Chinese Journal of Blood Purification

11 November 2022, Volume 21 Issue 11 Previous Issue    Next Issue

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Low Hepcidin level associated with relative erythrocytosis in chronic hemodialysis patients 2022, 21 (11):  785-789.  doi: 10.3969/j.issn.1671-4091.2022.11.001 Abstract ( 314 )   PDF (503KB) ( 52 )   Objective  To explore the mechanism of relative erythrocytosis in hemodialysis patients. Methods   Patients on chronic hemodialysis were divided into subgroups according  to the baseline hemoglobin levels and whether they treated with erythropoiesis stimulating agent (ESA). Clinical characteristics and laboratory data was collected at baseline. The degree of anemia, hyperparathyroidism, and iron metabolism were compared between the two groups. All patients were followed up for 84 months.  Results   In total, 161 patients were enrolled. Fourteen (8.7%) were diagnosed as relative erythrocytosis, with significantly higher level of hemoglobin compared to ESA treated group [(130.8±13.3) vs. (110.3±11.8)g/L, t=6.108, P＜0.001]. The level of hepcidin was significantly lower in patients without ESA treatment [(5.33±5.21) vs. (20.07±10.17)×104 pg/ml, t=-4.857, P＜0.001). And in both of groups, there was a negative correlation between hepcidin level and hemoglobin concentration (r=-0.491, P=0.007). The level of hepcidin positively correlated with ferritin (r=0.684, P＜0.001) and negatively correlated with the level of soluble transferrin receptor (sTfR,    r=-0.406, P=0.029). There was no association between hepcidin and proinflammatory cytokines.  Conclusion   A small portion of hemodialysis patients may maintain reasonable activity of erythropoiesis with no need of treatment with ESA or supplement of iron. They show a relatively lower level of circulating hepcidin than patients treated with ESA. And the higher the level of hepcidin, the less iron available for the tissue, and the lower activity of erythropoiesis. Metrics

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Clinical characteristics and prognosis of the first episode of peritoneal dialysis-associated peritonitis in patients with different peritoneal dialysis duration  2022, 21 (11):  790-794.  doi: 10.3969/j.issn.1671-4091.2022.11.002 Abstract ( 337 )   PDF (456KB) ( 268 )   Objectives   To investigate the clinical characteristics and prognosis of peritoneal dialysis-associated peritonitis (PDAP) in patients with different dialysis duration.  Method  A total of 166 peritoneal dialysis (PD) patients who experienced the first episode of PDAP in Peking University People's Hospital from January 2007 to October 2021 were retrospectively reviewed. According to PD duration, patients were divided into long PD duration group (≥60 months), medium PD duration group (36-59 months) and short PD duration group (＜36 months). Clinical characteristics and PDAP prognosis were collected and analyzed. Results  Among 166 patients，83(50%) were male and the mean age was (63.33±12.14) years. The major primary renal diseases were diabetic nephropathy(35.5%).There were 36 patients (21.7%) in long PD duration group. With the extension of PD duration, the proportion of patients with diabetes gradually decreased (62.1%, 45.7%, 30.6%, χ2=11.068, P=0.004), and the treatment failure rate and PDAP-related mortality gradually increased(χ2=10.095、11.171，P=0.005, 0.003). Logistic multivariate regression analysis showed that PD duration was not only independent risk factor for the treatment failure of the first-episode PDAP (OR1.291，95%CI : 1.048～1.591,P=0.016) , but also independent risk factor for first-episode PDAP death (OR: 1.675, 95%CI:1.262～2.222, P＜0.001).   Conclusion   Patients with PD duration of ≥60 months had the highest rate of treatment failure and PDAP-related mortality when they first experienced PDAP. PD duration is an independent risk factor for the first episode of PDAP treatment failure and death. The prevention of peritonitis in PD patients with long PD duration should be actively strengthened. Metrics

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Timing of renal replacement therapy initiation for critically ill patients with acute kidney injury--a meta-analysis  CHENG Hui-xin, DU Xin-xin, LI Xiang, YANG Chun-bo, WANG Yi, YU Xiang-you 2022, 21 (11):  795-795-800,807.  doi: 10.3969/j.issn.1671-4091.2022.11.003 Abstract ( 166 )   PDF (1098KB) ( 297 )   ackground  This study aimed to evaluate the impact of timing of renal replacement therapy (RRT) on prognosis in patients with severe acute kidney injury.  Methods  PubMed, Web of Science, Em-base, CNKI, Wanfang Data Knowledge Service platform, VIP and other databases were searched for literatures related to the influence of different start-up times of renal replacement therapy on patients with severe and complicated acute kidney injury. The retrieval time was limited to create database to December 30, 2021. The article type was limited to randomized controlled study (RCT). Literature screening and data extraction were independently completed by two researchers. The main outcome indicators were 28-day mortality, and the secondary outcome indicators were the need for renal replacement therapy at 90 days and the incidence of related complications. Meta-analysis was performed using RevMan 5.3 software. The Cochrane Risk of Bias Tool was used to assess the risk of bias in all studies.  Results  A total of 5709 severe patients were included in 15 RCTS in this study, including 2851 patients in the early initiation group and 2858 patients in the late initiation group. Meta-analysis showed that there was no significant difference in mortality between the early and late initiation groups [odds ratio (OR) = 0.96, 95%confidence interval (95% CI: 0.86～1.08, P =0.49]. Late initiation reduced RRT dependence within 90 days (OR=1.57, 95% CI:1.13～2.19, P ＜0.05), and the risk of catheter related blood stream infection (CRBSI), RRT-associated hypotension, and hypophosphatemia. (CRBSI:OR=1.4495%, CI:1.06～1.95, P =0.02; Hypotension: OR=1.4395% CI:1.17～1.76, P ＜0.05; Hypophosphatemia: OR=1.85, 95% CI:1.02～3.35, P =0.04).  Conclusions  Early RRT initiation does not reduce mortality in patients with severe AKI, but late RRT initiation can reduce RRT dependence within 90 days and the risk of related complications.  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 2022, 21 (11):  801-807.  doi: 10.3969/j.issn.1671-4091.2022.11.004 Abstract ( 285 )   PDF (1065KB) ( 526 )   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. Metrics

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Correlation between serum irisin level and lumbar bone mineral density in maintenance hemodialysis patients ZHAO Dan-dan, DAI Zhong-fang, SUN Jia-yao, MIAO Han 2022, 21 (11):  808-812.  doi: 10.3969/j.issn.1671-4091.2022.11.005 Abstract ( 183 )   PDF (499KB) ( 153 )   bjective To investigate the relationship between serum irisin level and lumbar bone mineral density (BMD) in maintenance hemodialysis (MHD) patients.  Methods A total of 200 MHD patients hospitalized in The First People's Hospital of Lianyungang City from Jan 2019 to Dec 2021 were recruited as the subjects for cross-sectional study. Based on the T value of lumbar bone, patients were divided into normal bone mass group (t ≥-1, n=119), osteopenia group (-2.5＜t＜-1, n=53) and osteoporosis group (t ≤-2.5, n=28). Clinical data and laboratory indexes were compared among the three groups. Pearson or Spearman correlation was used to analyze the correlation between lumbar BMD (expressed as T value) and clinical and laboratory indicators. The influencing factors for lumbar BMD were analyzed by ordered logistic regression.  Results  The serum irisin levels were 4.88±1.03μg/L, 35.05±8.94μg/L and 62.15±18.44μg/L in osteoporosis group, osteopenia group and normal bone mass group respectively (F=14.036, P＜0.001). Lumbar BMD in MHD patients was positively correlated with body mass index (BMI), creatinine and serum irisin (r=0.329, 0.295 and 0.448 respectively; P=0.001, 0.005 and ＜0.001 respectively), and negatively correlated with female, age, urea clearance index (Kt/V), urea clearance rate and alkaline phosphatase (r=-0.422, -0.291, -0.266, -0.270 and -0.292 respectively; P＜0.001, P=0.007, 0.017, 0.014 and 0.007 respectively). Ordered logistic regression showed that serum irisin level was an influencing factor for lumbar BMD in MHD patients (OR=0.466, 95% CI:0.304～0.714, P＜0.001).  Conclusion There is a positive correlation between serum irisin level and lumbar BMD in MHD patients. Serum irisin level is an influencing factor for lumbar BMD in MHD patients. Metrics

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A multi-center clinical research on the occurrence and influencing factors of pruritus in maintenance hemodialysis patients BAO Hong-da, WANG Xiao-xia, ZHANG Li-ming, WANG Ying-deng, ZOU Jian-zhou, FU Peng, MA Jun, LI Jiang-tao, WANG Feng, ZHANG Ran, WANG Nian-song, JIANG Geng-ru 2022, 21 (11):  813-817,839.  doi: 10.3969/j.issn.1671-4091.2022.11.006 Abstract ( 370 )   PDF (471KB) ( 360 )   Objective To investigate the incidence, severity and risk factors of pruritus in maintenance hemodialysis (MHD) patients.  Methods  The MHD patients in the nephrology departments of eleven hospitals were enrolled in this study. Patient self-reported pruritus was assessed by the Visual Analog Scale (VAS). The observed indicators included current dialysis scheme, dialysis age, complications, medications, and laboratory tests relating to calcium and phosphorus metabolism.  Results  A total of 1,540 patients were investigated, with 78.7% reporting pruritus, of which 34.2% had moderate to severe pruritus; the overall mean pruritus VAS score was 2.85±2.52. Lower Kt/V (β=-0.562, 95% CI:-0.916～-0.207, P=0.002), use of calcimimetics (β=-1.094, 95% CI: -1.462～-0.725, P＜0.001), HD+HDF protocol (β=0.604, 95% CI:0.119～1.089, P=0.015), HD+HDF+HP protocol (β=0.967, 95% CI:0.453～1.481, P＜0.001), hemodialysis combined with peritoneal dialysis (β=0.989, 95% CI:0.078～1.900, P=0.033), use of calcitriol (β=0.564, 95% CI:0.250～0.877, P＜0.001), use of topical antipruritics (β=2.740, 95% CI:2.052～3.428, P＜0.001), anemia (β=0.575, 95% CI:0.245～0.905, P＜0.001), chronic kidney disease-mineral and bone disease (β=0.841, 95% CI:0.527～1.155, P＜0.001), and higher calcium-phosphorus product (β=1.898, 95% CI:0.645～3.152, P=0.003) were associated with higher risk of pruritus.  Conclusion The higher prevalence of pruritus in MHD patients is mainly associated with the abnormalities of calcium and phosphorus metabolism. Metrics

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Correlation analysis on the influencing factors for erythropoietin responsiveness in hemodialysis patients  YU Wei-hong, XIONG Hao, SONG Jie, YUAN Fang 2022, 21 (11):  818-822.  doi: 10.3969/j.issn.1671-4091.2022.11.007 Abstract ( 269 )   PDF (448KB) ( 212 )   Objective To investigate the influencing factors for erythropoietin responsiveness in hemodialysis patients.  Methods  Patients with regular hemodialysis in the Hemodialysis Purification Center, the Second Xiangya Hospital of Central South University from January 1st, 2021 to July 31st, 2021 were recruited. Their clinical data were collected. According to the quartile and third quartile of erythropoietin resistance index (ERI), patients were divided into groups for comparison. The influencing factors for erythropoietin responsiveness were analyzed by logistic regression. Patients were further divided into groups according to body mass index (BMI), and the parameters were compared between the groups. ROC curve was used to evaluate the parameters for the predictive performance of ERI.  Results  BMI and hemoglobin were higher (t=2.896 and 4.246, respectively; P=0.004 and＜0.001, respectively), while interleukin-6 (IL-6) and weekly doses of erythropoiesis-stimulating agents were lower (Z=-2.738 and -8.820, respectively; P=0.006 and ＜0.001, respectively) in the lower ERI group, as compare with those in the higher ERI group. Logistic regression showed that BMI (OR=0.844, 95% CI: 0.740～0.963, P=0.012) and IL-6 (OR=1.119, 95% CI:1.031～1.215, P=0.007) were the independent risk factors for erythropoietin responsiveness in maintenance hemodialysis patients. The working characteristic curve showed that BMI had the greatest guiding and assistant effects on prediction of ERI. Overweight patients had lower ERI and erythropoiesis-stimulating agent doses (K=15.015 and 16.937, respectively; P=0.001 and ＜0.001, respectively), as compared with those in the low and  the normal BMI groups.  Conclusions  BMI and IL-6 are the independent risk factors for erythropoietin responsiveness in maintenance hemodialysis patients. BMI may have guiding and assistant roles in the diagnosis and prediction of ERI. 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 2022, 21 (11):  823-826.  doi: 10.3969/j.issn.1671-4091.2022.11.008 Abstract ( 471 )   PDF (336KB) ( 581 )   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. 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 2022, 21 (11):  827-830.  doi: 10.3969/j.issn.1671-4091.2022.11.009 Abstract ( 1556 )   PDF (351KB) ( 726 )   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. Metrics

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Research advances in the gut-derived uremic toxins ZHANG Wen-ting, CAI Mei-shun 2022, 21 (11):  831-834.  doi: 10.3969/j.issn.1671-4091.2022.11.010 Abstract ( 336 )   PDF (365KB) ( 370 )   Gut-derived uremic toxins (GUTs) accelerate the progression of chronic kidney disease, leading to various complications and increased mortality in patients with end-stage renal disease (ESRD). GUTs are difficult to be removed directly by dialysis. Therapeutic strategies to clear GUTs include dietary modifications, flora modifications, oral adsorbents and improvement of hemodialysis modalities. Clearance of GUTs is critical for ESRD patients. This article reviews the research advances in GUTs and the related therapies. Metrics

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Research Progress of ferroptosis in Acute kidney Injury SHI Jing, GUO Zhao-an 2022, 21 (11):  835-839.  doi: 10.3969/j.issn.1671-4091.2022.11.011 Abstract ( 312 )   PDF (484KB) ( 329 )   Acute kidney injury (AKI) is a clinical syndrome characterized by rapid deterioration of kidney function within a short period of time. In severe cases, AKI may lead to kidney failure or even death. Ferroptosis is closely related to glutathione peroxidase 4, cystine-glutamate antiporter (cystine/glutamate antiporter, system Xc-), and lipid metabolism. Ferroptosis plays an important role in ischemia reperfusion injury, rhabdomyolysis, and folic acid and other injuries derived AKI. Therefore, inhibition of ferroptosis may be useful for the treatment of AKI. This article systematically summarizes the mechanism of ferroptosis involved in AKI, the drugs to intervene ferroptosis, and ferroptosis as a potential therapeutic target of AKI. Metrics

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Vascular access at the initiation of hemodialysis in end stage renal disease patients XU Li-hua, YU Shu, WU Qi-shun, CHENG Hui-dong, LI Jing, HE Jian-qiang 2022, 21 (11):  840-843.  doi: 10.3969/j.issn.1671-4091.2022.11.012 Abstract ( 239 )   PDF (412KB) ( 426 )   Objective To analyze vascular access methods at the initial hemodialysis (HD) in end stage renal disease (ESRD) patients, so as to provide the bases for continuous quality improvement of management before dialysis and for planning autologous arteriovenous fistula (AVF) pathway in chronic kidney disease (CKD) patients.  Methods  This was a single center retrospective study, involving 204 ESRD patients beginning to have hemodialysis in the Affiliated Hospital of Jiangsu University from January 2019 to December 2021. According to the initial vascular access method, they were divided into autologous arteriovenous fistula (AVF) group (n=42) and central venous catheter (CVC) group (n=162). General demographic data, primary disease and laboratory indexes were compared between the two groups. The influencing factors for the initial use of CVC were analyzed. Based on the primary disease, the patients were further divided into diabetic nephropathy (DN) group (n=82) and non-DN group (n=122); the cause of initiatial hemodialysis, vascular access method and laboratory indexes were compared between the two groups.  Results  Among the initial hemodialysis patients, the utilization rates of AVF and CVC were 20.59% and 79.41% respectively. The proportion of urban residents was significantly higher in AVF group than in CVC group (78.6% vs. 55.6%, c2=7.380, P=0.007). The proportions of workers with medical insurance and patients with better eGFR before dialysis were higher in AVF group than in CVC group (c2=3.999, P=0.046; Z=-2.017, P=0.044). Logistic regression showed that residence area, medical insurance type and DN were the influencing factors for the use of CVC at the beginning of hemodialysis (OR=0.341, 0.488 and 3.076 respectively; 95% CI:0.153～0.758, 0.239～0.994 and 1.525～6.206 respectively; P=0.008, 0.048 and 0.002 respectively). At the initial hemodialysis, the use of AVF was significantly higher in DN group than in non-DN group (c2=10.369, P=0.001). In DN group, plasma albumin level and calcium phosphorus product were lower (Z=-2.274, P=0.023; Z=-1.790, P=0.073), serum creatinine was significantly lower (Z=-3.524, P<0.001), and eGFR was significantly higher (Z=-3.919, P < 0.001), as compared with those in non-DN group.  Conclusion  CVC was the main vascular access method at the beginning of hemodialysis in our hemodialysis center in the recent 3 years. Residence place and primary disease were the main influencing factors for the use of CVC. Management of CKD patients and use of AVF for initial hemodialysis must be emphasized in our future practice. Metrics

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Epidemiological survey of autologous arteriovenous fistula aneurysm in maintenance hemodialysis patients in Hainan province in 2020 AN Na, CHEN Ru-man, LI Hong, BAI Ya-fei, ZENG Xin, WEN Gong-xiong, YAN Xiao-xian, WANG Chun-li, Hainan Provincial Collaborative Group for the Investigation of Hemodialysis Autologous Arteriovenous Fistula Aneurysm 2022, 21 (11):  844-849.  doi: 10.3969/j.issn.1671-4091.2022.11.013 Abstract ( 212 )   PDF (675KB) ( 147 )   Objectives  To investigate the prevalence of autologous arteriovenous fistula aneurysm (AVFA) and the related clinical symptoms in patients with maintenance hemodialysis (MHD) for ≥3 months in Hainan province in 2020.  Methods  A cross-sectional survey was conducted to investigate the renal primary disease, age, gender, dialysis vintage, AVFA type, maximum diameter and length of the AVFA, and cannulation method in MHD patients using autologous arteriovenous fistula as the vascular access in Hainan province in March 2020. The prevalence of AVFA and the risk factors for AVFA were then derived.  Results   ①The prevalence of AVFA in MHD patients in Hainan province was 41.2%, with the type II AVFA of 54.3% and type III AVFA of 35.1% in the AVFA patients. ②The prevalence of type I AVFA was not correlated with sex, age and AVF puncture method. Patients with hypertension as the primary kidney disease had 3.9 times higher risk of developing type I AVFA than the patients with other primary kidney diseases. The risk of developing type I AVFA increased with increasing dialysis vintage. ③The prevalence of type II AVFAs was not correlated with age and primary kidney disease. Patient with local puncture had the highest prevalence of type II AVFA, being 4.27 times higher than that of buttonhole puncture and 1.73 times higher than that of rope ladder puncture. The risk of developing type II AVFA increased with increasing dialysis vintage; the risk of developing type II AVFA was 1.39 times higher in patient with dialysis vintage of ≥4 years than in patients with dialysis vintage of one year. ④Type III AVFA was relatively complex. The prevalence of type III AVFA correlated with sex, dialysis vintage and AVF puncture method. The risk of developing type III AVFA was 2.55 times higher in patients with other primary kidney disease than in patients with the primary kidney disease of diabetic nephropathy. The risk of developing type III AVFA was 2.11 times higher in young adults than in older patients.  Conclusion  The prevalence of AVFA was 41.2% in MHD patients in Hainan province, with Valentini II and III as the dominant types. Avoiding local puncture can effectively delay the occurrence and development of Valentini II and III AVFAs. Metrics

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Effects of exercise on physical function in maintenance hemodialysis patients: a Meta-analysis CHEN Jing, LIU Yi-xiu, LUO Xi-ju, DENG Si-yan, HU Hua-gang 2022, 21 (11):  850-857.  doi: 10.3969/j.issn.1671-4091.2022.11.014 Abstract ( 158 )   PDF (1261KB) ( 209 )   Objective  To systematically evaluate the effect of exercise on physical function in maintenance hemodialysis (MHD) patients.  Methods   PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM were searched for randomized controlled trials (RCTs) about the effects of exercise on physical function in MHD patients from the inception to January 1, 2022. Meta-analysis was performed by RevMan 5.3.  Results  A total of 25 RCTs with 1478 participants were included. Meta-analysis showed that exercise significantly improved peak oxygen uptake (MD =2.923, 95% CI:1.763～4.083, Z=4.940, P＜0.001), 30s sit-to-stand (STS) (MD=3.005, 95% CI:1.403~4.607, Z=3.680, P＜0.001), 60s STS (MD=2.456, 95% CI:1.140～3.772, Z=3.660, P＜0.001), time up and go (MD=-1.061, 95%  CI:-2.009，-0.114, Z=2.200, P=0.030), and handgrip strength (MD=2.436, 95% CI:0.278～4.595, Z=2.210, P=0.030), but there was no significant improvement in 5 times STS (Z=0.660,P=0.510).  Conclusion  Exercise can improve peak oxygen uptake, 30s STS, 60s STS, time up and go, and handgrip strength in MHD  patients. In practice, we can combine the condition of dialysis centers and MHD patients, actively carry out different exercises, improve the physical function of patients. 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 2022, 21 (11):  858-861.  doi: 10.3969/j.issn.1671-4091.2022.11.015 Abstract ( 541 )   PDF (485KB) ( 574 )   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. Metrics

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A preliminary study on the quality control of chemical raw materials and excipients of concentrates for hemodialysis YE Xiao-yan, LUO Qing-feng, HUANG Min-ju, QU Ya-nan, HUANG Qi-yu 2022, 21 (11):  862-864.  doi: 10.3969/j.issn.1671-4091.2022.11.016 Abstract ( 189 )   PDF (383KB) ( 184 )   By comparing the related international standards, industry standards and pharmacopoeia of chemical raw materials and excipients of concentrates for hemodialysis, the quality control requirements of chemical raw materials and excipients for hemodialysis concentrates were studied according to the current regulations and policies. At the same time, the additional requirements of raw materials and excipients for hemodialysis were described, for reference of the professionals in related fields. Metrics