Chinese Journal of Blood Purification

12 April 2019, Volume 18 Issue 04 Previous Issue    Next Issue

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Advances in the evaluation of small molecule solute clearance in peritoneal dialysis 2019, 18 (04):  217-219.  doi: 10.3969/j.issn.1671-4091.2019.03.001 Abstract ( 220 )   PDF (284KB) ( 556 )   【Abstract】Small molecule solute clearance is an important parameter in the evaluation of dialysis adequacy of peritoneal dialysis (PD). Here we discuss its main evaluation indicator - Kt/Vurea, including its definition, measurement method, research and progress relating to patient’s prognosis, and possible influencing factors. The value of Kt/Vurea is also related to patient's body mass index, gender, energy metabolism rate, ethnicity and other factors. It remains controversial that Kt/Vurea would independently affect the prognosis of PD patients. This review analyzes the role and limitation of Kt/Vurea in the assessment of small molecule solute clearance in PD. Metrics

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Peritoneal dialysis-related peritonitis caused by mycobacteria 2019, 18 (04):  220-222.  doi: 10.3969/j.issn.1671-4091.2019.03.002 Abstract ( 177 )   PDF (389KB) ( 336 )   【Abstract】Peritoneal dialysis (PD)-related peritonitis remains to be one of the most frequent and serious complications of PD, and is an important cause leading to technological failure. The incidence of peritonitis caused by mycobacteria is low. However, the diagnosis and treatment are difficult, the mortality is high, and the prognosis is poor. This article reviews the diagnosis, treatment and prognosis of PD-associated mycobacterial peritonitis. Metrics

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The therapeutic effect of peritoneal dialysis on 36 patients with acute kidney injury 2019, 18 (04):  223-225.  doi: 10.3969/j.issn.1671-4091.2019.03.003 Abstract ( 160 )   PDF (351KB) ( 245 )   【Abstract】Objective To investigate the therapeutic effect of peritoneal dialysis (PD) on acute kidney injury (AKI) patients. Methods The clinical data of 36 AKI patients treated with PD were retrospectively analyzed, and their clinical data and biochemical indexes including blood pressure, urine volume, and serum K+, HCO3-, creatinine (Scr) and urea nitrogen (BUN) were compared before and after PD. The safety and effectiveness of PD for the treatment AKI were then analyzed. Results Of the 36 patients, 10 (27.8%) were cured, 7 patients (19.4%) continued to be treated with PD, 10 patients (27.8%) died, and 9 patients (25%) were changed to hemodialysis. Patients’kidney function recovered within 2~30 days. After PD, hyperkalemia, hypertension, acute heart failure and uremia symptoms were quickly corrected. The average urea BUN decreased from 40.9±16.1mmol/L to 20.4±8.5mmol/L and the average Scr decreased from 1010.3±148.6μmol/L to 435.2±45.2μmol/L. The changes of serum K+, HCO3-, Na+, Ca2+ and P levels before and after PD were statistically significant (t=8.613, 12.783, 8.05, 4.445 and 3.487, respectively; P =0.021, 0.015, 0.028, 0.037 and 0.031, respectively). Conclusion PD has the advantages of easy and simple operation, no anticoagulation, little influence to hemodynamics and low medical expenses. Therefore, it is valuable to be widely used clinically. Metrics

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Risk factors for refractory peritonitis in peritoneal dialysis patients 2019, 18 (04):  226-229.  doi: 10.3969/j.issn.1671-4091.2019.04.004 Abstract ( 388 )   PDF (428KB) ( 1108 )   【Abstract】Objective To analyze the prevalence, clinical characteristics and risk factors of refractory peritoneal dialysis associated peritonitis in patients undergoing peritoneal dialysis (PD). Methods We recruited patients with peritoneal dialysis associated peritonitis (PDAP) treated in Beijing Luhe Hospital from January 2013 to December 2017. According to the definition of PDAP in the ISPD recommendations, the patients were divided into refractory peritonitis (RP) group and non-refractory peritonitis (NRP) group. Their morbidity characteristics and clinical data were retrospectively analyzed. Logistic regression was used to analyze the risk factors for refractory PDAP. Results A total of 101 PDAP patients were recruited in this study, and 178 episodes of PDAP happened in these PDAP patients. Forty patients presenting 42 episodes of refractory PDAP were divided into RP group. ①In RP group, patients had higher proportion of longer interval (＞one day) between the presence of symptoms and treatment (χ2=4.722, P=0.030), higher prevalence of intestinal obstruction (χ2=25.591, P＜0.001), more white blood cell count in fluid (Z=-2.270, P=0.023), higher serum C-reaction protein (Z=-2.322, P=0.020), and lower serum albumin (t=2.507, P=0.015), as compared with those in patients in NRP group. ②In RP group, the rate of Gram-positive bacterial infection was lower (χ2=7.370, P=0.007), but the rate of staphylococcus aureus infection was higher (χ2=4.156, P=0.041) and the rate of coagulase negative staphylococcus infection was lower (χ2=10.233, P=0.001). ③Logistic analysis showed that higher C-reaction protein (OR=1.012, P=0.004) and intestinal obstruction (OR=14.532, P=0.002) were the independent risk factors for refractory PDAP, and higher serum albumin level (OR=0.848, P=0.035) was the independent protection factor for refractory PDAP. Conclusions Higher C-reaction protein level and intestinal obstruction were the independently risk factors and higher serum albumin level was the independent protection factor for refractory PDAP. Metrics

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Risk factors for the incidence of hypokalemia among end- stage renal disease patients undergoing primary peritoneal dialysis 2019, 18 (04):  230-233.  doi: 10.3969/j.issn.1671-4091.2019.04.005 Abstract ( 370 )   PDF (357KB) ( 784 )   【Abstract】Objectives T o evaluate the incidence of hypokalemia and the factors associated with hypokalemia among patients with primary continuous ambulatory peritoneal dialysis (CAPD). Methods Clinical data of the 350 eligible CAPD patients undergoing peritoneal catheter placement in West China Hospital of Sichuan university from January 2011 to November 2016 were collected. The patients were divided into hypokalemia group (＜3.5mmol/L) and non-hypokalemia group (≥3.5mmol/L) based on the first serum potassium level. Results Hypokalemia group included 65 cases (18.57%). Serum albumin (Z=- 3.695, P＜0.001), urine volume (Z=-3.413,P=0.001) were lower in hypokalemia group than in non-hypokalemia group. In contrast, age (χ2=7.627, P= 0.006), serum IL-6 (Z=-2.832,P=0.005), dialysate Kt/V (Z=-2.543,P=0.011), 4-hour dialysate to plasma creatinine ratio (Z=-2.686,P=0.007) were higher in hypokalemia group than in non-hypokalemia group. There were no significant differences in gender (χ2=0.357, P=0.550), hemoglobin (Z=-0.031, P= 0.975), ultrafiltration capacity (Z=-1.105, P=0.269) and duration of CAPD (Z=-0.041,P=0.967) between the two groups. Pearson correlation analysis showed that serum potassium level correlated positively with serum albumin (r=0.185,P＜0.001), urine volume (r=0.036,P=0.011); and negatively with age (r=-0.142,P=0.008), D/P Cr (4h) (r=-0.185,P=0.001) and dialysate Kt/V (r=-0.188,P＜0.001). Multivariate stepwise linear regression analysis revealed that age (β =-0.006,P=0.011), serum albumin (β =0.017,P=0.013), total Kt/V (β =-0.181,P=0.005), CO2CP (β =-0.061,P＜0.001) and urine volume (β=0,P=0.016) were the risk factors for hypokalemia. Conclusion A higher incidence of hypokalemia is observed in primary CAPD patients. We should pay attention to serum potassium in PD patients, especially in senile and poor nutrition patients. Metrics

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Efficacy evaluation of short-term continuous renal replacement therapy in the treatment of severe acute pancreatitis 2019, 18 (04):  234-237.  doi: 10.3969/j.issn.1671-4091.2019.04.006 Abstract ( 264 )   PDF (394KB) ( 854 )   【Abstract】Objective To investigate the clinical efficacy of short- term continuous renal replacement therapy (CRRT) early interventional therapy for severe acute pancreatitis (SAP). Methods Retrospective analysis of clinical data of 21 patients with severe acute pancreatitis admitted from January 2010 to August 2018, compared 24 hours、48 hours (before CRRT) and 7 days (after CRRT) after admission Changes in the patient's monitoring indicators and improvement in clinical symptoms. Results Comparing the indicators from 24 hours to 48 hours after admission: APACHE II score, abdominal pain and other clinical symptoms were significantly improved (t=4.249, 2.439 respectively; P＜0.001,P=0.019 respectively), alanine aminotransfer Enzyme, amylase, lipase, and arterial oxygen partial pressure were significantly decreased (t/z =3.384,- 2.614, 3.521 and 2.567 respectively;P＜0.001, 0.008, 0.001 and 0.018 respectively); C-reactive protein was significantly elevated (z=-3.271, P=0.001); There were no significant differences in white blood cells, urea nitrogen, creatinine, triglyceride, and D-dimmer. Compared with the indexes before and after hemofiltration: APACHE II score, abdominal pain and other clinical symptoms were significantly improved (t=11.918, 8.068 respectively; P＜0.001,＜0.001 respectively), C-reactive protein, white blood cells, alanine Acid aminotransferase, creatinine, amylase, arterial oxygen partial pressure were significantly improved (t/z=-4.845,2.093,8.037,-4.076,- 2.638 and -3.602 respectively; P＜0.001, 0.049, ＜0.001, ＜0.001, 0.008 and 0.001 respectively), Hemofiltration treatment did not improve the indicators such as urea nitrogen, lipase, triglyceride, D-dimmer. Conclusion Short- term continuous renal replacement therapy can rapidly improve the clinical symptoms and biochemical parameters of patients with severe acute pancreatitis. Metrics

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Cross-sectional study of physiological function and quality of life and their influence factors in maintenance hemodialysis patients 2019, 18 (04):  237-241.  doi: 10.3969/j.issn.1671-4091.2019.04.007 Abstract ( 389 )   PDF (430KB) ( 1054 )   【Abstract】Objective To evaluate the situation of physiological function and quality of life (QOL) as well as their related factors in maintenance hemodialysis (MHD) patients. Methods A total of 123 MHD patients with regular hemodialysis for more than three months in Beijing Bo’ai Hospital of China Rehabilitation Research Center were enrolled to investigate physiological function (activity of daily living, grip strength, 6-minute walking test) and quality of life. Results ①Physiological function: Only 35 patients (28.5%) could independently complete all activities of daily living. There was a general decrease in grip strength in MHD patients (20.8+9.1kg). Multivariate linear regression analysis showed that sex, age, dialysis age, serum albumin level were closely related to the decrease of grip strength in MHD patients (standardized coefficient β=0.283, -0.772, -0.096 and 1.544 respectively; P＜0.001, ＜0.001, 0.022 and ＜0.001 respectively). The 6-minute walking test (6MWT) was 413.6+111.3m, significantly lower than that in healthy individuals. Multivariate linear regression analysis showed that the 6MWT decreased by 58.4m after the increase of 10 years of age, and the 6MWT increased by 191.8m in the increase of serum albumin 10g/L in MHD patients. ② Quality of life score: The decrease of quality of life score was detected in most MHD patients: body function 44.92+11.11, work ability 59.7+35.73, body pain 74.38+19.47, general health 48.38+11.41, vitality 57.71+10.01, social function 66.56+21.94, emotional role 41.38+35.96, mental health 36.87+7.81, and total SF-36 53.91+6.30. Conclusion Most MHD patients are accompanied by physiological dysfunction and lower quality of life. Early awareness of the dysfunctions and early rehabilitation intervention are of clinical significance to alleviate the dysfunctions and the lower quality of life in MHD patients. Metrics

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Pruritus in maintenance hemodialysis patients 2019, 18 (04):  242-245.  doi: 10.3969/j.issn.1671-4091.2019.04.008 Abstract ( 597 )   PDF (437KB) ( 1487 )   【Abstract】Objective To understand the symptom features and treatment condition of pruritus in maintenance hemodialysis (MHD) patients. Methods MHD patients with pruritus in Guangzhou and Beijing were recruited in this study. Symptoms, treatment situation and factors influencing pruritus severity were investigated. Results A total of 128 patients were enrolled in this study, and 49.22% of them had moderate to extreme pruritus. Pruritus was mainly occurred on back (75.78%) and lower limbs (57.81%), often occurring during night (73.44%) and in winter (62.50%); 46.88% of the patients were found to have scratches on skin; 28.13% of the patients were suffering from anxiety. The severity of pruritus increased with age (t=2.577, P=0.011); 12.50% of the patients receive treatment for pruritus, with the satisfaction rate of 37.50% to the treatment. Conclusions Uremic pruritus can cause skin damage and anxiety. Nearly half of the patients had moderate to extreme pruritus. The severity of pruritus was related to age. However, only a few patients received the treatment for pruritus and the satisfaction rate was quite low. Metrics

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Establishment of an improved peritoneal dialysis model in rats 2019, 18 (04):  246-249.  doi: 10.3969/j.issn.1671-4091.2019.04.009 Abstract ( 364 )   PDF (553KB) ( 1060 )   【Abstract】Objective To improve the traditional peritoneal dialysis (PD) model, we established an improved PD model with higher survival rate in rats. Method Sixty male SD rats were randomly divided into 6 groups of normal control group, sham operation group, left upper abdomen group, right upper abdomen group, middle abdomen group and lower abdomen group. The orifice of the dialysis tube was placed in the upper left gastric region in rats of left upper abdomen group, in the upper right hepatic region in rats of right upper abdomen group, in the middle right cecum-colon region in rats of middle abdomen group, and near rectumvesical fossa using traditional surgery in rats in lower abdomen group and sham operation group. After the surgery for one week, PD (dialysate 20ml, hold for one hour) was performed once daily in rats in left upper abdomen group, right upper abdomen group, middle abdomen group and lower abdomen group. After PD for one week, PD technical survival rate, ultrafiltration volume, body weight, serum albumin and peritoneal dialysis safety index were evaluated. Results No obstruction of the dialysis tubes was observed at the first day of the operation. The overall survival rate was 30.8% (12/39) after PD for one week. Rats in right upper abdomen group had the highest PD technical survival rate (80%), significantly higher than that of the other three groups (χ2=16.675, P=0.001). There were no significant differences in ultrafiltration volume (F=1.812, P=0.163), serum albumin (F=2.307, P=0.084), erythrocyte volume (F=1.258, P=0.311), serum potassium (F=1.101, P=0.376) and sodium (F=1.134, P=0.323) among the four groups. Conclusion PD tube placed in the upper right hepatic region was a better method than the traditional method for the establishment of PD in rats, with a higher survival rate for long-term PD. Metrics

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Zinc delays peritoneal fibrosis in peritoneal dialysis patients and its mechanism 2019, 18 (04):  250-253.  doi: 10.3969/j.issn.1671-4091.2019.04.010 Abstract ( 396 )   PDF (321KB) ( 912 )   【Abstract】Peritoneal dialysis (PD) is an alternative treatment effective for end-stage renal disease (ESRD) patients and even the first choice of renal replacement therapy. With the longer duration of PD, however, nonbiocompatible dialysate, peritonitis, cytokines, oxidative stress and other factors cause peritoneal fibrosis (PF), leading to the gradual decrease of peritoneal ultrafiltration capacity and eventually to ultrafiltration failure. PF is the main etiology for patients to give up PD. In the cohort of patients with chronic stable PD, the prevalence of zinc deficiency is high. Zinc is an important trace element that plays an important role in the body. Zinc as an antioxidant alleviates micro-inflammation, oxidative stress and cell apoptosis, as well as the progression of PF. This article summarizes the recent advances made by foreign and Chinese researchers in the prevention and treatment of PF, and explores the possible mechanisms underlying the prevention and treatment of PF by zinc. Metrics

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Research advances in the self-management and psychological status in hemodialysis patients with diabetic nephropathy 2019, 18 (04):  254-256.  doi: 10.3969/j.issn.1671-4091.2019.04.011 Abstract ( 300 )   PDF (285KB) ( 870 )   【Abstract】As the incidence of diabetes increases year by year, the proportion of maintenance hemodialysis patients due to diabetic nephropathy (DN) is also increasing. The studies on self-management in hemodialysis patients with DN are abundant in foreign countries, but are limited in China. By searching and collating relevant foreign and Chinese literature published in recent years, we found that the studies of self-management in hemodialysis patients with DN mainly focused on three aspects: the self-management level and psychological status, the factors relating to self-management level and psychological status, and the intervention measures to improve self-management level and psychological status. This article summarizes the above content and provides a theoretical basis for improving self-management ability and psychological status in hemodialysis patients with DN. Metrics

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Research on constipation in hemodialysis patients 2019, 18 (04):  257-259.  doi: 10.3969/j.issn.1671-4091.2019.04.012 Abstract ( 559 )   PDF (281KB) ( 1181 )   【Abstract】Constipation is one of the most common digestive symptoms among hemodialysis patients. However, the pathological mechanism of constipation is still unclear. This paper reviews definition, measurement scales, prevalence and factors relating to constipation in hemodialysis patients. Healthcare professionals should pay attention to the constipation experienced by hemodialysis patients, and help improve the constipation distress and quality of life in these patients. Metrics

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Professional roles of vascular access coordinators in multidisciplinary collaboration of hemodialysis vascular access and its enlightenment to the present situation in China 2019, 18 (04):  260-262.  doi: 10.3969/j.issn.1671-4091.2019.04.0013 Abstract ( 319 )   PDF (271KB) ( 663 )   【Abstract】The vascular access coordinator (VAC) has multiple roles in the multidisciplinary collaboration of hemodialysis vascular access. This article proceeds from the four aspects: the origin and concept of VAC, the composition and role of the multidisciplinary treatment team in the vascular access, the role of VAC in the team, and the clinical contribution. This review provides a reference for guiding future clinical practice to develop VACs. Metrics

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Percutaneous transluminal angioplasty for the treatment of chronic thrombosed arteriovenous graft 2019, 18 (04):  263-265.  doi: 10.3969/j.issn.1671-4091.2019.04.014 Abstract ( 392 )   PDF (419KB) ( 771 )   【Abstract】Objective To observe the curative effect of percutaneous transluminal angioplasty (PTA) for the treatment of chronic thrombosed arteriovenous graft (AVG). Methods A retrospective analysis was performed on 18 maintenance hemodialysis patients who underwent PTA for the treatment of chronic thrombosed AVG in West China Hospital of Sichuan University from January 2017 to January 2018. The technical success rate, patency rate, pathological feature and complication of the procedure at different intervals were analyzed. Results A total of 18 patients were enrolled in the study. The occlusion of AVG lasted for 10.5 (3, 14) days. There were 12 cases of venous anastomotic stenosis, 7 cases of venous outflow stenosis, 6 cases had more than 2 stenotic lesions. The technical success rate of the procedure was 94.4% and complication rate was 5.6%. Primary patency after one month, 3 months, 6 months and one year were 72.2%, 66.7%, 55.6% and 33.3% respectively, and secondary patency rates after the same intervals were 88.9%, 83.3%, 77.8% and 50% respectively. Conclusion PTA is an effective, safe, minimally invasive method for the treatment of chronic thrombosed AVG, with no requirement for the occlusion time. This method prolongs the survival time of arteriovenous graft. Metrics

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The value of color Doppler ultrasound examination of wrist radiocephalic arteriovenous fistula to predict maturity 2019, 18 (04):  266-269.  doi: 10.3969/j.issn.1671-4091.2019.04.015 Abstract ( 496 )   PDF (356KB) ( 1007 )   【Abstract】Objective The aim of this study was to assess the accuracy of pre-operative and post-operative ultrasound (US) examination for predicting maturity of wrist radio-cephalic arteriovenous fistula (RC-AVF). Method The patients with the operation of RC-AVF performed from October 2015 to December 2017 were enrolled in this study. US examination for RC-AVF was conducted before the operation and after the operation for 2 weeks. RC-AVF maturation was defined as the successful cannulation of fistula with two needles, delivery of blood at a flow rate ≥ 200 ml/min for 4 hours via the access, and dialysis via the fistula for at least six consecutive sessions. Results Eighty-two wrist RC-AVFs were analyzed, of which 13 failed. Pre-operative US parameters did not correlate with RC-AVF maturity. Cephalic vein diameter (CVD) ＞4.285 mm and brachial artery peak systolic velocity (BAPSV) ＞134.75 cm/s from US examination were the best post-operative predictors of RC-AVF maturity (P＜0.001 and 0.011, respectively). Conclusions T wo weeks after surgery, a new wrist RC-AVF with a CVD ＞4.285 mm is suitable for dialysis. Early intervention to a high-risk failure AVF would thus be possible. Metrics

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Design and clinical application of the fixation device for temporary internal jugular vein catheter in hemodialysis 2019, 18 (04):  270-272.  doi: 10.3969/j.issn.1671-4091.2019.04.016 Abstract ( 367 )   PDF (344KB) ( 835 )   【Abstract】Objective To investigate the effect of a fixation device for temporary internal jugular vein catheter in hemodialysis. Methods A total of 110 patients with temporary dual-chamber internal jugular venous catheter for hemodialysis in Aero Space Center Hospital were enrolled in this study. In the control group, the catheter was wrapped with conventional gauze and pasted with ordinary transparent adhesive tape; in the observation group, the catheter was fixed with a special device. After 2 weeks, the incidence of catheter slip, skin cleanliness around the fixed catheter, medical adhesive-related skin injury (MARSI), comfort of patients, stability of the fixed catheter, and satisfaction of patients with the catheter fixation were evaluated and compared. Results The cleanliness of the skin around the catheter was better in the observation group than in the control group (χ ２=8.419,P=0.004); the comfort of the patients was better in the observation group than in the control group (χ２=4.583,P=0.032); the stability of catheter fixation was better in the observation group than in the control group (χ ２=9.340, P=0.002);the incidence of MARSI was lower in the observation group than in the control group (χ２=5.986, P=0.014). Patients satisfied with the catheter fixation were more in the observation group than in the control group (t=-4.763,P＜0.001). The incidence of catheter slip was lower in the observation group than in the control group, but the difference was not statistically significant (χ ２ =0.259,P=0.611). Conclusion The specific fixation device for temporary internal jugular vein catheter in hemodialysis can improve patients’comfort, fixation stability and peripheral skin cleanliness and reduce the incidence of catheter infection and MARSI with higher satisfication from the patients. This device is suitable for clinical use. Metrics

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Effect of behavioral intervention on the rate of blood phosphorus reaching the standard level in hemodialysis patients 2019, 18 (04):  273-276.  doi: 10.3969/j.issn.1671-4091.2019.04.017 Abstract ( 336 )   PDF (365KB) ( 893 )   【Abstract】Objective To explore the effect of behavioral intervention on the rate of blood phosphorus reaching the standard level in hemodialysis patients in order to provide an alternative management for blood phosphorus. Methods A total of 146 patients in the Hemodialysis Center of our hospital were randomly divided into control group (n=73) and experiment group (n=73). Routine health education was used in the control group, and behavioral intervention model of health education was carried out in the experiment group. Questionnaire about blood phosphorus metabolism knowledge, self-efficacy scale for blood phosphorus control, and compliance behavior scale for blood phosphorus control were used to investigate the levels of blood phosphorus metabolism knowledge, self- efficacy of blood phosphorus control and compliance behavior as well as the rate of blood phosphorus reaching the standard level before and after the intervention for 6 months in the two groups. Result After the intervention for 6 months, the scores of blood phosphorus metabolism knowledge (t=- 9.775), self- efficacy of blood phosphorus control (t=- 4.170) and compliance behavior (t=-11.679) were significantly higher in the experiment group than in the control group (P＜0.001); the average blood phosphorus value was lower in the experiment group than in the control group (t=3.641,P＜0.001); and the rate of blood phosphorus reaching the standard level was significantly higher in the experiment group than in the control group (χ ２=7.65, P ＜0.006). Conclusion Behavioral intervention model of health education was useful to control blood phosphorus level and to increase the rate of blood phosphorus reaching the standard level in hemodialysis patients Metrics

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Clinical research of ABC emotional therapy on negative emotion and malnutrition in hemodialysis patients 2019, 18 (04):  277-280.  doi: 10.3969/j.issn.1671-4091.2019.04.018 Abstract ( 337 )   PDF (313KB) ( 842 )   【Abstract】Objective To investigate the therapeutic effect of Ellis ABC emotional therapy on negative mood and malnutrition in hemodialysis patients. Methods This study enrolled 152 maintenance hemodialysis patients. They were randomly divided into two groups; patients (n=76) in the control group were treated with routine nursing and those (n=76) in the experimental group were treated with Ellis ABC emotional therapy in addition to routine nursing. Anxiety, depression, appetite, nutritional status and quality of life were compared between the two groups. Results There were no significant differences in self-rating depression scale (SDS) score and quality of life score between the two groups before the study. After the treatment for 3 months, self- rating anxiety scale (SAS) and SDS scores were significantly lower in the experimental group than in the control group (t=-1.972, P=0.049; t=-1.982, P=0.039). After the intervention for 6 and 12 months, the council on nutrition appetite questionnaire(CNAQ) and malnutrition inflammation score(MIS) scores were significantly lower in the experimental group than in the control group (t=1.976, P=0.041; t=1.996, P=0.021). After the intervention for 6 months, the scores of body physical function, physiological function and emotional function were significantly higher in the experimental group than in the control group (t=2.357, P=0.021; t=2.982, P＜0.001; t=2.181, P=0.012). After the intervention for 12 months, the scores of body physical function, physiological function, somatic pain, general health, vitality, emotional functional domain, SAS and SDS were significantly higher in the experimental group than in the control group (t=2.901, -2,023, 2.721, 2.981, 2.324, 2.181, -2.935 and -3.121 respectively; P＜0.001,＜0.001, 0.011, 0.021, 0.031, 0.013, 0.001 and 0.023 respectively). Conclusion ABC emotional therapy can effectively improve the negative emotion, nutritional status and quality of life in hemodialysis patients. Metrics

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Effects of continuous care based on Omaha system on self-management ability and quality of life in maintenance hemodialysis patients 2019, 18 (04):  281-283.  doi: 10.3969/j.issn.1671-4091.2019.04.019 Abstract ( 277 )   PDF (336KB) ( 1116 )   【Abstract】Objective To discuss the effect of continued nursing based on Omaha system (OS) on self-management capability and quality of life in maintenance hemodialysis (MHD) patients. Methods A total of 120 MHD patients treated in the period from September 2016 to March 2017 were recruited and randomly divided into group A (n=60) and group B (n=60). Patients in group A were given conventional nursing, and those in group B were treated with continued nursing based on OS. Results The rate of disease knowledge was significantly higher in group B than in group A (P=0.043). After the intervention for 3 and 6 months, exercise of selfcare agency (ESCA) score and kidney disease quality of life short from (KDQOL-SFTM) score were significantly higher in group B than in group A (P＜0.001). Conclusions Continued nursing based on OS can improve the disease knowledge degree and self-management ability in MHD patients and help improve quality of life in these patients. Metrics

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A Thought for Hemodialysis Engineer to Eliminate Waterway Alarm of Dialysis Machine 2019, 18 (04):  284-285.  doi: 10.3969/j.issn.1671-4091.2019.04.020 Abstract ( 355 )   PDF (268KB) ( 788 )   【Abstract】Objective To explore the feasibility of the idea of hemodialysis engineers to quickly determine the alarm fault clearance interval according to the waterway flow and the positive and negative pressure in the pipeline. Methods Through the disposal of different alarm cases such as temperature alarm and conductivity alarm toveryfy The feasibility of hemodialysis engineer's diagnostic thought. Results According to the idea of hemodialysis engineers, the two alarm cases were quickly found and eliminated, thus avoiding the potential safety hazard. Conclusion It is effective and strict to diagnose fault point according to waterway flow and positive and negative pressure in pipeline. Metrics

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End-stage renal disease patients complicated with tuberculosis: report of 3 cases and review of the literature 2019, 18 (04):  286-288.  doi: 10.3969/j.issn.1671-4091.2019.04.021 Abstract ( 374 )   PDF (407KB) ( 725 )   【Abstract】Objective To investigate the diagnostic criteria of tuberculosis and the suitable period to start treatment in three end stage of renal disease (ESRD) patients complicated with atypical tuberculosis infection. Methods We retrospectively analyzed the clinical manifestations, diagnosis, treatment and prognosis of 3 ESRD cases complicated with tuberculosis and reviewed the related literature. Results One patient died of old age, complications and too late to be diagnosed. One patient improved after ant-tuberculosis therapy with less symptoms and stable disease conditions. One patient was highly suspected to have tuberculosis peritonitis because of no improvement after intraperitoneal antibiotics for 5 days; after removal of peritoneal dialysis tube and change to hemodialysis and administration of anti-tuberculosis therapy for one year, the patient’s disease condition became stable. Conclusion In ESRD patients complicated with tuberculosis, extra- pulmonary tuberculosis is very common with atypical tuberculosis symptoms. ESRD patients suspected with tuberculosis infection may have a trial of anti-tuberculosis treatment as early as possible under the close surveillance of side- effects of the drugs. Misdiagnosis and delayed treatment of tuberculosis would lead to an adverse prognosis. Metrics