occurred. Reference | Related Articles | Metrics

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Role of Ferrostatin-1 prevent high glucose-induced Ferroptosis of renal tubular epithelial cells WU Zi-yu, LIN Yan, LIANG Yuan-qi, GUO Tai-lin Chinese Journal of Blood Purification    2023, 22 (09): 679-684.   DOI: 10.3969/j.issn.1671-4091.2023.09.010 Abstract （111）      PDF（pc） （774KB）（523）       Knowledge map    Objective To investigate the role of Ferrostatin-1(Fer-1) in high glucose-induced ferroptosis of renal tubular epithelial cells. Method (1) 24 DBA/2J mice were randomly divided into 4 groups: normal control group, Fer-1 intervention group, DM model group, DM + Fer-1 intervention group with 6 mice in each group. According to the body weight of mice, DBA/2J mice were injected intraperitoneally with freshly prepared Streptozocin at a dose of 40 mg / kg for 5 days to establish DM model. Fer-1 intervention group and DM+Fer-1 intervention group were given intraperitoneal injection of Fer-1 (2.5μmol/kg) every day for 12 weeks after modeling.. The control group and DM Group were intraperitoneally injected with the same volume of normal saline for 12 weeks. The expression levels of activated glutathione peroxidase 4(GPX4)and solute carrier family 7 A11(SLC7A11)were detected by Western blotting, and the expression and localization of GPX4 in renal tissue were detected by immunohistochemistry.(2) Human renal tubular epithelial cells (HK-2) were stimulated with high glucose (30 mmol/L) , and treated with 200 nm Fer-1. The expression of ferroptosis signaling in renal tubular epithelial cells was detected by Western blotting and immunofluorescence staining. Results  Compared with the normal control group, the levels of Fe2+and Malondialdehyde (MDA) in the kidney of DM model group were significantly up-regulated, glutathione (GSH) was significantly down-regulated ( t=35.073、15.732 and 4.954 respectively，all P ＜ 0.001) , and the protein expression levels of GPX4 and SLC7A11, which were related to ferroptosis, were significantly up-regulated (t=12.432 and 5.484；P=0.006 and 0.003) . Compared with the DM model group, the levels of Fe2+ and MDA in the kidney of DM +Fer-1 intervention group were down-regulated, while GSH was up-regulated (t=14.503、4.675 and 7.124； all P＜0.001) . The protein expression levels of GPX4 and SLC7A11 were up-regulated (t =4.573 and 27.942；P= 0.039 and 0.001) . In addition, high glucose could induce the expression levels of ferroptosis related proteins GPX4 and SLC7A11 in HK-2 cells cultured in vitro to decrease significantly ( t=12.433 and 7.716；P=0.006 and 0.019) , the expression levels of GPX4 and SLC7A11 were significantly increased by Fer-1(t=5.136 and 5.043；P=0.035 and 0.037) . Conclusions  Inhibition of ferroptosis in renal tubular epithelial cells induced by high glucose may be a new strategy to prevent the progression of DM. Related Articles | Metrics

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The regulatory role of p38 MAPK signaling pathway in the processes of neointimal hyperplasia in dialysis access vessels XIE Chun-he, WANG Bao-xing Chinese Journal of Blood Purification    2022, 21 (08): 588-591.   DOI: 10.3969/j.issn.1671-4091.2022.08.011 Abstract （262）      PDF（pc） （381KB）（519）       Knowledge map    The p38 mitogen-activated protein kinase (MAPK) signaling pathway is one of the important signaling systems that mediates extracellular to intracellular signaling to regulate a variety of pathophysiological processes such as cell proliferation, migration, differentiation, matrix deposition, inflammation and apoptosis. Hyper- or hypoactivation of this signaling pathway may lead to the development of various diseases, including neointimal hyperplasia-mediated autogenous arteriovenous fistula dysfunction. The p38 MAPK signaling pathway is closely related to neointimal hyperplasia that causes many cardiovascular diseases as well as vascular stenosis after arteriovenous fistulas, bypass grafting and angioplasty operations, resulting in health problems of the patients and even social financial burdens. Based on the role of p38 MAPK signaling pathway in neointimal hyperplasia, modulation of this signaling pathway may be an alternative way for the treatment of neointimal hyperplasia-related diseases. Reference | Related Articles | Metrics

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Calciphylaxis is a misnomer and the Chinese translation of calciphylaxis is also a wrong name Yangming Cao Chinese Journal of Blood Purification    2022, 21 (09): 628-632.   DOI: 10.3969/j.issn.1671-4091.2022.09.002 Abstract （279）      PDF（pc） （609KB）（514）       Knowledge map    This review article explains that the term calciphylaxis originated from an animal model studying dermatomyositis in 1961. Shortly, it was borrowed to explain the calcification syndrome found in chronic kidney disease patients. But calciphylaxis in animal model and the calcification syndrome in kidney patients have different pathogenesis and different pathological findings. Obviously calciphylaxis is a misnomer for kidney patients. Therefore, calcific uremic arteriolopathy (CUA) was proposed to explain the calcification syndrome in kidney patients. However, this syndrome can also occur in patients without kidney failure, including patients with normal kidney function, which will make CUA not suitable for such patients. Therefore,recently we proposed the term“calcific arteriolopathy”to more accurately describe this calcification syndrome in patients with normal kidney function as well as those with kidney diseases. We also shared our experience in diagnosing CUA. For comparison, Martorell HYTILU (hypertensive ischemic leg ulcer), a diagnosis not commonly made in many countries, is reviewed. Apparently HYTILU and calciphylaxis are the same entity. In addition, we also points out that the term calciphylaxis is the combination of calcium and anaphylaxis, while  while “钙化防御” “ (calcification defense”)is obviously from the combination of calcium and prophylaxis. In other words, the previous translator mistook anaphylaxis for prophylaxis. Therefore calcific arteriolopathy is a better term to describe the syndrome and is easier to be translated into Chinese. Related Articles | Metrics

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Summary of the best evidence for exit-site care in peritoneal dialysis patients  FENG Chun-yan, LIU Yue, SU Chun-yan Chinese Journal of Blood Purification    2023, 22 (03): 227-231.   DOI: 10.3969/j.issn.1671-4091.2023.03.015 Abstract （208）      PDF（pc） （424KB）（511）       Knowledge map    Objective To retrieve, evaluate and integrate the best evidence for exit-site care in peritoneal dialysis patients for the guidance of clinical practice.  Methods  We searched the relevant guidelines, systematic reviews, and expert consensuses about the exit-site care. The retrieval period was from the establishment of the databases to June 30, 2022.  Results  A total of 14 articles were enrolled, including 8 guidelines, 2 expert consensuses, one systematical review and 3 cohort studies.  Conclusions  This study summarized the best evidence for exit-site care in peritoneal dialysis and provided the best practice evidence for clinical nursing. Reference | Related Articles | Metrics