Chinese Journal of Blood Purification

12 February 2025, Volume 24 Issue 02 Previous Issue    Next Issue

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Chinese expert consensus on hemodialysis arteriovenous graft nursing（1st edition） Chinese Expert Consensus working group on Hemodialysis Arteriovenous Graft 2025, 24 (02):  89-107.  doi: 10.3969/j.issn.1671-4091.2025.02.001 Abstract ( 229 )   The application of arteriovenous graft in hemodialysis treatment is becoming more and more common. Clinical nursing staff have an urgent need for specialized nursing standard operation and management of arteriovenous graft. With reference to domestic and foreign literature, combined with practical experience in clinical application, we developed the 'Chinese. Expert Consensus on Hemodialysis Arteriovenous Graft Nursing' from eight dimensions: establishment of arteriovenous graft, perioperative nursing and follow-up monitoring, puncture preparation, safe puncture, puncture complications, monitoring reports, reports of nursing events, and patient education, This consensus is the first expert consensus to guide the nursing operation and management of hemodialysis arteriovenous graft in China. Metrics

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Correlation between first dialysis serum albumin level and prognosis in maintenance hemodialysis patients MA Rong, MAO Nan, XIAO Xiang, XIE Chun-peng, FENG Ya 2025, 24 (02):  108-112.  doi: 10.3969/j.issn.1671-4091.2025.02.002 Abstract ( 140 )   Objective  This study aimed to explore the clinical characteristics of first dialysis serum albumin (ALB) level in patients with maintenance hemodialysis (MHD) and its influence on prognosis, and to analyze the value in predicting all-cause death in patients with MHD.  Methods  A retrospective analysis was performed in the Blood Purification Center from January 20009 to October 2022, and 1000 patients with MHD were finally included. The demographic and clinical characteristics of the patients were collected. The study endpoint was all-cause death. The optimal cut-off point of ALB is obtained by using R software. The patients were divided into groups (high ALB group and low ALB group) according to the ALB cut-off value. The clinical characteristics of patients with different ALB levels and the correlation between ALB and clinical indicators were analyzed, and the influence of ALB on the prognosis of MHD patients was evaluated. Results ALB and hemoglobin (r=0.176, P<0.001), Kt/V (r=0.217, P<0.001), URR (r=0.192, P<0.001), blood creatinine (r=0.259, P<0.001), blood calcium (r=0.225, P<0.001), blood phosphorus (r=0.225, P<0.001), PTH (r=0.196, P<0.001) are positively correlated, and negatively correlated with age (r=-0.147, P=0.001), C-reactive protein (r=-0.279, P<0.001), and glucose (r=-0.145, P<0.001). During the follow-up period, 164 patients (16.40%) died, age (HR=1.022, 95% CI: 1.010～1.034, P<0.001, PTH (HR=0.999, 95% CI: 0.998～1.000, P=0.046), urea clearance index, urea reduction rate, and ALB level is an independent predictor of mortality in MHD patients (HR=0.940, 95% CI: 0.904～0.977, P=0.002). Conclusion Low ALB level on first dialysis is an independent risk factor of all-cause death in MHD patients. MHD patients with ALB level above 39.8g/L on first dialysis have a better prognosis. Clinicians should pay attention to the ALB level of MHD patients on first dialysis. The higher the ALB level of MHD patients on first dialysis, the lower the risk of all-cause death. Metrics

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Relationship between serum liver kinase B1 and abdominal aortic calcification in peritoneal dialysis patients TENG Jian, HU Yan-qiu, WAN Mei-yan 2025, 24 (02):  113-117.  doi: 10.3969/j.issn.1671-4091.2025.02.003 Abstract ( 81 )   Objective  To explore the relationship between serum liver kinase B1 (LKB1) level and vascular calcification in peritoneal dialysis (PD) patients.  Methods  A total of 78 patients (≥ 3 month) who were treated with PD in the Department of Nephrology of Qingdao Municipal Hospital from September 2022 to September 2023 were included in the study. Collect the clinical data and laboratory indicators of Finalists; ELISA was used to detect the serum LKB1 level; the degree of vascular calcification and the abdominal aortic calcification score (ACCs) was evaluated by abdominal lateral X-ray plain film. Spearman correlation analysis and multiple linear regression analysis of influencing factors of serum LKB1 level in patients with PD; the influencing factors for serum LKB1 level were evaluated by Spearman correlation analysis and multivariate linear regression, and the influencing factors for abdominal aortic calcification score (AAC) in PD patients were assessed by Logistic regression. Results  Serum LKB1 level was lower in the PD patients than in the healthy controls (Z=-4.393，P<0.001). LKB1 level was negatively correlated with age, dialysis age, PTH, triglyceride and AACs (r=-0.262，-0.227，-0.293，-0.259，-0.611; P=0.021，0.046，0.009，0.022，＜0.001). Multivariate linear regression showed that PTH and AACs were the independent influencing factors for serum LKB1 level (β=-0.208, -0.519; P=0.042，＜0.001). Logistic regression analysis demonstrated that high serum LKB1 level was an independent protective factor for AAC in PD patients (OR,95% CI：0.961 (0.936, 0.986), P=0.003). ROC-AUC of serum LKB1 for moderate to severe AAC was 0.812 (95% CI：0.719～0.905, P＜0.001), cut-off value 115.68ng/L, sensitivity 0.622, and specificity 0.854, the Yoden index is 0.476. Conclusions  Serum LKB1 level in PD patients is lower than that in healthy people, and was associated with the AAC. Metrics

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Expression and clinical significance of platelet parameters and NLR ratio in diabetic nephropathy patients under peritoneal dialysis LIU Yi-rong, TIAN De-kuan, WANG Ting-ting, FENG Ping 2025, 24 (02):  118-121.  doi: 10.3969/j.issn.1671-4091.2025.02.004 Abstract ( 65 )   Objective  To investigate the expression and clinical significance of platelet parameters and neutrophil-to-lymphocyte ratio (NLR) in diabetic nephropathy (DN) patients under peritoneal dialysis (PD). Methods  A retrospective analysis was conducted on 83 DN patients who underwent PD treatment in our hospital from February 2020 to June 2022. The patients' general information and laboratory indicators after admission were collected, and the patients were divided into survival group and death groups according to their survival outcomes within 2 years. The receiver operating curve (ROC) was used to analyze the predictive value of platelet-related parameters and NLR on the prognosis of PD in patients with DN, and multivariate logistic regression was used to analyze the influencing factors of patient death.  Results  Compared with the death group, the mean platelet volume (MPV), platelet distribution width (PDW), platelet count (PLT), NLR, and blood urea nitrogen (BUN) and serum creatinine (Scr) were lower in the survival group (t=6.071, 5.093, 3.730, 3.604, 19.166, 23.365, P<0.001, <0.001, <0.001, <0.001, <0.001, <0.001). Multivariate logistic regression analysis pointed out that high levels of PLT (OR=1.879, 95% CI:1.355～2.607, P＜0.001), MPV (OR=2.063, 95% CI:1.504～2.828, P＜0.001), PDW (OR=1.998, 95% CI:1.449～2.755, P＜0.001), NLR (OR=1.828, 95% CI:1.282～2.606, P=0.001), Scr (OR=2.924, 95% CI:1.712～4.993, P＜0.001), BUN (OR=2.746, 95% CI:1.653～4.561, P＜0.001) are risk factors for death after PD in DN patients. ROC curve analysis suggested PLT (AUC=0.714, P=0.007), MPV (AUC=0.788, P＜0.001), PDW (AUC=0.750, P=0.002), and NLR (AUC=0.741, P=0.002) as predictors of the outcome of DN patients. The sensitivity and specificity (AUC=0.838, P＜0.001) were 89.4% and 88.2%, respectively.  Conclusion  MPV, PDW, PLT, NLR, Scr, and BUN levels were the contributing factors for death after PD in DN patients. The expression levels of MPV, PDW, PLT and NLR can effectively predict the survival of DN patients treated with PD, and the combined prediction efficacy is higher. Metrics

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Investigation of recurrent catheter-associated bloodstream infections in hemodialysis patients caused by Bacillus cereus YAO Yan-lan, YANG Qian, LUO Min, ZHU Xing-hua, YE Dan, HUANG Yan-chun 2025, 24 (02):  122-126.  doi: 10.3969/j.issn.1671-4091.2025.02.005 Abstract ( 65 )   Objective To investigate the causes of recurrent bloodstream infections by Bacillus cereus in maintenance hemodialysis patients in the First People's Hospital of Longquanyi District Chengdu, and to explore the biofilm-forming ability of the isolates and the importance of preventing nosocomial infection.  Methods A total of 15 strains of Bacillus cereus including 11 clinical and 4 environmental strains were collected. Bacterial identification, antimicrobial susceptibility test and biofilm formation experiments were conducted. Three clinical strains selected at the clinical stage of different antibiotic therapies and 3 environmental strains were subjected to phylogenetic analysis and biofilm formation-associated genes detection.  Results All the 15 strains were identified as Bacillus cereus by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility test showed that all of the clinical strains (11/11, 100%) were sensitive to levofloxacin, meropenem, erythromycin, rifampicin, tetracycline and vancomycin and resistant to penicillin, 63.6% (7/11) were resistant to cotrimoxazole, and 72.7% (8/11) were intermediately resistant to clindamycin. Three of the clinical strains phylogenetically resemble the strains isolated from hands of the staff working in the blood purification room, and carried 7 biofilm-forming genes, including calY, cdgD, cdgF, sinl, sinR, spoOA and tasA. Biofilm-forming ability was found in 9 (81.8%) of the 11 clinical strains, and this ability could be transiently inhibited in the presence of moxifloxacin or vancomycin.  Conclusions Bacillus cereus can cause catheter-associated bloodstream infection in hemodialysis patients. The formation of biofilm causes the difficulties to eradicate the infection. Hand hygiene should be emphasized to avoid nosocomial infection. Metrics

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The predictive value of total bilirubin to albumin ratio for cardiovascular disease mortality in peritoneal dialysis patients with diabetes mellitus WANG Huan, WANG Hong-feng, SUN Hao-yue, JIN Yan-hua, ZHANG De-wei, ZHANG Yan-ning 2025, 24 (02):  127-131.  doi: 10.3969/j.issn.1671-4091.2025.02.006 Abstract ( 65 )   Objective  To explore the predictive value of total bilirubin to albumin ratio (TBAR) on cardiovascular disease morality in peritoneal dialysis (PD) patients with diabetes mellitus.  Methods  This study was a single center and retrospective study aiming to analyze the clinical data of diabetes mellitus patients undergoing PD catheterization in the Northern Theater Command General Hospital from January 2013 to September 2021. The restricted cubic spline (RCS) was used to determine the cutoff value of TBAR. Patients were divided into low TBAR and high TBAR groups according to the cutoff value of TBAR. Kaplan-Meier method was used to compare the overall survival rate, and multivariate Cox regression proportional hazards model was used to analyze the risk factors affecting the cardiovascular disease mortality.  Results  A total of 203 PD patients with diabetes mellitus were included in this study. RCS showed that the cutoff value of TBAR predicting cardiovascular disease morality was 0.142. The study subjects were then divided into low TBAR group (n=103) and high TBAR group (n=100). The high TBAR group had higher calcium (Z=-1.996, P=0.046) and total bilirubin (Z=-11.202, P＜0.001), and lower serum creatinine (Z=-2.015, P=0.044), phosphorus (Z=-3.525, P＜0.001) and platelet (t=2.924, P=0.004) as compared with those in the low TBAR group. Kaplan-Meier analysis showed that the survival rate was 12.60% in the high TBAR group and was 75.20% in the low TBAR group (Log rank, χ2=8.616, P=0.003). After adjusting for confounding factors, multivariate cox regression analysis showed that TBAR (HR=2.131, 95% CI：1.102～4.121, P=0.025), body mass index (HR=0.859, 95% CI：0.781～0.944, P=0.002), and serum creatinine (HR=0.998, 95% CI：0.7996～1.000, P=0.017) were the risk factors for cardiovascular disease morality in PD patients with diabetes mellitus.  Conclusion TBAR can be used as a simple indicator to evaluate prognosis of the patients. TBAR higher than 0.142 is an independent risk factor for cardiovascular disease morality in PD patients with diabetes mellitus. Metrics

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Clinical characteristics and prognosis of the hemodialysis patients with end-stage kidney disease and cardiorenal anemia syndrome ZHU Meng-yue, LU Chun-lei, LIU Min, HE Da-feng, BI Guang-yu, WANG Rong 2025, 24 (02):  132-136.  doi: 10.3969/j.issn.1671-4091.2025.02.007 Abstract ( 90 )   Objective  To investigate clinical characteristics and prognosis of the end-stage kidney disease (ESKD) patients undergoing hemodialysis and complicated with cardiorenal anemia syndrome (CRAS).  Methods This was a retrospective cohort study. We recruited the baseline demographic and clinical data of the ESKD patients undergoing hemodialysis patients and complicated with CRAS admitted to the Hospital from August 2012 to August 2021. According to the left ventricular ejection fraction (LVEF) at baseline, they were divided into LVEF ≤40% group,  LVEF ≥41% ～≤49% group, and LVEF ≥50% group. The baseline data were compared among the three groups. They were followed up until July 31, 2022 or death. Cox regression model was used to analyze the risk factors for all-cause mortality of the patients. The relationship between LVEF and all-cause mortality risk was analyzed by generalized additive model smoothing curve fitting and multivariate Cox regression model.  Results  A total of 386 ESKD hemodialysis patients with CRAS were included in this study, with a median age of 58 (46，70) years old and 252 males (65.28%). During the follow-up interval [median 32(17，52) months], 164 patients (42.49%) died. Multivariate Cox regression showed that age (HR=1.049, 95% CI: 1.033～1.064, P＜0.001), dialysis age (HR=1.007, 95% CI: 1.002～1.011, P=0.004), cerebral infarction (HR=1.748, 95% CI:1.087～2.812, P=0.021), New York Heart Association (NYHA) heart functional grade (HR=1.455, 95% CI: 1.045～2.024, P=0.026), and LVEF (HR=0.695, 95% CI: 0.579～0.836, P=0.001) were the independent predictors for all-cause mortality in ESKD hemodialysis patients with CRAS. Generalized additive model smoothing curve fitting model showed that LVEF level was linearly correlated with the mortality risk trend of the patients (log-likelihood ratio test, P=0.043).  Conclusions  LVEF is an independent protective factor for mortality risk in ESKD hemodialysis patients with CRAS. Early diagnosis and management of lower LVEF is therefore essential to prognosis of these patients. Metrics

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Visualization analysis of the research hotspot and development trend in home hemodialysis in the past decade ZHU Lu, HE Zhu, FU Yan-ru, LIU Qi, LUO Xiao-yun, XIE Ting 2025, 24 (02):  137-141.  doi: 10.3969/j.issn.1671-4091.2025.02.008 Abstract ( 87 )   Objective  To explore the research hotspot and development trend in home hemodialysis, and to provide references for the promotion and optimization of related research in China.  Methods  The literature related to home hemodialysis in the Web of Science core collection was searched, and CiteSpace 6.3 R1 software was used to visualized analyze the countries, institutions, authors, keywords, etc.  Results  A total of 315 articles were included in the English literature, involving 924 authors from 39 countries. In the past 10 years, home hemodialysis has shown a trend of fluctuation growth, mainly concentrated in developed countries such as Canada and United States. The research hotspots included patient safety, survival outcome, and barrier factors.  Conclusion  The research on home hemodialysis is currently in the processes of continuous exploration, improvement and maturation. For the promotion of home hemodialysis in China, a framework system must be established based on the demand of our dialysis patients and the advanced program of home hemodialysis in foreign countries.  Metrics

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Clinical application of urgent start peritoneal dialysis DONG Shan-shan, YANG Huan, YANG Chun-rui, LI Ting, BAI Yi-hua, HE Zhen-kun 2025, 24 (02):  142-144.  doi: 10.3969/j.issn.1671-4091.2025.02.009 Abstract ( 80 )   Peritoneal dialysis (PD) is an important modality of renal replacement therapy for renal insufficiency either as a routine treatment in conventional settings or as an urgent and initial treatment after a natural disaster. Urgent start peritoneal dialysis (USPD) is defined as the initiation of PD within 2 weeks after PD tube placement. Most studies have shown that the safety and efficacy of USPD is comparable to those of planned start PD and hemodialysis, and that it is an effective, safe and cost-effective renal replacement method with a prospect of broad applications. Metrics

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Research progress in tertiary hyperparathyroidism WANG Xiu-chuan, WANG Zhao-jun 2025, 24 (02):  145-148.  doi: 10.3969/j.issn.1671-4091.2025.02.010 Abstract ( 61 )   Tertiary hyperparathyroidism (THPT) develops on the basis of long-standing secondary hyperparathyroidism (SHPT), characterized by autonomous secretion of parathyroid hormone (PTH) and elevated serum calcium level, and typically happens after kidney transplantation. THPT can lead to the risks of bone fracture and coronary artery calcification, and is an important factor affecting the recipients of renal transplantation. Surgery is the preferable treatment for THPT. However, some patients lose the optimal period of surgical treatment due to delayed diagnose of THPT. This article reviews recent advances in pathogenesis, clinical manifestations, imaging characteristics, diagnosis, and treatment of THPT in order to improve our knowledge about THPT. Metrics

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Advances in the application of artificial intelligence for management of arteriovenous fistula in maintenance hemodialysis patients YAO Shi-yan, SHEN Hua-juan, DONG Yong-ze, JIA Yan-qing, ZHAO Meng-jiao 2025, 24 (02):  149-152.  doi: 10.3969/j.issn.1671-4091.2025.02.011 Abstract ( 134 )   End-stage renal disease has become one of the important public health problems due to its long-term and incurable nature. Maintenance hemodialysis is the most effective renal replacement therapy for patients with end-stage renal disease, and arteriovenous fistula (AVF) is the frequently used blood access for hemodialysis. However, maturation of newly established AVF and maintenance of AVF patency are two critical obstacles required to be solved. Recently, artificial intelligence (AI) has been successfully used in the field of dialysis. AI provides a novel alternative for the management of AVF. This article reviews recent advances in the application of AI for management of AVF dealing with six aspects: decision-making of AVF site, postoperative maturity prediction, functional monitoring, acoustic feature monitoring, thrombosis and stenosis prediction, and aneurysm grading, aiming to provide references for the application of AI for management of AVF in maintenance hemodialysis patients. Metrics

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Research progress in local perivascular treatment methods for inhibiting intimal hyperplasia in arteriovenous fistula RONG Dan, WANG Tao-xia, YE Tao, LI Gui-ying 2025, 24 (02):  153-156.  doi: 10.3969/j.issn.1671-4091.2025.02.012 Abstract ( 75 )   Arteriovenous fistula (AVF) is the preferable modality of blood access for hemodialysis. However, AVF dysfunction is the main cause that limits its clinical use, in spite of the fact that perioperative management, surgical technology and prevention of primary AVF dysfunction have been greatly improved. The culprit of AVF dysfunction is neointimal hyperplasia, which is resulted from the comprehensive effects of inflammation, hypoxia and hemodynamic changes. Local treatment to provide structural and functional support for AVF and to deliver high dose of drugs directly to AVF site can be used to promote AVF maturation and to reduce the potential side effects from systemic drug therapies. This article reviews a series of local vascular treatment methods, offering new perspectives of therapies targeting AVF dysfunction. Metrics

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Effect of functional end-to-side anastomosis with radial artery superficial displacement on the maturation of radiocephalic arteriovenous fistula in distal forearm ZHUGE Xiang-di, JIAO Zi-zhao, AN Chuan-guo, LI Feng-lou, CHEN Chao-jin, DI Peng-fei, FU Hai-xia, FAN Qing 2025, 24 (02):  157-161.  doi: 10.3969/j.issn.1671-4091.2025.02.013 Abstract ( 83 )   Objective  To observe the effect of functional end-to-side anastomosis with radial artery superficial displacement (FETSRAS) on the maturation of radiocephalic arteriovenous fistula (RC-AVF) in the distal forearm.  Method  Patients undergoing the first RC-AVF creation in distal forearm at the Department of Blood Purification, the People’s Hospital of Rizhao from March 2020 to June 2022 were selected as the study subjects. They were divided into the conventional end-to-side anastomosis (CETS) group and FETSRAS group, according to the method of RC-AVF creation. During the 12 weeks of postoperative follow-up, clinical vascular examination and fistula’s pump controlled blood flow were used to evaluate the clinical fistula maturation status, and color Doppler angiography was used to evaluate the image fistula maturation status.  Result  A total of 121 patients subjected to distal forearm RC-AVF surgery were enrolled in this study, including 64 cases in CETS group and 57 cases in FETSRAS group. After the creation of fistula for 6 and 12 weeks, the clinical fistula maturation rates were 80.7% and 89.5% respectively in FETSRAS group, higher than those of 64.1% and 73.4% respectively in CETS group (χ2=4.132 and 5.036 respectively, P=0.042 and 0.025 respectively); the image fistula maturation rates were 86.0% and 93.0% respectively in FETSRAS group, higher those of 67.2% and 75.0% respectively in CETS group (χ2=5.833 and 7.066 respectively, P=0.016 and 0.008 respectively). The fistula was used for the first time after 36.6±10.5 days in FETSRAS group, shorter than that after 43.3±13.1 days in CETS group (t=2.800, P=0.006). Variance analysis of repeated measurement data showed that radial artery diameter, cephalic vein diameter and natural blood flow in fistula were higher in FETSRAS group than in CETS group in the postoperative observation period of 12 weeks (F=5.356, 7.356 and 9.154 respectively; P=0.022, 0.008 and 0.003 respectively).  Conclusion  Functional end-to-side anastomosis with radial artery superficial displacement to create the RC-AVF in the distal forearm obtains a shorter fistula maturation period and a higher fistula maturation rate as compared with those using conventional end-to-side anastomosis. Metrics

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Survey of initial dialysis vascular access types and procedural burden in hemodialysis patients WANG Ying, HU Rong-rong, LIU Li-fen, HU Yan, CHEN Zhi-chun, LIU Bing-yan 2025, 24 (02):  162-165,171.  doi: 10.3969/j.issn.1671-4091.2025.02.014 Abstract ( 79 )   Objective  To investigate the types of vascular access used at the start of dialysis and the procedural burden in hemodialysis patients.  Methods This study included end-stage renal disease (ESRD) patients on dialysis who scheduled appointments online at the vascular access center of Peking Union Medical College Hospital from March 2018 to February 2024. Demographic data, cause of ESRD, dialysis history, and vascular access history were collected retrospectively through questionnaires. Data were analyzed using SPSS software.  Results  Of the 420 patients, there were 239 males (56.9%), with an average age of 54.7±14.8 years and median dialysis vintage (DV) of 17.0 (2.5, 58.0) months. The initial dialysis access types were non-cuffed catheters (66.0%), tunnel-cuffed catheters (10.7%), arteriovenous fistula/graft (22.6%), and straight percutaneous access (0.7%). The presence of congestive heart failure (OR=0.337, 95% CI: 0.137～0.825, P=0.017), the time interval between diagnosis of kidney disease and initial dialysis (OR=1.003, 95% CI: 1.000～1.007, P=0.032), and the time interval between discovery of renal insufficiency and initial dialysis (OR=1.006, 95% CI: 1.000～1.012, P=0.037) were found to affect initial dialysis access type. The first time of arteriovenous access placement was as follows: 4.2 % at least 12 months before dialysis, 22.5% within 2～12 months before dialysis initiation, 50.0% within 2 months before and one month after dialysis initiation, and 23.3% after one month of dialysis initiation. The procedural burden for maintenance dialysis patients decreased gradually with the prolongation of DV: 3.0/person-year for DV ≥3 months to ＜12 months, 1.5/person-year for DV ≥12 months to ＜24 months, 0.7/person-year for DV ≥24 months to ＜60 months, and 0.4/person-year for DV≥60 months. The procedural burden for maintenance dialysis patients according to arteriovenous access group vs. non-arteriovenous access group was as follows: 2.0/person-year vs. 3.3/person-year (Z=2.491, P=0.013) for DV ≥3 months to ＜12 months; 0.7/person-year vs. 1.8/person-year (Z=3.248, P=0.001) for DV ≥12 months to ＜24 months; 0.3/person-year vs. 0.8/person-year (Z=3.478, P＜0.001) for DV ≥24 months to ＜60 months; and 0.3 procedures/person-year vs. 0.4 procedures/person-year (Z=1.432, P=0.152) for DV ≥60 months.  Conclusion  The placement of arteriovenous access in most hemodialysis patients is often delayed. The procedural burden of dialysis access is highest at the early stages of dialysis initiation. Timely establishing functional arteriovenous access before dialysis can help reduce the risk of central venous catheter placement and subsequent procedural burden in hemodialysis patients. Metrics

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Research progress on the intervention of dietary adherence behavior in maintenance dialysis patients: based on the CALO-RE taxonomy CAO Jun-jun, TAO Xing-juan 2025, 24 (02):  166-171.  doi: 10.3969/j.issn.1671-4091.2025.02.015 Abstract ( 91 )   Objective To analyze the intervention strategies of dietary adherence behavior in maintenance dialysis patients.  Methods Pubmed, Embase, Web of Science, CNKI, CBM, Wanfang and other databases were searched for randomized controlled studies on the intervention of dietary adherence behavior in maintenance dialysis patients. The intervention strategies were uniformly coded by using the CALO-RE taxonomy.  Results  A total of 13 articles were included, covering 26 behavior change techniques, mainly including “provide information on consequences of behavior in general” (76.9%), “provide information on consequences of behavior to the individual” (53.8%), “prompt self-monitoring of behavior” (46.2%), “provide instruction on how to perform the behavior” (38.5%), and “plan social support/social change” (38.5%). A total of 9 articles used more than 3 interventions, and 4 articles used 1 to 3 intervention strategies.  Conclusion The intervention of dietary adherence behavior in maintenance dialysis patients belongs to the complex intervention modes, and the intervention strategies can be combined variously. The assessment tools and intervention strategies for dietary adherence behavior also vary greatly. The opportunities coexist with challenges in prospect of remote dietary adherence behavior intervention. The strategies of dietary adherence behavior intervention need to be further ameliorated to form a comprehensive strategy with simple, cost-effective, and efficient characteristics. Metrics

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Analysis of potential classes and influencing factors for sleep quality in maintenance hemodialysis patients MA Rong-rong, DENG Si-yan, ZHAO Juan, ZHENG Jing, CHEN Chen, HU Hua-gang, CHEN Dong-ying 2025, 24 (02):  172-176.  doi: 10.3969/j.issn.1671-4091.2025.02.016 Abstract ( 104 )   Objective To explore the potential categories and influencing factors for sleep quality in maintenance hemodialysis (MHD) patients.  Methods  A total of 480 MHD patients were recruited from hemodialysis center of The Central Hospital Affiliated to Jiangnan University and other 3 hospitals by convenient sampling method. General information questionnaire, Pittsburgh Sleep Quality Scale (PSQI), Patient Health Questionnaire, and Generalized Anxiety Scale were used for the investigation.  Results  The prevalence of sleep disorders in MHD patients was 50.7%. By selecting the optimal model, sleep quality could be classified into four potential categories: overall better sleep group (C1, 22.8%), typical insomnia group (C2, 14.2%), daytime dysfunction with nocturnal sleep disorder group (C3, 28.4%), and overall worse sleep group (C4, 34.6%). Logistic regression analysis showed that the influencing factors for sleep disorders in C4 group included age (OR=1.028, 95% CI: 1.005～1.052, P=0.015), depression (OR=16.097, 95% CI: 6.397～40.503, P＜0.001) and anxiety (OR=3.511, 95% CI: 1.038～11.873, P=0.043), when C1 group was used as the reference group; the influencing factors for sleep disorders in C4 group included depression (OR=13.683, 95% CI: 5.072～36.917, P＜0.001) and dialysis age (OR=6.983, 95% CI: 1.510～32.284, P=0.013), when C2 group was used as the reference group.  Conclusion The sleep quality is heterogeneous in MHD patients. Clinical healthcare professionals should focus on the sleep status and intervene the sleep disorders in MHD patients especially in those with older age, having dialysis age more than 10 years, and complicated with  depression and anxiety. Metrics