Chinese Journal of Blood Purification

12 March 2018, Volume 17 Issue 03 Previous Issue    Next Issue

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Clinical efficacy of different blood purification modalities for the treatment of patients with hypertriglyceridemia pancreatitis 2018, 17 (03):  145-150.  doi: 10.3969/j.issn.1671-4091.2018.03.001 Abstract ( 480 )   PDF (469KB) ( 540 )   【Abstract】Objective To evaluate different blood purification modalities on the clinical efficacy and prognosis in patients with hypertriglyceridemia pancreatitis (HTGP). Methods Clinical data of the 63 patients with moderate-to-severe HTGP treated with blood purification in our hospital in the period from March 2012 to March 2017 were recruited. The patients were divided into two groups based on blood purification modalities: combined group treated with continuous veno-venous hemofiltration (CVVH) plus hemoperfusion(HP) (n=33), and CVVH group treated with CVVH only (n=30). Vital signs, serum levels of triglyceride (TG), amylase (AMS), interleukin-6 (IL-6) and blood calcium (Ca2+  ), white blood cells (WBC), hemoglobin (Hb), platelets (PLT), and scores of acute physiology and chronic health evaluation (APACHE II) were compared between the two groups before treatment and after the treatment for 24 hours, 72 hours and one week. Duration from abnormal to target TG level, number of blood purification times, recovery period to stable disease status, hospitalization day and mortality rate were also compared between the two groups. Results There were no significant differences in vital signs, serum TG level, other laboratory tests including inflammatory makers and internal environment indices, and APACHE II scores between the two groups before the treatment (P＞0.05). After the treatment, clinical indices were significantly improved in combined group and CVVH group, including temperature, respiratory rate, heart rate, TG, AMS, Ca2+ , IL-6, WBC and APACHE II score, but HB and PLT were not changed (for temperature, F=87.116, P=0.021 and F=46.658, P=0.038, respectively; for respiratory rate, F=276.236, P＜0.001 and F=109.768, P=0.004, respectively; for heart rate, F=207.657, P＜0.001 and F=96.857, P=0.023, respectively; for TG, F=16.853, P＜0.001 and F=4.315, P=0.015, respectively; for AMS, F=10.254, P＜0.001 and F=8.795, P＜0.001, respectively; for Ca2+, F=23.795, P＜0.001 and F=22.836, P＜0.001, respectively; for IL-6, F=13.982, P＜0.001 and F=10.352, P=0.005, respectively; for WBC, F=17.249, P＜0.001 and F=7.582, P=0.017, respectively; for APACHE II score, F=277.158, P＜0.001 and F=63.052, P＜0.001, respectively). Serum TG, AMS and APACHE II score decreased faster in combined group than in CVVH group (7.14±1.04 vs. 10.83±1.10 mmol/L, t=3.334, P=0.015 for TG; 457.80±60.56 vs. 705.56±72.46U/L, t=3.604, P=0.010 for AMS; 8.96±0.77 vs. 10.63±0.93, t=3.726, P=0.001 for APACHEⅡ score), and the differences in decrease rates between the two groups became more remarkable after the treatment for 24 hours. The durations to reach safe serum levels, normal vital signs and WBC were shorter in combined group than in CVVH group (t=4.090, P=0.001 for TG; t=1.843, P=0.032 for AMS; t= 8.059, P＜0.001 for APACHE II score; t=15.356, P=0.035 for temperature; t=9.909, P=0.035 for respiratory rate; t=9.729, P＜0.001 for heart rate; t=2.861, P=0.007 for WBC). Mortality rate was also lower in combined group than in CVVH group but without statistical significance, probably due to insufficient case number (0% vs. 10.00%, corrected χ2=1.611, P=0.204). The duration to achieve normal TG and stable disease status, blood purification times, hospitalization day were less in combined group than in CVVH group (2.58±1.45 vs.7.71±2.69 days, t=4.866, P=0.002 for TG; 7.46±3.05 vs.16.14±4.10 days, t=6.136, P＜0.001 for stable disease status; 2.38±0.98 vs. 7.57±2.57 times, t=5.232, P=0.002 for blood purification times; 20.00±12.12 vs. 30.00± 6.40 days, t=2.088, P=0.045 for hospitalization days). Consequently, prognosis was better in combined group than in CVVH group. Conclusion CVVH combined with hemoperfusion has the advantages of quickly lowering serum TG and blocking inflammation responses, resulting in a better therapeutic effects and improved disease condition in a short period of time. Metrics

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Effects of residual renal function on cardiac valve calcification in maintenance hemodialysis patients 2018, 17 (03):  151-155.  doi: 10.3969/j.issn.1671-4091.2018.03.002 Abstract ( 451 )   PDF (519KB) ( 565 )   【Abstract】Objective To illuminate the effect of residual renal function on valve calcification and cardiac structure in maintenance hemodialysis (MHD) patients. Methodology Clinical data of the 88 patients on MHD were recruited. The mean values of urea nitrogen removal rate and creatinine clearance rate were used to evaluate residual renal function (RRF) in these patients, and then the RRF (-) group (n=45) and the RRF (+) group (n=43) were divided. Clinical information, laboratory blood tests, cardiac structure and valve calcification were compared between the two groups. Results For clinical information, dialysis age and hypertension above stage 2 were statistically different between the two groups. For laboratory tests, serum calcium, calcium phosphorus product, parathyroid hormone and C reactive protein were higher in RRF (+) group than in RRF (- ) group (t=3.796, 2.739, 2.435 and 3.081 respectively; P=0.001, 0.006, 0.10 and 0.001 respectively). For cardiac structure, left ventricular short-axis shortening had no difference between the two groups, but left ventricular end-diastolic diameter (LVEDd), end-diastolic left ventricular posterior wall thickness (LVPWT), end- diastolic ventricular septal thickness (IVST), left atrial diameter (LA), left ventricular ejection fraction (LVEF) and cardiac valve calcification were significantly different between the two groups (55.78±5.92 vs.51.91± 5.31mm, t=3.013, P=0.002 for LVEDd; 10.98±1.24 vs. 10.45±0.78mm, t=2.833, P=0.03 for LVPWT; 11.12±1.45 vs. 10.58±1.06mm, t=2.395, P=0.024 for IVST; 40.71±5.73 vs. 37.95±6.59mm, t=3.761, P=0.030 for LA; 54.22±9.62 vs. 59.79±7.78mm, t=-2.142, P=0.041 for LVEF; χ2=8.340, P=0.020 for valve calcification). Conclusion For maintenance hemodialysis patients, residual renal function can improve calcium and phosphorus metabolism, micro-inflammatory state as well as cardiac structural, and alleviate cardiac valve calcification. Metrics

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The clinical significance of miR-126 in maintenance hemodialysis patients 2018, 17 (03):  156-159.  doi: 10.3969/j.issn.1671-4091.2018.03.003 Abstract ( 487 )   PDF (381KB) ( 616 )   【Abstract】Objective To investigate the clinical significance of miR-126 in patients on maintenance hemodialysis (MHD). Method In the 60 MHD patients, we found 45 cases complicated with coronary artery disease, including stable angina (n=15, group 1), unstable angina (n=12, group 2), non-ST segment elevated myocardial infarction (n=10, group 3) and ST segment elevated myocardial infarction (n=8, group 4), as well as 15 cases without coronary artery disease. Forty healthy people were recruited as controls. The 60 MHD patients were undergone ultrasonography to examine internal carotid arteies and to measure intimal-medial thickness (IMT) of internal carotid arteries. They were then divided in to group A (normal IMT, n=8), group B (abnormal IMT, n=7), group C (abnormal IMT with plaque, n=28), and group D (narrow vessel lumen, n=17). miR-126 was determined by real-time fluorescence quantitative PCR. Results There were significant differences in miR-126 expression level among MHD patients with and without coronary artery disease and normal controls (LSD, t=8.553, P=0.000), and between MHD patients with and without coronary artery disease (LSD, t=8.024, P=0.000). miR-126 expression level was statistically different among groups A, B, C and D (F=11.219, P=0.000) and between 2 of the 4 groups except for comparisons between groups A and B (LSD, t=0.203, P=1.252) and between groups C and D (LSD, t=0.193, P=1.342). miR-126 expression level was also statistically different among groups 1, 2, 3 and 4 (F=6.342, P=0.000) and between 2 of the 4 groups except for comparison between groups 1 and 2 (LSD, t=0.173, P=1.349) and between groups 3 and 4 (LSD, t=0.225, P=1.024). miR-126 expression level was negatively correlated with LDL-C (r=-0.358, P=0.031) and positively correlated with HDL-C (r=0.405, P=0.029). Conclusion Assay of miR-126 expression level is useful to suggest the complication of coronary artery disease and its clinical type in MHD patients. Metrics

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Clinical study on the middle molecular toxin clearance by hemodiafiltration using the automated pressure control of convection mode 2018, 17 (03):  160-164.  doi: 10.3969/j.issn.1671-4091.2018.03.004 Abstract ( 405 )   PDF (451KB) ( 616 )   【Abstract】Objective To investigate the effect of middle molecular toxin clearance by hemodiafiltration using the automated pressure control of convection mode (ULTRAc-HDF). Method Thirty maintenance hemodialysis patients were enrolled in this self-control study. They were treated with ULTRAc-HDF followed by hemodiafiltration with volume-controlled mode (VOLc-HDF), and used post-dilution convection for all patients. We investigated the convective volumes, the times of high TMP alarm and coagulation condition in different mode, and compared the clearance for blood β2-MG and PTH. Results The convection volume was significantly higher in ULTRAc-HDF mode than in VOLc-HDF mode (20.78 ± 1.41L vs. 18.30 ± 0.27L, t=9.417, P=0.000). The number of high TMP alarm was lower in ULTRAc-HDF mode than in VOLc-HDF mode (0 vs. 16 times, χ2=9.231, P=0.002). The prevalence of coagulation in dialyzer and dialysis tubing was significantly lower in ULTRAc-HDF mode (χ2=7.680, P=0.006). The average PTH clearance rate was higher in ULTRAc-HDF mode than in VOLc-HDF mode (57.40±4.19% vs. 51.23±6.54%; t=4.352, P=0.000). β2-MG decreased more in ULTRAc-HDF mode (72.51±2.82%) than in VOLc-HDF mode (70.81±2.93%) but without statistical significance (t=2.289, P=0.062). Conclusions This study showed that the ULTRAc-HDF mode resulted in higher convection volumes and correspondingly higher clearance for β2-MG and PTH, lower risk of blood clotting, and less number of high TMP alarm. Metrics

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Effects of rennin-angiotensin system inhibitors on VEGF level in serum and dialysis fluid in CAPD patients 2018, 17 (03):  165-169.  doi: 10.3969/j.issn.1671-4091.2018.03.005 Abstract ( 378 )   PDF (411KB) ( 539 )   【Abstract】Objective This study discusses the effects of rennin-angiotensin system inhibitor (RASI) on vascular endothelial growth factor (VEGF) levels in serum and dialysis fluid in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A total of 34 patients received CAPD and in stable conditions were enrolled in this study. Twenty cases were treated with RASI (treatment group), and 14 cases did not use any ACEI/ARB (control group). They were observed for 6 months. Estimation of peritoneal function, such as Kt/V and cCr of the peritoneum and protein in dialysis fluid, was performed. Serum and dialysate were collected for the assay of VEGF. Results ① There were no significant differences in basal data between treatment group and control group. ②There were no differences in clinical indicators including 4h D/P Cr, Kt/V, MTAC Cr, etc, between the two groups at the beginning and after the treatment for 6 months. ③There were no significant differences in serum and dialysate VEGF at the beginning between the two groups (P>0.05). After 6 months of the treatment, however, serum VEGF was significantly lower in treatment group than in control group (171.515±84.831 vs. 276.598±129.866pg/ml, t=-2.859, P=0.007), but dialysate VEGF had no difference between the two groups (46.017±19.104 vs. 54.673±19.691pg/ml, t=-1.284, P=0.208). ④There was no significant difference in protein loss from dialysate at the beginning between the two groups. After 6 months of the treatment, however, protein loss from dialysate was significantly lower in treatment group than in control group (3.379±2.329 vs. 6.397±3.049g/day, Z=-2.800, P=0.005). Conclusion RASI can reduce and stabilize VEGF expression level on peritoneum and thus protect peritoneal function in CAPD patients. Metrics

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The outcome of 996 peritoneal dialysis patients in a single center 2018, 17 (03):  170-176.  doi: 10.3969/j.issn.1671-4091.2018.03.006 Abstract ( 437 )   PDF (523KB) ( 886 )   【Abstract】Objective To analyze the clinical features and outcomes of peritoneal dialysis (PD) patients in our hospital. Methods We retrospectively analyzed 996 PD patients treated in our hospital for more than 3 months and followed up for more than 3 months during the period from Jan. 1st, 1996 to Dec. 1st, 2016. Their demographic characteristic, living place, medical insurance type, education level, primary disease, outcome and its related factor were recruited and analyzed. Results A total of 996 patients were enrolled in this study, in which 488 were males (49%) and 508 were females (51%), the mean age at the beginning of PD was 54.93±14.50 years, and the mean peritoneal dialysis duration was 41.58±33.72 months. The primary diseases for end stage renal disease were primary glomerulonephritis (38.7%), hypertension (24.1%) and diabetes (14.4%), in which primary glomerulonephritis was the most important primary disease. Up to Dec. 1st, 2016, the patients remained on PD in 413 cases (41.5%), died in 319 cases (32%), changed to hemodialysis in 178 cases (17.9%), treated with kidney transplant in 49 cases (4.9%), and dropped out of our follow-up in 37 cases (3.7%). In the 583 cases (58.5%) dropped out of PD, time on therapy (TOT) was 35.96 months; TOT increased gradually with year and was 48.89 months in 2016. The dropout rate (DOR) decreased gradually and was only 9.28% in 2016. The DOR was significantly lower in stage C (2010～2016) than in stage A (1996～2002) and stage B (2003～2009) (c2=275.543, P=0.000). Death as the dropout cause turned into less in stage C than in stages A and B (c2=8.063, P=0.018). Kidney transplantation as the dropout cause became more in stage C than in stages A and B (c2=9.649, P=0.008). However, there were no significant differences in the proportion of transfer to hemodialysis and loss of follow-up as the dropout causes between stages A, B and C (c2= 3.100 and 1.631, P=0.212 and 0.442). Gender did not affect the dropout rate and mortality rate (c2=1.774 and 0.135, P=0.183 and 0.713), but living in urban area, less medical insurance, illiteracy and glomerulonephritis as the primary disease were the factors for a higher dropout rate (c2=19.690, 41.145, 8.004 and 14.553 respectively; P=0.000, 0.000, 0.046, and 0.001 respectively) and a higher mortality rate (c2=10.935, 16.344, 23.854 and 34.051 respectively; P=0.040, 0.000, 0.000 and 0.000 respectively). The main cause of death was cardiovascular events (19.1%), followed by cerebrovascular events (11.6%), infection (11.6%) including pulmonary infection (3.1%) and peritonitis (8.5%), and malnutrition (5%). The major reason for transfer to hemodialysis was PD-related peritonitis (51.1%) followed by dysfunction of peritoneal catheter (20.2%) such as occlusion and drift, and insufficient peritoneal dialysis (7.9%). Cox proportional hazards model analyses indicated that the risk factors for mortality were older age (HR: 1.052, P=0.000), lower education level (HR: 1.420, P=0.004), primary glomerulonephritis (HR: 0.672, P=0.002) and cardiovascular diseases (HR: 2.788, P=0.000). Conclusion In this peritoneal dialysis center, the major cause of dropout from PD was death, followed by the transfer to hemodialysis. Cardiovascular event was the most important cause of death, and peritonitis was the major reason for the change from PD to hemodialysis. In addition, factors such as living place, type of medical insurance and education level also affected the dropout rate and mortality in PD patients. Older age, lower education level, primary glomerulonephritis and cardiovascular disease were the risk factors for all causedeath. Metrics

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The value of digital blood pressure for the diagnosis of hemodialysis access induced distal ischemia 2018, 17 (03):  177-181.  doi: 10.3969/j.issn.1671-4091.2018.03.007 Abstract ( 341 )   PDF (525KB) ( 660 )   【Abstract】Objective To evaluate digital blood pressure for the diagnosis of hemodialysis access induced distal ischemia (HAIDI) by using photoplethysmography before and after arteriovenous fistula operation. Methods Sixty-two end stage renal disease patients were enrolled in this study, and 55 of them completed the flow-up investigation. Smoking habit, diabetes history and artery calcification evaluated by X-ray on forearm were collected. Before fistula operation, arterial blood pressure of brachial arteries was measured, and the systolic blood pressure at thumb, index and middle fingers of both hands were measured by photoplethysmography. After fistula operation for one day, one month and 3 months, ischemia in distal areas was evaluated by questionnaire, and arterial pressure in fingers and brachial arteries were retested. After the operation for one month and 3 months, digital blood pressure in fingers was measured under the condition that fistula blood flow was temporarily blocked by compression. The patients were then divided in to HAIDI group and non- HAIDI group. Results The prevalence of HAIDI was 16.1%, and the ischemia degree was around HAIDI1 and HAIDI2a. In 8 patients with HAIDI, the ischemia scores after the operation for one month and for 3 months were similar (Z=-0.368, P=0.713). After the operation for 3 months, the digital brachial index (DBI) of thumb, index and middle fingers in the fistula side were significantly lower in HAIDI group than in non- HAIDI group (t=- 4.915, - 4.448 and - 3.681 respectively; P＜0.001, 0.001 and P=0.001 respectively); Change in digital pressure (CDP) was significantly greater in HAIDI group than in non- HAIDI group (t=2.522, 3.316 and 2.187 respectively; P=0.015, 0.002 and P=0.033 respectively). At the operation day, and after the operation for one month and 3 months, DBI of the thumb, index and middle finger were significantly lower in the operation side than in the opposite side (t=-11.057, -10.374 and -8.117 respectively, P＜0.001, 0.001 and 0.001 respectively at the operation day; t=- 10.803, - 11.767 and - 9.526 respectively, P＜0.001, 0.001 and 0.001 respectively after the operation for one month; t=-10.684, -9.952 and -8.080 respectively, P＜0.001, 0.001 and ＜0.001 respectively after the operation for 3 months). Analysis of variance showed significant differences in DBI among thumb, index and middle fingers (F=11.261, 6.342 and 6.697 respectively, P＜ 0.05, P=0.002 and 0.002 respectively). After the operation for one month and 3 months, blood pressure in thumb, index and middle fingers increased significantly when fistula blood flow was temporarily blocked by compression (t=-14.457, -15.679 and -15.087 respectively, P＜0.001, 0.001 and 0.001 respectively after the operation for one month; t=-12.671, -14.087 and -14.854 respectively, P＜0.001, 0.001 and 0.001 respectively after the operation for 3 months). Using thumb DBI for the diagnosis of HAIDI, the area under the receiver operating characteristic (ROC) curve was the biggest. When the value of the thumb DBI was set at 0.595, the sensitivity for the diagnosis of HAIDI was 0.900 and specificity was 0.822. Conclusion The finger pressure and DBI in fistula limb were significantly decreased after arteriovenous fistula operation. The thumb DBI can be used for the diagnosis of HAIDI, and CDP is an early warning for HAIDI. Metrics

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Clinical outcome of aneurysmorrhaphy for true venous hemodialysis access aneurysms 2018, 17 (03):  182-185.  doi: 10.3969/j.issn.1671-4091.2018.03.008 Abstract ( 351 )   PDF (954KB) ( 721 )   【Abstract】Objectives To summarize the effect and management experiences of aneurysmorrhaphy for arteriovenous fistula (AVF) aneurysms in hemodialysis patients. Methods Thirty- four hemodialysis patients with AVF aneurysm treated between October 2014 and May 2017 were retrospectively analyzed. Etiology, management method and outcome were summarized. Results There were 17 males and 17 females with the mean age of (53.33±12.73)years old. The average time of AVF creation was (26.14±32.92)months. Aneurysm was present from one month to 13 years. Stenosis or occlusion lesions existed in 27 cases, thrombosis in 7 cases, and calcification in 9 cases. Thirty-four cases underwent 40 aneurysmorrhaphy operations, and 6 cases underwent two stage repair. The proximal stenosis was corrected. Three cases had constriction of the fistula. The fistulas were reused for blood access after the operation for one month. Patients were followed up for 1~31 months with the average follow-up period of (9.08±8.74)months. AVFs were patent except in one case that was dropped out from our follow-up. Enlargement of aneurysms occurred in 4 cases. Conclusions AVF aneurysm is often secondary to stenosis or occlusion lesions in hemodialysis patients, and should be detected and treated earlier. Although the surgical trauma is bigger, aneurysmorrhaphy largely preserves the venous resources, avoids central venous catheterization, and results in high patency rate and low complications. This surgery has clinical values in practice. Metrics

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The time of first puncture of the fistula after surgery, patency rate and complications in hemodialysis patients using novel arteriovenous gifts: a systematic review 2018, 17 (03):  186-192.  doi: 10.3969/j.issn.1671-4091.2018.03.09 Abstract ( 473 )   PDF (452KB) ( 912 )   【Abstract】Objective The aim of this review is to summarize the data in the literature about the first puncture time, patency rate and complications in patients using the novel arteriovenous gifts (AVG) for arteriovenous fistula. Methods Electronic databases including PubMed, MedLine, Cochrane Library (Issue7, 2017), Embase and CNKI before July 2017 were searched for studies about the use of early cannulation grafts for dialysis. According to the inclusion and exclusion criteria, related cohort studies were collected, and data were extracted and cross-checked by two reviewers. The primary outcome in this study was primary patency (PP) rate and secondary patency (SP) rate. The secondary outcome was complication rate of AVGs including thrombosis, hematoma, pseudoaneurysm, infection and steal blood syndrome. Results A total of 20 studies involving 1,230 cases treated with AVGs were included in this systematic review. Four types of AVGs including FlixeneTM, VectraTM, AcusealTM and AvfloTM were used. Most of the AVGs could be used for puncture after the surgery for 3 days, and some of them could be used after the surgery for 48 hours or even for 24 hours. There were no significance differences in patency rate and complications as compared with those using the traditional ePTFE AVG. AcusealTM AVG had the advantage of less thrombosis, and AvfloTM AVG had less infections. Conclusion This review shows that the novel AVGs have the advantages of early puncture within 3 days without impacts on primary patency rates, secondary patency rates and complications. Metrics

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Effect of empowerment education on health literacy and self-management ability in maintenance hemodialysis patients 2018, 17 (03):  193-196.  doi: 10.3969/j.issn.1671-4091.2018.03.010 Abstract ( 360 )   PDF (366KB) ( 557 )   【Abstract】Objective To investigate the effect of empowerment education on health literacy and selfmanagement ability in maintenance hemodialysis patients. Methods A total of 80 hemodialysis patients were randomly divided into observation group (n=40) treated with empowerment education method and control group (n=40) group using the traditional method of health education. Health literacy and self- management ability were compared between the two groups. Results After the intervention for 6 months, health literacy scores of information acquisition ability, communication ability and willingness to improve health score were significantly higher in observation group than in control group (P＜0.05). The willingness to change financial support was not statistically significant (P＞0.05). In self-management after the intervention, the partnership, problem-solving, emotional treatment, implementation of self-care activities and total score were significantly higher in observation group than in control group (P＜0.05). Conclusion Empowerment education can improve the health literacy and self-management ability in maintenance hemodialysis patients. This education method is worthwhile to be promoted in clinical practice. Metrics

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Novel understanding about proton pump inhibitors related renal injury 2018, 17 (03):  197-200.  doi: 10.3969/j.issn.1671-4091.2018.03.012 Abstract ( 471 )   PDF (486KB) ( 774 )   【Abstract】Proton pump inhibitors (PPIs) are a kind of over the counter (OTC) drugs and are widely used in clinical departments in hospitals. Patients in many countries use these drugs for long period of time. Recently, safety issues related to PPIs have been emphasized. Side effects on various systems have been reported. The effects on renal function, especially causing acute interstitial nephritis (AIN), have been proposed and become one of the common factors for AIN. While AIN always has no specific symptoms, it is hard to make a biopsy diagnosis until 6 months after the use of PPIs. AIN develops gradually as chronic kidney disease (CKD) and finally to end- stage renal disease. Currently, the incidence of AIN caused by PPIs and the mechanism underlying the development of CKD by PPIs remain unclear. This article briefly describes the latest research progress in PPI-related renal disease. Metrics

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The application and significance of predictive maintenance for dialysis equipment 2018, 17 (03):  204-205.  doi: 10.3969/j.issn.1671-4091.2018.03.013 Abstract ( 331 )   PDF (313KB) ( 555 )   【Objective】To discuss the importance and application of predictive maintenance for dialysis devices. Methods Predictive maintenance was applied to 57 dialysis equipment in a center in the year from 2016 to 2017. The number of equipment failure, predicted and unpredicted failure frequencies, cost of maintenance, equipment vacancy time were retrospectively compared with those in the year from 2015 to 2016, during which predictive maintenance was not adopted. Results The failure rate dropped by 30.65%, the maintenance cost decreased by 69.44 %, and the device vacancy time decreased by 52.90%. The predictive failure of dialyzers dropped by 35.57%, and the non- predictive failure declined by 15.15%. Conclusion Predictive maintenance can greatly improve the efficiency of dialysis equipment, reduce the equipment failure rate and avoid failure during running, so as to improve the economic benefits and patient satisfaction. Metrics

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Application of nutrition evaluation tools for elderly maintenance hemodialysis patients 2018, 17 (03):  206-209.  doi: 10.3969/j.issn.1671-4091.2018.03.014 Abstract ( 281 )   PDF (375KB) ( 442 )   【Abstract】Malnutrition is prevalent among elderly maintenance hemodialysis (MHD) patients, which reduces dialysis tolerance and affects the adequacy of dialysis. Early diagnosis, nutritional support and followup for these patients should be conducted. This article reviews the type, function and clinical application of nutritional evaluation tools for elderly MHD patients. Metrics

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The application of "one point two source" adaptive nursing model based on personality classification in hemodialysis patients 2018, 17 (03):  210-212.  doi: 10.3969/j.issn.1671-4091.2018.03.015 Abstract ( 313 )   PDF (384KB) ( 576 )   【Abstract】Objective To observe the application effect of "one point two sources" adaptive nursing model based on personality classification in hemodialysis patients. Methods A total of 60 uremic patients treated with hemodialysis in our hospital in the period from Jan. to Dec. 2016 were recruited. They were randomly divided into control group receiving conventional hemodialysis nursing (n=30) and test group (n=30) receiving "one point two source" adaptive nursing model based on personality classification. Psychological parameters and compliance to treatment were compared between the two groups. Results After the intervention, the scores of depression and anxiety were significantly lower in test group than in control group. The scores of treatment compliance were significantly higher in test group than in control group (P<0.05). Conclusion The "one point two sources" adaptive nursing model based on personality classification can improve the depression and anxiety and the compliance to therapy in hemodialysis patients. Metrics

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The effects of collaborative care model on self-care ability and compliance in elderly patients with hemodialysis 2018, 17 (03):  213-216.  doi: 10.3969/j.issn.1671-4091.2018.03.016 Abstract ( 381 )   PDF (379KB) ( 853 )   【Abstract】Objective To explore the effects of collaborative care model on elderly patients with hemodialysis (HD). Methods A total of 64 elderly HD patients were randomly divided into two groups, the intervention group (n=32), in which patients were treated with collaborative care model and the control group (n= 32), in which patients were treated with routine care procedure. The scores of self-care ability and compliance with medical treatment were compared after the intervention for 6 months between the two groups. Results After the intervention for 6 months, the mean score of self-care ability was higher in intervention group than in control group (P<0.001), and the scores of compliance were also higher in intervention group than in control group (P<0.001～0.035) except the score of compliance with dialysis protocols, which had no statistical significance between the two groups. Conclusion The collaborative care model can improve the self- care ability and compliance with medical treatment in elderly HD patients. Metrics