Chinese Journal of Blood Purification

12 March 2025, Volume 24 Issue 03 Previous Issue    Next Issue

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Interpretation of hemoadsorption to clear myoglobin: consensus report of HRTF ZHOU Xiao-chun, YANG Ying-ying, ZHANG Ling, FU Ping 2025, 24 (03):  177-180.  doi: 10.3969/j.issn.1671-4091.2025.03.001 Abstract ( 65 )   Rhabdomyolysis (RM) is a syndrome in which multiple factors lead to the entry of myoglobin (MB) and creatine kinase (CK) into the circulation after necrosis of muscle tissue. Accumulation of these substances in the body can lead to serious complications, especially acute kidney injury (AKI). Hemoadsorption (HA) has been shown to be effective in removing MB from circulation. In 2024, the consensus of the hemoadsorption in rhabdomyolysis task force (HRTF), composed of international expert groups from six European countries, has formulated a global consensus on removing MB by HA (hereinafter referred to as consensus). This article interprets the key points of the consensus for the reference of domestic counterparts. Metrics

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Correlation study of TyG, CRP/ALB and coronary artery calcification in patients with end-stage renal disease undergoing dialysis CAO Qian-ying, YANG Fan, LIU Xiao-Jing, LI Zhong-xin 2025, 24 (03):  181-184,192.  doi: 10.3969/j.issn.1671-4091.2025.03.002 Abstract ( 53 )   Objective  To investigate the relationship between Triglyceride glucose (TyG), C-reactive protein to albumin ratio (CRP/ALB) and coronary artery calcification in patients with end-stage renal disease (ESRD) who were going to start dialysis treatment.  Methods  Patients with ESRD who were admitted to the Department of Nephrology of our hospital from January 2020 to December 2023 to undergo dialysis were selected as the study objects. The patients were divided into calcification group and non-calcification group according to the coronary score. Logistic regression was used to analyze the risk factors of coronary artery calcification in ESRD patients. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TyG, CRP/ALB and their combined detection in baseline coronary artery calcification in dialysis patients by area under ROC curve (AUC). Results  ①Among the 303 patients included in the study, 182 had vascular calcification (60.06%). The average age of the patients was 61.2 years, with 181 males (59.74%), and 199 patients (65.68%) combined with diabetes. 276 patients (91.09%) had hypertension, and 145 patients (47.85%) were smokers. There were statistically significant differences in age and the proportion of patients with diabetes between the two groups (P＜0.05). ② Comparison of laboratory examination indexes between the two groups: TyG (Z=-4.908, P＜0.001) and CRP/ALB (Z=-5.559, P＜0.001) in the calcification group were higher than those in the non-calcification group. ③Multivariate Logistic regression analysis showed that: The age of the patients with ESRD (OR =1.030, 95% CI：1.006～1.054, P=0.015), diabetes (OR=1.747, 95% CI：1.039～2.938, P=0.035), TyG (OR =1.123, 95% CI：1.046～1.207, P=0.001) and CRP/ALB ratio (OR=2.307, 95% CI：1.475～3.609, P＜0.001) were independent risk factors for coronary calcification in ESRD patients. ④ROC curve analysis results showed that the sensitivity of serum TyG, CRP/ALB and their combination for the diagnosis of coronary artery calcification in ESRD patients undergoing hemodialysis were 0.731, 0.692 and 0.896, and the specificity was 0.570, 0.628 and 0.446, respectively. The AUC was 0.666, 0.688 and 0.724, and the Jorden index was 0.301, 0.320 and 0.342, respectively. Conclusion: Serum TyG and CRP/ALB in ESRD patients undergoing dialysis are independent risk factors for coronary calcification, and serum TyG, CRP/ALB and their combined detection have high diagnostic efficacy in patients with coronary calcification. Metrics

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Analysis of risk factors for all-cause mortality in elderly hemodialysis patients JIA Wan-ning, HE Wen-wen, DONG Wan, FAN Xue-ting, CHEN Zhuo-zhuo, LI Jing 2025, 24 (03):  185-188,230.  doi: 10.3969/j.issn.1671-4091.2025.03.003 Abstract ( 78 )   Objectibve  To explore the risk factors of death in elderly patients with maintenance hemodialysis (MHD), and to provide reference for improving the prognosis of dialysis patients and reducing mortality.  Methods   The related data of elderly MHD patients (aged ≥ 80 years) in multiple centers were collected and retrospectively analyzed, and they were divided into death group and control group. Univariate analysis and logistic regression model were used to analyze the risk factors of death. RESULTS: a total of 112 elderly patients with MHD were included, including 26 deaths (23.214%). The first cause of death was cardiovascular events in 9 cases (34.615%). The type of vascular access (χ2= 4.825, P=0.028), primary disease (F =24.243, P=0.004), white blood cell count (t =-4.869, P＜0.001), lymphocyte count (t=3.400, P＜0.001), eosinophil count (t =2.895, P=0.005), albumin (t=3.089, P=00.003), prealbumin (t=3.247, P=0.002), total cholesterol (t = 2.037, P=0.044), cholinesterase (t=2.595, P=0.011) was statistically different between the two groups. Multivariate logistic regression analysis showed that diabetic nephropathy(OR=67.196,95% CI:5.034～896.973, P=0.001), hypertensive nephropathy (OR=15.577, 95% CI:1.765～137.477, P=0.013), high-level white blood cell count (OR=1.661, 95% CI:1.117～2.469, P=0.012) were independent risk factors for death in elderly patients with MHD. The high level of lymphocytes in the normal range (＞3.556×1012/L)(OR=0.120, 95% CI: 0.014～0.986, P=0.049) was the protective factor of death in elderly patients with MHD.  Conclusion  In this study, the main cause of death in elderly patients with MHD is cardiovascular events. Diabetes nephropathy, hypertensive nephropathy, high level of white blood cell count and lymphocyte level are independent related factors of death in elderly MHD patients. Metrics

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Application of HA380 combined with CVVHDF technology in organ maintenance of septic shock donors LIU Jin-quan, WANG Shu-xian, FENG Shuai, XU Chuan-shen 2025, 24 (03):  189-192.  doi: 10.3969/j.issn.1671-4091.2025.03.004 Abstract ( 65 )   Objective   To explore the maintenance effect of HA380 hemoperfusion combined with continuous veno-venous hemodiafiltration (CVVHDF) on liver function of septic shock donors, in order to improve the utilization rate of liver of septic shock donors. Methods  The clinical data of 33 septic shock donors who successfully donated organs in our hospital from November 2020 to November 2022 were retrospectively analyzed. All of them received HA380 combined with CVVHDF for organ function maintenance treatment, and the changes of inflammatory reaction and liver function indexes of septic shock donors before and after treatment were observed. Results  Compared with before treatment, the levels of white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin -6 (IL-6) and total bilirubin (TB) of septic shock donors decreased after treatment (t=12.462, 6.252, 6.995, 3.305, 6.360, P＜0.001). There was no significant difference in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among donors with septic shock before and after treatment (t=0.035,0.930, P=0.972, 0.356).  Conclusion  HA380 combined with CVVHDF technology is effective in organ maintenance of septic shock donors, which can reduce inflammatory reaction, improve the quality of donor liver and organ function, and improve the organ utilization rate of donors to some extent. Metrics

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A study on the correlation between serum magnesium and all-cause death in maintenance hemodialysis patients HU Pan-pan, WANG Kai, XU Zhuo-jia 2025, 24 (03):  193-197.  doi: 10.3969/j.issn.1671-4091.2025.03.005 Abstract ( 61 )   Objective  To explore the relationship between serum magnesium (Mg) and all-cause death in maintenance hemodialysis (MHD) patients.  Methods  We reviewed the general condition, biochemical indexes and prognosis of MHD patients treated in the Hemodialysis Center of Beijing Civil Aviation General Hospital from January 2018 to December 2023.  Results A total of 415 patients were enrolled, including 156 females (37.6%), with a mean age of 65.64±13.46 years and a median dialysis age of 69.0 (33.0, 129.0) months. The observation period was 48.0 (27.0, 69.0) months, during which a total of 156 died. Kaplan-Meier curve analysis revealed a significantly lower survival rate in the low Mg group (≤1.04mmol/L) than in the high Mg group (＞1.04mmol/L) (Log-rank, χ2=6.767, P=0.009). Univariate Cox regression analysis revealed that serum magnesium was a protective effect on all-cause death in MHD patients (HR=0.903, 95% CI: 0.823～0.991, P=0.032). However, multivariate regression analysis showed that serum magnesium had no independent protective effect on all-cause death in MHD patients (HR=0.952, 95% CI: 0.964～1.019, P=0.120); albumin (HR=0.793, 95% CI: 0.725～0.868, P＜0.001) was identified as an independent protective factor, while advanced age (HR=1.028, 95% CI:1.012～1.045, P=0.001), diabetes mellitus (HR=1.249, 95% CI: 1.109～1.792, P=0.022), and cardiovascular and cerebrovascular disease (HR=1.654, 95% CI: 1.105～2.476, P=0.015) were associated with a higher risk of mortality. Kaplan-Meier curve analysis revealed that the double negative group (Mg＞1.04mmol/L and albumin≥38g/L), single positive group (Mg ≤1.04mmol/L or albumin ＜38g/L) and the double positive group (Mg ≤1.04mmol/L and albumin＜38g/L) showed a successively decreased survival rate (Log-rank, χ2=48.746, P＜0.001). Compared with the single positive group, the double positive group had a higher risk of death (HR=1.150, 95% CI: 1.089～1.683, P=0.046), and the double negative group had a significantly lower risk of death (HR=0.537, 95% CI: 0.316～0.912, P=0.021).  Conclusion Hypomagnesemia is not an independent risk factor for all-cause death in MHD patients, but hypomagnesemia combined with hypoalbuminemia increase the risk of all-cause death in MHD patients. Metrics

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Construction and validation of a risk prediction model for sarcopenia in maintenance hemodialysis patients LU Fei, YUAN Wei-dong, FAN Ya-ping 2025, 24 (03):  198-202.  doi: 10.3969/j.issn.1671-4091.2025.03.006 Abstract ( 44 )   Objective  To construct a risk prediction model for sarcopenia in maintenance hemodialysis (MHD) patients based on the data from meta-analysis and to verify the predictive efficacy of the model.  Methods   Literature about the risk factors for sarcopenia in MHD patients published by CNKI, China Biology Medicine disc, VIP, Wanfang, Pub Med, Embase, Web of Science were retrieved . The search period was from January 2010 to April 2022. The related articles were manually retrieved and rescreened according to the inclusion and exclusion criteria, and meta-analysis was then performed. A risk prediction model using the data from meta-analysis for the presence of sarcopenia in MHD patients was constructed. A total of 134 MHD patients admitted to Nantong Haimen People's Hospital from March 2022 to March 2023 were retrospectively recruited as a validation set. Receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test were used to evaluate the efficacy of the model to predict sarcopenia in the validation set.  Results  A total of 20 studies were found from the databases. Meta-analysis showed that age ≥60 years old (RR=1.781, 95% CI:1.661～4.623,P＜0.001), higher C-reactive protein (RR=1.663, 95% CI:1.234～4.923, P＜0.001), low physical activity (RR=1.488, 95% CI:1.214～3.853,P＜0.001), history of diabetes (RR=1.559, 95% CI:1.222～2.732, P＜0.001), longer dialysis vintage (RR=1.101,95% CI:1.041～1.161,P＜0.001), male (RR=1.354, 95% CI: 1.142～2.958, P＜0.001), and higher modified quantitative subjective global assessment (MQSGA) score (RR=1.523, 95% CI:1.323～3.266, P＜0.001) were the risk factors, while higher body mass index (BMI) (RR=0.553, 95% CI:0.122～0.986, P＜0.001) and high plasma phosphorus (RR=0.586, 95% CI:0.443～0.777, P＜0.001) were the protective factors for sarcopenia in MHD patients. Based on the results of the meta-analysis, a risk prediction model for sarcopenia in MHD patients was constructed. ROC curve analysis showed that the area under the curve (AUC) of the model for prediction of sarcopenia in the validation set was 0.849 (95% CI: 0.768～0.930), the optimal truncation value was 35 scores, the sensitivity was 70.0%, and the specificity was 93.7%. Hosmer-Lemeshow test showed χ2=8.97 and P=0.201.  Conclusion  The risk prediction model we constructed has better prediction and discrimination abilities for the presence of sarcopenia in MHD patients. This prediction model may be clinically useful. Metrics

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Roxadustat protects residual renal function by up-regulating Nrf2/HO-1 signal pathway in patients undergoing peritoneal dialysis QIU Jie-shan, FANG shen-shen, JI Li-jun, XU Zhi-yong, LI Xia, CHEN Jing-jing 2025, 24 (03):  203-207.  doi: 10.3969/j.issn.1671-4091.2025.03.007 Abstract ( 57 )   Objective  To investigate the effect of Roxadustat (Rox) on residual renal function (RRF) in patients undergoing peritoneal dialysis (PD) and its possible mechanism.  Methods  A total of 78 patients undergoing PD were divided into erythropoietin (ESA) treatment group (ESA group) and Rox treatment group (Rox group). Urinary 8-hydroxydeoxyguanosine (8-OHdG), β2-microglobulin (β2-MG), N-acetyl-β glucosamine glucosidase (NAG) enzyme, retinol binding protein (RBP), blood Nrf2 mRNA and HO-1 mRNA were measured. These laboratory parameters were compared between the two groups before and after treatment. The correlations of the laboratory parameters with the levels of Nrf2 mRNA, HO-1 mRNA and urinary 8-OHdG were analyzed.  Results At the end of follow-up in Rox group, urinary β2-MG, NAG enzyme, RBP and 8-OHdG were significantly lower than those before treatment (t=3.751, 2.522, 3.292 and 3.829 respectively; P＜0.001, =0.014, =0.002 and ＜0.001 respectively), and were significantly lower than those in ESA group (t=3.889, 1.627, 3.694 and 2.769 respectively; P＜0.001, =0.035,＜0.001 and P=0.007 respectively); while Nrf2 mRNA and HO-1 mRNA were significantly higher than those before the treatment (t=2.797 and 1.724 respectively; P=0.007 and 0.032 respectively) and those in ESA group (t=3.507 and 2.087 respectively, P=0.001 and 0.040 respectively). After the treatment, RRF was significantly higher in Rox group than in ESA group (t=4.710, P＜0.001). Nrf2 mRNA was negatively correlated with urinary β2-MG, NAG enzyme, RBP and            8-OHdG (r=-0.617, -0.511, -0.598 and -0.591 respectively; P＜0.001, =0.001, ＜0.001 and ＜0.001 respectively), and positively correlated with RRF (r=0.579, P＜0.001). HO-1 mRNA was negatively correlated with urinary β2-MG, RBP and 8-OHdG (r=-0.668, -0.406 and 0.606 respectively; P＜0.001, =0.013 and ＜0.001 respectively), and positively correlated with RRF (r=0.532, P=0.001). Urinary 8-OHdG was positively correlated with urinary β2-MG, NAG enzyme and RBP (r=0.456, 0.453 and 0.639 respectively; P =0.005, =0.005 and ＜0.001 respectively), and negatively correlated with RRF (r=-0.343, P=0.038).  Conclusion  Rox may alleviate the damage of renal tubular epithelial cells and protect RRF in PD patients by activating Nrf2/HO-1 signal pathway and inhibiting oxidative stress reaction. Metrics

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Predictive diagnosis of sarcopenia in maintenance hemodialysis patients and the effect of anti-resistance exercise combined with probiotics on their quality of life ZHAO Juan, ZHAO Xiao-qian, ZHANG Shi-qi, ZOU Chun-bo 2025, 24 (03):  208-213.  doi: 10.3969/j.issn.1671-4091.2025.03.008 Abstract ( 45 )   Objective  To explore the factors enable us to predict the diagnosis of sarcopenia, and the effects of anti-resistance exercise combined with probiotics on quality of life in the maintenance hemodialysis (MHD) patients with sarcopenia.  Methods  The MHD patients admitted to Tongzhou District People's Hospital of Nantong City from July 2023 to December 2023 were enrolled in this study. They were divided into sarcopenia group (n=44) and non-sarcopenia group (n=89) according to the diagnostic criteria of sarcopenia. The baseline data were compared between the two groups, serum myostain (MSTN) and interleukin-6 (IL-6) were measured, and the risk factors for sarcopenia were analyzed. ROC curve was used to analyze the efficacy of myostain (MSTN), interleukin-6 (IL-6) and MSTN combined with IL-6 on the diagnosis of sarcopenia. The patients in sarcopenia group were further and randomly divided into control group and experimental group. The patients in control group were treated with anti-resistance exercise, high quality protein diet, control of blood pressure, maintenance of water and electrolyte balance, and other routine methods; the patients in experimental group were treated with anti-resistance exercise and probiotics for 3 months in addition to the measures given to the control group. The quality of life during follow-up study was compared between the two groups.  Results  A total of 133 patients were included in this study. Serum MSTN (OR=1.243, 95% CI: 1.105～1.399, P＜0.001) and IL-6 (OR=1.214, 95% CI: 1.107～1.331, P＜0.001) were the risk factors for sarcopenia in MHD patients. The AUC of MSTN combined with IL-6 for the diagnosis of sarcopenia was 0.741, with the sensitivity of 65.9%, the specificity of 70.8%, and 95% CI: 0.651～0.831. After the intervention, physiological functions and mental health were better in experiment group than in control group.  Conclusion  Serum MSTN combined with IL-6 can effectively predict the presence of sarcopenia in MHD patients. Anti-resistance exercise combined with probiotics can successfully and safely improve the quality of life in MHD patients with sarcopenia. Metrics

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Measurement of priming volume for different types of dialyzers used for hemodialysis CUI Dong-mei, SONG Li, ZHAO Li-yan, QUAN Zi-lin, HU Yu-hang, LIANG Qi-zhen, KANG Xiao-li, FENG Zhong-lin, YIN Yan 2025, 24 (03):  214-217.  doi: 10.3969/j.issn.1671-4091.2025.03.009 Abstract ( 70 )   Objective  In clinical practice, a pre-charge volume has to be administered during the machine setup to prevent rapid blood pressure drop after blood drawing for hemodialysis (HD). The theoretical blood chamber volume varies among different dialyzer models, which poses a challenge for clinical assessment of pre-charge volume. This study aims to measure the pre-charge volume of different types of dialyzers used in HD and compare with the theoretical pre-charge volume to provide a reference for the dosage of pre-charge in clinical dialyzers.  Methods  The blood chamber volume and HD circuit volume of 9 types of dry membrane dialyzers commonly used in the Hemodialysis Division of Guangdong Provincial People's Hospital in June 2023 were tested.  Results  A total of 31 pre-charge data from 9 types of dry membrane dialyzers were collected, including 14 instances with cellulose acetate membrane and 17 instances with synthetic membrane. The physiological saline (NS) pre-charge volume required for the dialyzers with cellulose acetate membrane filters was 215.6(203.5～225.2) ml and that required for the dialyzers with synthetic membrane filters was 208.0 (192.2～217.6) ml. The amount of NS required for the internal wetting of synthetic membranes was statistically higher than that of cellulose acetate membranes [118.0(96.4, 141.0) ml vs. 33.8(23.7, 47.5) ml, Z=-9.181, P＜0.001]. Overall, there was a significant difference between the theoretical pre-charge volume and the measured pre-charge volume for dialyzers with both types of membranes, with the measured pre-charge volume significantly lower than the theoretical pre-charge volume (t=10.270, P＜0.001); the measured pre-charge volume for dialyzers with cellulose acetate membrane filter was significantly lower than the theoretical pre-charge volume (t=-14.429, P＜0.001), and the measured pre-charge volume for dialyzers with synthetic membrane was also significantly lower than the theoretical pre-charge volume (t=-13.339, P＜0.001).  Conclusion  The measured pre-charge volumes of the dialyzers used in this study were all less than the theoretical pre-charge volumes suggested in the manuals, and the NS volume required for internal wetting during pre-charge was higher for synthetic membranes than for cellulose acetate membranes. The conclusions of this study provide a theoretical basis for the precise management of volume in hemodynamically unstable HD patients who require pre-charge before blood drawing treatment. Metrics

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Progress in the application of adsorption technology and adsorption membrane materials for blood purification LU Xu, LI Jing 2025, 24 (03):  218-221.  doi: 10.3969/j.issn.1671-4091.2025.03.010 Abstract ( 68 )   Adsorption technology is indispensable in blood purification. Hemodialysis can remove various inflammatory mediators, cytokines and large, medium and small molecular toxins in blood by virtue of the characteristics of adsorption materials, being one of the assistant therapies to manage acute and critical patients with liver, kidney, blood and autoimmune diseases, poisoning and others. In this paper, we have reviewed recent progresses in the application of adsorption membrane materials and adsorption technology for blood purification.  Metrics

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Furosemide loading test: potential to predict the timing of renal replacement therapy in patients with acute kidney injury ZHOU Jie-rong, HOU Qi-liang, WANG Sen, YUAN Zi-qian, GAO Xing-mei, LI Bin 2025, 24 (03):  222-225.  doi: 10.3969/j.issn.1671-4091.2025.03.011 Abstract ( 50 )   The medical community has never reached a consensus on when to initiate renal replacement therapy (RRT) in patients with acute kidney injury (AKI). In recent years, furosemide loading test (FST) has shown its predictive potential. Early initiation of RRT is desirable in FST-positive patients, while it can be delayed in negative patients. However, the application of FST still has limitations and needs to be optimized to improve its prediction accuracy. In the future, a better AKI prediction model can be constructed by combining other biomarkers and clinical indicators to provide comprehensive guidance for physicians. Metrics

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Research progress in the use of mesenchymal stem cells to inhibit intimal hyperplasia in arteriovenous fistula in uremic patients LUO Tong, YAN Yan 2025, 24 (03):  226-230.  doi: 10.3969/j.issn.1671-4091.2025.03.012 Abstract ( 46 )   The incidence of chronic kidney disease (CKD) is increasing year by year. Continuous progress of CKD may finally lead to end-stage renal disease (ESRD). Maintenance hemodialysis (MHD) is one of the alternative treatments for ESRD patients, and arteriovenous fistula (AVF) is the preferred type of blood access for MHD. However, AVF dysfunction occurs frequently, leading to a short lifetime of blood access. Narrowing of AVF by neointimal hyperplasia is the main cause of AVF dysfunction. Previous studies have shown that both systemic and local treatments may inhibit the intimal hyperplasia. Mesenchymal stem cells have the potentials of diverse differentiation, self-renewal, tissue repair, homing and paracrine activities, probably useful for the reversal of neointimal hyperplasia in AVF. This article reviews recent advances in the mechanism and treatment of AVF dysfunction, the use of mesenchymal stem cells, and the mechanisms underlying the reversal of neointimal hyperplasia, in order to find out new ideas for the prevention of AVF dysfunction. Metrics

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Research progress in the changes of phase angle in chronic kidney disease patients with sarcopenia CHEN Yan-fen, WANG Jing-fu 2025, 24 (03):  231-234.  doi: 10.3969/j.issn.1671-4091.2025.03.013 Abstract ( 40 )   Bioelectrical impedance analysis (BIA) is a simple, rapid, and noninvasive method for assessing body composition. Phase angle (PA) that derives from BIA can be used for the measurement of muscle mass and strength and thus for the diagnosis and prediction of sarcopenia. Sarcopenia is associated with poor health outcomes in chronic kidney disease (CKD) patients.  Studies have suggested that PA may be an important marker for assessing muscle health status in CKD patients. In this article, we present a review about recent progress in the changes of PA in CKD patients with sarcopenia, with the aim of providing a basis for screening, evaluating, and monitoring sarcopenia in CKD patients. Metrics

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Research progress in the prediction models of sarcopenia risk in end-stage renal disease patients CHEN Lu-chen, SHEN Hua-juan, DONG Yong-ze, ZHAO Meng-jiao, CHEN Yan-fang, JIA Yang-qing, YAO Shi-yan, MA Guan-nan 2025, 24 (03):  235-238.  doi: 10.3969/j.issn.1671-4091.2025.03.014 Abstract ( 50 )   Sarcopenia is one of the common complications in end-stage renal disease (ESRD) patients, and is frequently associated with adverse outcomes. This article reviews the risk factors for sarcopenia, and construction and verification of prediction models for sarcopenia in ESRD patients, aiming to provide references for construction of a high-quality prediction model for sarcopenia. Metrics

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A primary experience of Venovo venous stent for the treatment of left innominate vein stenosis in the blood access pathway BAO Xue-dong, SHI Ya-xue, FU Xin-yi, MI Lan-hua, WU Chang, LIU Si-jie 2025, 24 (03):  239-242.  doi: 10.3969/j.issn.1671-4091.2025.03.015 Abstract ( 41 )   Objective  To investigate the efficacy and safety of Venovo venous stent for the treatment of left innominate vein stenosis in hemodialysis patients.  Method  Clinical data of the 10 patients treated with implanted Venovo venous stent for left innominate vein stenosis in Longhua Hospital of Shanghai University of TCM from March 2023 to May 2024 were retrospectively analyzed.  Results  Preoperative chest CT of the 10 patients showed that the average diameter of the narrowest part of the left innominate vein was 3.09±2.31 (0～5.9) mm. Venography confirmed that the left innominate vein was occluded in 3 cases; the innominate vein was narrowed at the confluence of the superior vena cava in 5 cases, and the horizontal segment of the innominate vein was narrowed in 2 cases. After stent implantation, a mean diameter of 10.80±1.0 (9.89～12.68) mm was found at the narrowest part of the stent. The follow-up period was 1～15 months, with a mean of 7.76±4.4 months. The primary patency rate at 6 months was 100%. None of the patients showed relapse of the clinical symptoms.  Conclusion  Venovo venous stent as a better supporter with a proper flexibility successfully corrected left innominate vein lesions from anatomical compression. However, further observation is required for its long-term effect. Metrics

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Calibration and stability analysis of dialysis fluid flow in hemodialysis machines and optimization of quality control strategies LI Tao, HE Yu, WANG Wei 2025, 24 (03):  243-245.  doi: 10.3969/j.issn.1671-4091.2025.02.016 Abstract ( 14 )   Objective  The calibration and stabilization of dialysate flow rate were compared among three brands of hemodialysis machines, in order to optimize the quality control system, to guide the improvement of hemodialysis procedures, and thereby to ensure the adequacy and reliability of hemodialysis.  Method  According to the JJF1353-2012 standard, the HDM99XP blood dialysis machine quality detector was used to examine and analyze the dialysate flow rate in three groups of dialysis machines (groups A, B, and C, 8 units in each group). The machine with the largest deviation in each group was subjected to a stability test for 6 months.  Result  At the 500mL/min calibration point, the average dialysate flow rates of the three groups were 497.6±14.4 mL/min, 489.4±19.0 mL/min, and 484.0±23.2 mL/min respectively, without statistical differences (F=1.021, P=0.377). Stability tests showed that group C was the worst, with a deviation up to 33.8mL/min.  Conclusion  The stability of dialysate flow rate was unsatisfactory in group C machines, despite the fact that the average dialysate flow rate was similar among the three brands of machines. We recommend that stability test should be incorporated into the quality control system, and that the set value should be appropriately increased in clinical practice in the present situation of lower dialysate flow rate to ensure hemodialysis effectiveness and medical service quality. Metrics

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Summary of the best evidence for symptom management of restless leg syndrome in maintenance hemodialysis patients CAI Hui-fang, FENG Qian, WU Zong-bi, XU Ming-ming, WANG Tai-fen, ZHOU Hua-hui, XU Jie-ling 2025, 24 (03):  246-250.  doi: 10.3969/j.issn.1671-4091.2025.03.017 Abstract ( 68 )   Objective   To retrieve and summarize the best evidence for symptom management of restless leg syndrome (RLS) in maintenance hemodialysis (MHD) patients, and to provide evidence-based references for clinical practice.  Methods  Clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus and randomized controlled trials on RLS symptom management in MHD patients were systematically searched in domestic and foreign databases from establishment of the database to May 30, 2024.  Results  A total of 14 articles were picked up, including 4 clinical decisions, 2 guidelines, 1 evidence summary and 7 systematic reviews. A total of 29 titles of evidence were summarized in 8 aspects, including management benefit, diagnosis and management, risk/aggravating factors, evaluation and monitoring, dialysis optimization, supplementary replacement therapy, drug therapy and health education.  Conclusion  This study summarizes the best evidence for RLS symptom management in MHD patients, and provides evidence-based references for clinical practice in clinicians and nurses. Metrics

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Family participation in the remote care during hospital-home transition period for patients undergoing peritoneal dialysis XU Sa, TIAN Rui-jie, SHI Juan-juan, WANG Hui-ping 2025, 24 (03):  251-254.  doi: 10.3969/j.issn.1671-4091.2025.03.018 Abstract ( 49 )   Objective  To explore the effect of the 4Y management model-based family participation in remote care program during hospital-home transition period in peritoneal dialysis (PD) patients.  Method A total of 80 patients with newly implanted PD tubes in the Peritoneal Dialysis Center of The First Affiliated Hospital of Zhengzhou University from September to December 2023 were recruited as the research subjects by convenient selection method. They were randomly divided into a test group (n=40) and a control group (n=40). The control group received routine health guidance and out-of-hospital home follow-up, while the test group received a 4Y-managed (yes plan, yes duty, yes check, and yes drive) home participation remote care program. After 8 weeks, effects of the two intervention programs were compared using the Peritoneal Dialysis Self-Management Scale, Coping Effectiveness Scale, and Family Care Capacity Scale.  Results  In test group after 8 weeks of intervention, the self-management score was higher than that of the control group (t=3.174, P=0.002), the coping efficacy score was higher than that of the control group (t=5.551, P＜0.001), and the family care ability was stronger than that of the control group (t=-2.883, P=0.005).  Conclusion  The 4Y management model of family participation in remote care can improve the self-management ability, coping efficiency, and family care ability of the PD patients during hospital-home transition period. Metrics

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The correlation between oral frailty and sarcopenia in maintenance hemodialysis patients MEI Yan, LIU An-nuo, DOU Jun-kai, YANG Liang, LI Xue-qing, ZHANG Yu-yu 2025, 24 (03):  255-259.  doi: 10.3969/j.issn.1671-4091.2025.03.019 Abstract ( 38 )   Objective  To study the current situation of oral frailty and sarcopenia and their correlation in patients undergoing maintenance hemodialysis (MHD).  Methods  A total of 237 MHD patients were selected for a cross-sectional study. General information questionnaire, oral frailty index-8, simplified nutritional appetite questionnaire and a body composition analyzer were used for this study.  Results  The incidence of oral frailty was 40.9%, and the incidence of sarcopenia was 34.6% in the MHD patients. Logistic regression analysis showed that sarcopenia (OR=3.858, 95% CI: 1.453～10.242, P=0.007) was the main risk factor for oral frailty, and the parameters of sarcopenia, including grip strength (OR=0.904, 95% CI: 0.849～0.963, P=0.002), and gait speed (OR=0.015, 95% CI: 0.003～0.083, P＜0.001) were also risk factors for oral frailty in the MHD patients.  Conclusion  The incidence rates of oral frailty and sarcopenia are higher in MHD patients, and sarcopenia is the risk factor for oral frailty. Clinicians and nurses should pay attention to the presence of  oral frailty and sarcopenia in MHD patients. Metrics

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Effect of multi buttonhole puncture on intimal hyperplasia in arteriovenous fistula and puncture site infection in hemodialysis patients YANG Bin-jiao, SHEN Fang, ZHANG Huan-qian 2025, 24 (03):  260-264.  doi: 10.3969/j.issn.1671-4091.2025.03.020 Abstract ( 59 )   Objective  To investigate the effect of multiple buttonhole puncture on intimal hyperplasia in arteriovenous fistula (AVF) and puncture point infection in hemodialysis patients.  Methods  We select 60 patients undergoing regular hemodialysis at the Blood Purification Center of Suzhou Ninth People's Hospital from January to April 2023 as the research subjects. According to the random number method, they were divided into single buttonhole puncture group (30 cases) and multiple buttonhole puncture group (30 cases). The intimal thickness, blood flow and arterial resistance index at AVF puncture area were measured before buttonhole puncture and on non-dialysis day at 3, 6 and 12 months after buttonhole puncture. Infection at the buttonhole puncture site was also observed.  Results  In the multi buttonhole puncture group after using this puncture method for 3, 6 and 12 months, the intimal thickness in AVF was lower (t=3.246, 5.585 and 6.055 respectively; P=0.002,＜0.001 and ＜0.001 respectively), natural blood flow in AVF was higher (t=2.697, 4.551 and 7.504 respectively; P=0.009,＜0.001 and ＜0.001 respectively), and arterial resistance index of AVF was lower (t=3.254, 4.779 and 5.336 respectively; P=0.001,＜0.001 and ＜0.001 respectively), as compared with those in the single buttonhole puncture group. Intimal thickness in AVF and arterial resistance index increased over time (Ftime=70.030 and 74.750, Ptime ＜0.001), while natural blood flow in AVF decreased over time (Ftime=42.610, Ptime＜0.001) in both groups. The changes of intimal thickness in AVF, natural blood flow, and arterial resistance index had an interaction effect with puncture time in both groups (Finteraction=16.740, 6.640 and 14.070 respectively; Pinteraction＜0.001). The overall incidence of infection at the puncture site was lower in the multi buttonhole puncture group than in the single buttonhole puncture group (χ2=4.812, P=0.028).  Conclusion  When using the buttonhole puncture technique for blood access from AVF, multiple buttonhole puncture can reduce intimal hyperplasia in AVF and lower the infection rate at the puncture site. Metrics