Chinese Journal of Blood Purification

12 October 2025, Volume 24 Issue 10 Previous Issue    Next Issue

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Interpretion of the standard YY/T 0793.4-2022 Preparation and quality management of fluids for hemodialysis and related therapies-Part 4: Quality of dialysis fluid for hemodialysis and related therapies KE Jun, YE Xiao-yan, HE Xiao-fan, ZHANG Yun 2025, 24 (10):  793-797.  doi: 10.3969/j.issn.1671-4091.2025.10.001 Abstract ( 159 )   This article analyzes the differences between the standard YY/T 0793.4-2022 and the international standard (the International Organization for Standardization, ISO) 23500-5:2019, and provides an interpretation of key clauses. Through in-depth analysis of the standards, it aims to help clinical institutions further improve the quality of dialysis fluids used in hemodialysis and related therapies, which playing a crucial role in ensuring patient clinical safety. Metrics

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The predictive value of sST2 and CACS combined detection for cardiovascular events in patients with maintenance hemodialysis CHENG Hong-juan, WU Xiao-rong, ZHA Bai, WANG jian-ping, ZHOU Wei 2025, 24 (10):  798-802.  doi: 10.3969/j.issn.1671-4091.2025.10.002 Abstract ( 86 )   Objective  To explore the predictive value of soluble growth stimulation expressed gene2 (sST2) combined with coronary artery calcium score (CACS) for cardiovascular events (CVE) in patients undergoing maintenance hemodialysis (MHD).  Method  A total of 200 patients who received MHD treatment for more than 3 months at the Hemodialysis Center of Gaochun People’s Hospital in Nanjing from January to December 2022 were included. Clinical data were collected, serum sST2 levels were detected using ELISA, and CACS was assessed using multi-slice spiral CT. The patients were divided into groups according to the median value of serum sST2 and CACS. All patients were followed up for 2 years, andt major cardiovascular events were recorded. The incidence of CVE among different groups and related risk factors were analyzed to explore the value of sST2 combined with CACS in predicting CVE in MHD patients.  Results  After a 2-year-follow-up, the incidence of CVE among the 200 MHD patients was 34.5% (69/200). The high sST2 group (≥27.06ng/ml) and high CACS group (≥183.5 points) exhibited significantly higher incidence rates and cumulative risks of CVE compared to their low-level counterparts (sST2 group: χ2=13.829, P＜0.001; χ2=15.797, P＜0.001; CACS group: χ2=18.608, P＜0.001; χ2=22.977, P＜0.001). The following factors were significantly higher in the CVE group than in the non-CVE group: age (t=2.858, P=0.005), dialysis duration (Z=3.473, P =0.001), proportion of diabetes (χ2=4.029, P=0.045), low-density lipoprotein (t=1.987, P =0.047)，sST2 (Z=4.743, P＜0.001) and CACS (Z=5.565, P＜0.001). Multivariate Logistic regression analysis showed that advanced age (OR=1.033, 95% CI: 1.000～1.066, P=0.047), long dialysis duration (OR=1.009, 95% CI: 1.001～1.018, P =0.038), high sST2 (OR=1.073, 95% CI: 1.045～1.101, P＜0.001) and high CACS (OR=1.001, 95% CI: 1.000～1.002, P =0.002) were independent risk factors for CVE in MHD patients. ROC curve analysis revealed that the combination of serum sST2 and CACS in predicting CVE in MHD patients achieved an AUC of 0.846, surpassing the individual predictors with AUC values of 0.724(Z=2.410，P =0.016) and 0.749 (Z=2.093，P=0.035) , respectively.  Conclusion  The incidence of CVE in MHD patients is high. Both serum sST2 and CACS have good predictive value for CVE in MHD patients, but their combination has higher predictive value. Metrics

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A study on the relationship between blood vitamin D and NLR levels with erythropoietin hypo-responsiveness in maintenance hemodialysis patients WANG Li -hong, HU Lan-fang 2025, 24 (10):  803-807.  doi: 10.3969/j.issn.1671-4091.2025.10.003 Abstract ( 98 )   Objective  To analyze the relationship between blood vitamin D levels, neutrophil-to-lymphocyte ratio (NLR), and erythropoietin (EPO) hypo-responsiveness in patients undergoing maintenance hemodialysis (MHD).  Methods  The clinical data of 160 patients who underwent MHD in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine were reviewed.  The efficacy of blood vitamin D and NLR in predicting EPO hypo-responsiveness and their dose-response relationship were evaluated.  Results  Compared with the non-EPO hypo-responsive group, the EPO hypo-responsive group had significantly lower 25(OH)D (t =7.671, P<0.001) and hemoglobin levels (t=8.601, P<0.001), and significantly longer dialysis vintage, higher weekly recombinant human erythropoietin (rhuEPO) dosage, higher parathyroid hormone, C-reactive protein (CRP), and NLR levels (t=2.153, P=0.033; t=12.685, P<0.001; t=3.330, P=0.001; t=3.004, P= 0.003; t=4.148, P<0.001). Logistic regression analysis showed that dialysis vintage, NLR, and parathyroid hormone were risk factors for EPO hypo-responsiveness (OR=1.813, 95% CI： 1.354～2.272; OR=2.724, 95% CI ：2.379～3.068; OR=1.416, 95% CI ：1.001～2.246; all P<0.001), while 25(OH)D was a protective factor (OR =0.413, 95% CI：0.404～2.379, P<0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the combined prediction of 25(OH)D and NLR was 0.920, indicating higher predictive efficacy (95% CI ：0.859～0.960, P = 0.005). A nonlinear dose-response relationship was observed between 25(OH)D, NLR, and EPO hypo-responsiveness.  Conclusion  The combination of 25(OH)D and NLR demonstrates high predictive efficacy for EPO hypo-responsiveness, and a dose-response relationship exists between them. Metrics

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Relationship between lumbar vertebral fractures and baseline trabecular volumetric bone mineral density in maintenance hemodialysis patients CHEN Tian-yi, ZHANG Dong-liang 2025, 24 (10):  808-812.  doi: 10.3969/j.issn.1671-4091.2025.10.004 Abstract ( 64 )   Objective To analyze the progression of vertebral fractures (VF) in maintenance hemodialysis (MHD) patients using quantitative computed tomography (QCT) and to explore the significant role of baseline lumbar spine trabecular volumetric bone mineral density (Tb.vBMD) in VF progression. Methods  A total of 44 MHD patients from October 2019 to April 2022 were enrolled. Baseline and follow-up lumbar QCT images with an interval of more than two years were collected. Tb.vBMD was measured, and VF was assessed using the Genant semi-quantitative method. VF progression was diagnosed if new VFs occurred, existing VFs worsened in grade, or the number of fractured vertebrae increased. Patients were divided into a VF progression group (n=17) and a non-progression group (n=27). Logistic regression was used to examine the impact of baseline lumbar Tb.vBMD and other factors on VF progression.  Results  Among the 44 patients, 34 had no VF at baseline, while 10 had existing VFs. In the VF progression group, 11 patients developed new VFs. The number of fractured vertebrae increased from 16 at baseline to 41 at follow-up. Baseline lumbar Tb.vBMD was negatively correlated with VF progression (OR=0.842, 95% CI: 0.715～0.992, P=0.039). A decrease of 10 mg/cm³ in baseline Tb.vBMD was associated with a 15.8% increase in the risk of VF progression. Both the progression and non-progression groups showed significant decreases in follow-up lumbar Tb.vBMD compared to baseline (P=0.002 and P=0.007, respectively), but the degree of decrease did not differ significantly between the two groups.  Conclusion  VF progression is significant in MHD patients. Baseline lumbar Tb.vBMD, rather than the degree of Tb.vBMD decline, is an independent risk factor for VF progression in MHD patients. Tb.vBMD measured by QCT has certain predictive value for VF occurrence in this population. Metrics

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Geriatric nutritional risk index is associated with renal progression in patients with chronic kidney disease ZHAO Xue, YAN Meng-yao, GAO Zhu-mei, LIANG Shan-shan, JIANG Hong-li, WEI Li-min 2025, 24 (10):  813-817.  doi: 10.3969/j.issn.1671-4091.2025.10.005 Abstract ( 65 )   Objective  To investigate the association between the Geriatric Nutritional Risk Index (GNRI) and the progression of renal impairment in patients with chronic kidney disease (CKD).  Methods  A secondary analysis was conducted using data from the CKD-ROUTE study available in the DRYAD open database. Based on baseline clinical data, patients were categorized into a high GNRI group (GNRI ≥ 98) and a low GNRI group (GNRI<98). A Cox proportional hazards model was used to evaluate the association between GNRI and CKD progression, defined as a ≥50% decline in estimated glomerular filtration rate (eGFR) or initiation of renal replacement therapy. Subgroup analyses were also performed.  Results   A total of 996 patients with CKD stages G2 to G5 were included. The mean baseline GNRI was 97.28±10.28. The high GNRI group consisted of 562 patients (56.4%), while the low GNRI group had 434 patients (43.6%). Compared to the high GNRI group, the low GNRI group had older age (t =-4.245; P <0.001), higher prevalence of hypertension (Z=10.433; P=0.001), diabetes (Z=31.137; P<0.001), and cardiovascular disease (Z=14.934; P< 0.001), as well as higher rates of baseline hematuria (t =40.894; P<0.001) and proteinuria (t =102.023; P< 0.001). However, baseline eGFR (t =-7.859; P <0.001), hemoglobin (t =14.368; P <0.001), and albumin levels (t =35.454; P<0.001) were lower in the low GNRI group. CKD progression occurred in 264 patients, with a cumulative incidence of 26.5%. Cox regression analysis showed that, compared to the high GNRI group, the low GNRI group had a hazard ratio of 1.563 (95% CI: 1.166～2.095, P<0.001) for CKD progression. Subgroup analysis revealed that the association between low GNRI and increased risk of CKD progression was consistent across different genders (HR=1.477, 95% CI: 1.035～2.107, P=0.032), presence or absence of type 2 diabetes (HR =1.793, 95% CI: 1.154～2.786, P =0.009), history of cardiovascular disease (HR =1.413,     95% CI: 1.010～1.978, P=0.044), and varying levels of hemoglobin (HR =1.557, 95% CI: 1.144～2.119, P= 0.005) and systolic blood pressure (HR =1.578, 95% CI: 1.004～2.479, P =0.048).  Conclusion  Low GNRI is an independent risk factor for the progression of renal impairment in non-dialysis CKD patients. Regular screening and appropriate nutritional interventions may help improve their prognosis.  Metrics

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Oral medicinal charcoal tablets alleviates intestinal epithelial barrier damage in maintenance hemodialysis patients WEI Meng, WEI Li-min, ZHAO Xue, WANG Jing, JIANG Hong-li, LIANG Shan-shan 2025, 24 (10):  818-822.  doi: 10.3969/j.issn.1671-4091.2025.10.006 Abstract ( 69 )   Objective  To investigate the effect of oral medicinal charcoal tablets on the structure of intestinal epithelial barrier in maintenance hemodialysis patients.  Methods  Patients undergoing maintenance hemodialysis in the Nephrology Department of Hanzhong Central Hospital from December 2015 to March 2016 were selected as subjects and randomly assigned to a hemodialysis (HD) group and a medicinal charcoal tablets (MCT) group (3 tablets/time, 3 times/day for 3 consecutive months). Healthy individuals from outpatient physical examinations during the same period were selected as the control group (Control group). A monolayer cell model was constructed using Caco-2 cells. The cells were cultured with 10% mixed serum from different groups for intervention. Transepithelial electrical resistance (TEER) of Caco-2 intestinal epithelial cells was measured using a resistance meter. Cell growth and proliferation rates were assessed using the methylthiazolyldiphenyl-tetrazolium bromide (MTT) colorimetric assay. The expression levels of tight junction proteins claudin-1, occludin, and zonula occludens-1 (ZO-1) were detected by Western blot.  Results  Serum samples were collected from 9 subjects each in the HD, MCT, and Control groups. Every 3 serum samples were pooled to create mixed serum for subsequent intervention on intestinal epithelial cells. Compared to the Control group, serum from the HD group significantly reduced TEER of intestinal epithelial Caco-2 cells after 24 h and 48 h of intervention (24 h: t =11.436, P=0.004; 48 h: t =11.587, P =0.001), inhibited cell viability and proliferation (24 h: t =10.701, P =0.007; 48 h: t =-5.295, P =0.002), and these effects were time-dependent (comparison between 24 h and 48 h in the HD group: TEER t =17.206, P<0.001; cell viability: t =10.701, P< 0.001). The expression levels of tight junction (TJ) proteins claudin-1 (t =17.962, P =0.003), occludin (t =6.824, P = 0.021), and ZO-1 (t =8.070, P =0.015) were decreased in the HD group. Compared to the Control group, serum from the MCT group also reduced TEER after different intervention times (24 h: t =-7.420, P =0.001; 48 h: t =-6.969, P =0.004) and mildly decreased cell proliferation viability (24 h:t=17.746, P=0.039; 48 h:t=-2.911, P =0.042). The expression levels of claudin-1 (t =6.346, P =0.032) and ZO-1 (t =8.356, P =0.043) were reduced, while the change in occludin expression did not reach statistical significance (t =3.897, P =0.060). Conclusions Uremia impairs intestinal epithelial barrier function. Oral medicinal charcoal tablets can mitigate the damage to intestinal epithelial tight junction structures caused by uremia. Metrics

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A study on social frailty status and interpretable analysis of influencing factors in maintenance hemodialysis patients LI Ying, CHEN Xiao-an, LIANG Wei-wei, YANG Bin, PAN Wei, WU Hai-bo 2025, 24 (10):  823-827.  doi: 10.3969/j.issn.1671-4091.2025.10.007 Abstract ( 81 )   Objective  To investigate the prevalence and determinants of social frailty among maintenance hemodialysis (MHD) patients, and to establish a theoretical framework for its prevention. Methods  From November 2023 to April 2024, MHD patients from the hemodialysis centers of Binzhou Medical University Hospital and Shanghai East Hospital were selected as study subjects. Variables were screened based on univariate analysis, and an optimized eXtreme Gradient Boosting (XGBoost) tree model was constructed using the XGBoost library to predict the degree of social frailty.  Results  A total of 354 patients were included, with a social frailty prevalence of 26.27% (93/354). Based on the optimal feature subset, an optimized XGBoost classification model was constructed. The Shapley Additive exPlanations (SHAP) importance ranking (mean absolute SHAP values) was as follows: physical exercise（0.447）, social participation(0.358), sleep conditions (0.328), among others. Conclusion  The prevalence of social frailty among MHD patients in this study was relatively high. Clinical healthcare providers can early identify high-risk groups and implement effective interventions based on the factors influencing social frailty in MHD patients. Metrics

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Research hotspots and development trends of sodium in peritoneal dialysis LIN Yun-yao, LI Ruo-lin, CHEN Zhi-hao, XIE Ying-xin, FANG Jun-yan, LIU Ying-li 2025, 24 (10):  828-833.  doi: 10.3969/j.issn.1671-4091.2025.10.008 Abstract ( 74 )   Objective  To conduct a bibliometric analysis of research on sodium and peritoneal dialysis (PD) to explore the current status and research hotspots in this field.  Methods  Studies related to PD and sodium published from January 2000 to October 2024 were retrieved from the Web of Science Core Collection and Scopus databases. Bibliometric tools were used to perform visual analyses.  Results  A total of 693 studies were included, identifying high-yield and high-impact countries, institutions, researchers, journals, and trending keywords. Early studies in this field predominantly focused on exploring the physiological functions of PD, such as ultrafiltration, transport mechanisms, and peritoneal characteristics. Later studies shifted towards areas related to patient outcomes, such as blood pressure control and the incidence of cardiovascular events. Comparisons between continuous ambulatory PD and automated PD, as well as the development of different PD solutions, also emerged as significant topics during the studied period.  Discussion  The bibliometric analysis objectively and comprehensively depicts the global collaboration network and current research progress in sodium-related studies in PD. It provides a valuable reference for understanding the role of sodium in PD. Metrics

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Research progress of machine learning in risk prediction models for peritoneal dialysis complications LIU Xin-yue, JIANG Gai-ying, WANG Xiao-juan, WANG Ju-zi, ZUO Miao-he, LIU Zhi-yan 2025, 24 (10):  834-837,852.  doi: 10.3969/j.issn.1671-4091.2025.10.009 Abstract ( 82 )   The rising prevalence of end-stage renal disease (ESRD) promotes the application of peritoneal dialysis (PD), a therapeutic option to conveniently conduct at home. However, PD-associated infectious and non-infectious complications occur frequently. Early and precise prediction and management of PD-associated complications are therefore critical to quality of life and outcome of the patients. The risk prediction models based on machine learning can evaluate the complication risk of a patient; while its branch, the deep machine learning, can automatically extract hierarchical features from raw data with higher accuracy and efficiency through multi-layer neural network structures. This review summarizes the basic concepts of machine learning and its branch deep machine learning, their utility in PD complication prediction and recent research advances to provide references for complication management in PD patients. Metrics

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Recent development of extracorporeal carbon dioxide removal techniques and future research directions WANG Min -min, WEI Yi -fan, YAO Qiang 2025, 24 (10):  838-841.  doi: 10.3969/j.issn.1671-4091.2025.10.010 Abstract ( 62 )   Extracorporeal carbon dioxide removal (ECCO2R) is an emerging technique designed to reduce carbon dioxide (CO2) levels in venous blood while enabling lung-protective ventilation or alleviating the work of breathing. Despite encouraging results in controlling respiratory acidosis, its broader adoption is hindered by complications, including hemolysis, thrombosis, and bleeding. Technological advances, including enhanced membrane design, gas exchange efficiency and anticoagulation strategies, are essential to improving safety and efficacy ultimately enhancing the role of ECCO2R in critical care settings.  Metrics

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A meta-analysis of intra-arterial and intravenous injection of contrast agents on the incidence and short-term prognosis of contrast-induced acute kidney injury CHANG Min-nan, HUANG Ke-xin, HUANG Xin-yi, WU Hao-yu, MA Zi-ming, WANG Shun, MAIERZIYA · wusiman 2025, 24 (10):  842-848.  doi: 10.3969/j.issn.1671-4091.2025.10.011 Abstract ( 52 )   Objective  A meta-analysis was conducted to explore the impact of intra-arterial and intravenous injection of contrast agents on the incidence of contrast-induced acute kidney injury (CI-AKI) and its short-term prognosis.  Methods  A comprehensive literature search was conducted in databases such as PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, and VIP Database. Meta-analysis was performed using RevMan5.4 software.  Results  According to the inclusion and exclusion criteria, a total of 7 articles were finally included. The total incidence of CI-AKI (OR=1.222, 95% CI: 1.040～1.435, P=0.010) and the incidence of CI-AKI in patients with baseline estimated glomerular filtration rate (eGFR) ≥60 ml/min (OR=1.400, 95% CI: 1.061～1.848, P=0.020) were higher in the intra-arterial angiography group than those in the intravenous angiography group. The all-cause mortality rate was higher in the intravenous angiography group than that in the intra-arterial angiography group (OR=0.471, 95% CI: 0.254～0.872, P=0.020). The average age of the patients was older in the intravenous angiography group than that in the intra-arterial angiography group (MD=-1.139, 95% CI: -1.611～-0.668, P<0.001).  Conclusions  The risk of CI-AKI after intra-arterial injection of contrast agents is higher than that after intravenous injection, but the prognosis of patients is worse in the intravenous angiography group than in the intra-arterial angiography group. The angiography route is one of the risk factors for CI-AKI, suggesting that clinicians should pay attention to the impact of angiography route on the incidence of CI-AKI and the prognosis of patients, and carry out individualized interventions as early as possible to delay the progression of CI-AKI. Metrics

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Research progress in exercise compliance of maintenance peritoneal dialysis patients HE Pei-pei, YANG Ting-jun, SUN Miao-juan, HU Li-jun 2025, 24 (10):  849-852.  doi: 10.3969/j.issn.1671-4091.2025.10.012 Abstract ( 57 )   Appropriate exercise not only helps improve the physical function of patients on maintenance peritoneal dialysis, but also alleviates their negative emotions such as anxiety and depression. The benefits of exercise depend on the long-term exercise compliance of patients. However, due to concerns about the impact on dialysis and the lack of an established exercise plan, the actual exercise compliance of patients on maintenance peritoneal dialysis is generally low. This article reviews the benefits of long-term exercise for maintenance peritoneal dialysis patients, the current situation of exercise compliance, the reasons for non-compliance, and the strategies for improving exercise compliance among these patients, aiming to provide references for formulating long-term and compliant exercise programs for maintenance peritoneal dialysis patients. Metrics

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Efficacy of ultrasound-guided endovascular treatment for arteriovenous graft thrombosis in 124 cases GAO Tong-xin, HE Cong-shuang, LI Jiang-li, YANG Tao 2025, 24 (10):  853-857.  doi: 10.3969/j.issn.1671-4091.2025.10.013 Abstract ( 49 )   Objective  This study aims to evaluate the efficacy and long-term patency rate of thrombosis in artificial vascular arteriovenous grafts treated with endovascular methods under ultrasound guidance.  Methods  A total of 124 arteriovenous accesses (16 brachio-cephalic, 31 brachio-median, 65 brachio-basilic,10 brachio-brachial and 2 brachio-axillary) were included in the study. All patients were treated with endovascular therapy under ultrasound guidance. Baseline data and surgical information were collected. They were followed up for 12 months to observe the postoperative patency and to analyze the factors affecting the primary patency.  Results The procedural technical success rate was 98.39%. The total complication rate was 1.6%. No symptomatic pulmonary embolism and arterial embolism happened. The primary patency rates for postoperative arteriovenous grafts were 87.9% at 3 months, 74.19% at 6 months, and 62.10% at one year. The assisted primary patency rates for postoperative arteriovenous grafts were 100% at 3 months, 91.13% at 6 months, and 85.48 % at one year. Cox analysis showed that outlet stenosis (95% CI：1.451～4.950, P=0.035), higher low density lipoprotein cholesterol (95% CI：1.507～3.139, P=0.048) and hypoproteinemia (95% CI：1.854～4.295, P=0.043) were the risk factors affecting primary patency after intervention of thrombus in arteriovenous grafts.  Conclusion  Ultrasound-guided endovascular thrombolytic treatment for thrombosis in vascular arteriovenous graft has a high technical success rate and can effectively improve the long-term patency rate of vascular arteriovenous grafts. Metrics

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Construction and verification of a risk prediction model for unplanned extubation in patients with temporary dialysis catheter HUANG Zhong-ping, ZHENG Fang-fang 2025, 24 (10):  858-862.  doi: 10.3969/j.issn.1671-4091.2025.10.014 Abstract ( 65 )   Objective  To analyze the risk factors for unplanned extubation in patients with temporary dialysis catheters and construct a risk prediction model, so as to provide a reference for early warning of unplanned extubation.  Methods  A total of 250 patients with temporary dialysis catheters admitted to Huzhou First People's Hospital from January 2021 to August 2022 were retrospectively reviewed and randomly divided into a training group and a validation group at a ratio of 7:3. Risk factors were screened by univariate and multivariate logistic regression, and a prediction model was constructed and validated.  Results  The risk prediction model was Y=6.392×age+4.088×first dialysis+6.679×hypertension+5.749×indwelling time ≥ 12 days. In the training group, the area under the receiver operating characteristic curve (AUC) was 0.872 (95% CI: 0.813～0.931), with a sensitivity of 83.3% and a specificity of 83.5%, indicating that the model can effectively distinguish high-risk and low-risk patients for unplanned extubation in the training group. In the validation group, the AUC was 0.979 (95% CI: 0.934～1.000), with a sensitivity of 93.8% and a specificity of 92.6%, indicating that the model has excellent predictive performance in independent samples.  Conclusion  Age ≥60 years, first dialysis, hypertension, and catheter indwelling time ≥ 12 days are independent risk factors for unplanned extubation. The nomogram model constructed based on the above risk factors can effectively guide the risk prevention and control. Metrics

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Risk factor analysis of poor maturation of autologous arteriovenous endovascular fistula and construction and validation of a decision tree prediction model LI Wen-qin, LIU Guang-we 2025, 24 (10):  863-867.  doi: 10.3969/j.issn.1671-4091.2025.10.015 Abstract ( 57 )    Objective  To analyze the risk factors for poor maturation of autologous arteriovenous fistula (AVF) and construct a decision tree prediction model based on the risk factors.  Methods  A total of 648 maintenance hemodialysis patients undergoing AVF creation surgery in the Department of Nephrology, the First Affiliated Hospital of Chongqing Medical University from October 2023 to October 2024 were retrospectively reviewed. Their general data were analyzed. The diagnostic efficacy of the decision tree prediction model was analyzed. Statistical processing was performed using SPSS 26.0 and SPSS Modeler 18.0 software.  Result  Among the 648 patients undergoing AVF creation surgery, 145 had poor AVF maturation with an incidence rate of 22.38%. BMI ＞28 kg/m² (OR=1.863, 95% CI: 1.252～2.771, P=0.002), hypertension (OR=2.033, 95% CI: 1.362～3.035, P= 0.001), smoking (OR=2.134, 95% CI: 1.432～3.181, P<0.001), radial artery diameter <2 mm (OR=1.814, 95% CI: 1.217～2.704, P=0.003), brachial artery blood flow <650 mL/min (OR=2.086, 95% CI: 1.398～3.113, P<0.001), parathyroid hormone >65ng/L (OR=1.708, 95% CI: 1.149～2.539, P=0.008), and no calcium channel blocker medication (OR=1.707, 95% CI: 1.145～2.547, P=0.009) are independent risk factors for poor AVF maturation (P<0.05). The decision tree model selected brachial artery blood flow, BMI, smoking, calcium channel blocker medication, parathyroid hormone, hypertension, and radial artery diameter as the nodes in the model. Among these nodes, brachial artery blood flow was in the first layer, showing the strongest correlation with AVF immaturity. The AUC value for validating the decision tree model was 0.822 (95% CI: 0.790～0.854).  Conclusion  The decision tree prediction model constructed in this study has a higher clinical applicability. It can comprehensively analyze the impact of a specific predictor variable in different subgroups, offering a useful reference for predicting AVF immaturity. Metrics

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Analysis the registrational problems of citric acid disinfectant ZHAN Na LIU Rui-yi LIU Wei-chen 2025, 24 (10):  868-870.  doi: 10.3969/j.issn.1671-4091.2025.10.016 Abstract ( 60 )   The citric acid disinfectant is widely used for cleaning and disinfecting the internal tubing of dialysis machines. It's safety and validity affect the efficiency of dialyzer reuse. This article analyses the common problems of citric acid disinfectant registration, and combines the current standards and product registration guidelines to provide examples with usual difficulties for offering guidance of registration application. Metrics

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Summary of the best evidence for non-pharmacological interventions for sleep disorders in maintenance hemodialysis patients XIAO Jiao, LIU Tian-tian, ZHANG Qin, YUAN Ye, ZHU Hong-yi, LIU Fang, LI Lu-ning, LIU Yan, YANG Lin 2025, 24 (10):  871-875.  doi: 10.3969/j.issn.1671-4091.2025.10.017 Abstract ( 66 )   Objective  To summarize relevant evidence on non-pharmacological interventions for sleep disorders in maintenance hemodialysis patients, and to provide practical guidance for improving their sleep quality.  Methods  A systematic search and evaluation were conducted on domestic and international databases and relevant guideline websites to identify evidence related to non-pharmacological interventions for sleep disorders in hemodialysis patients.  Results  A total of 17 articles were included, comprising 4 clinical decision-making papers, 2 guidelines, 10 systematic reviews, and one best evidence summary. From the two domains, screening and assessment of sleep disorders and non-pharmacological interventions in maintenance hemodialysis patients, 14 best evidence items were extracted. The evidence covers the use of sleep disorder screening and assessment tools, as well as the application details of various non-pharmaceutical therapies for sleep disorders.  Conclusion  This study systematically summarizes the best available evidence for the assessment and non-pharmacological intervention of sleep disorders in maintenance hemodialysis patients. It provides guidance for clinical healthcare professionals to implement evidence-based management of sleep disorders in this population. Metrics

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Practical exploration of multi-dimensional interventions on peritoneal dialysis nursing quality: analysis of the continuous improvement path based on the quality control inspection in Beijing JIA Wan-ning, WANG Xue-ling, WANG Qian, SHA Wei, XIA Lian-hong 2025, 24 (10):  876-880.  doi: 10.3969/j.issn.1671-4091.2025.10.018 Abstract ( 61 )   Objective  To explore the implementation effect and existing problems of multi-dimensional intervention measures for nursing quality management in peritoneal dialysis centers in Beijing, and to provide a basis for optimizing quality control strategies.  Methods   A retrospective analysis was conducted on the quality control data of 26 randomly selected peritoneal dialysis centers from 2023 to 2024. The changes in total scores, patient training, and patient follow-up deduction rates were analyzed using t-test and chi-square test. The management effectiveness was evaluated in combination with the intervention measures of the Beijing Quality Control Center (such as experience sharing, information technology construction and hierarchical supervision).  Results The total quality control scores in 2023 and 2024 were 95.00 (91.00, 100.00) and 96.00 (94.00, 99.00) respectively (U=302.000, P=0.506), with the lowest score rising from 60.00 to 90.50. In 2024, the number of hospitals that were deducted points in patient training and follow-up was lower than that in 2023 (χ2=6.718 and13.499; P=0.010 and ＜0.001).  Conclusion  The Beijing Nephrology and Blood Purification Quality Control Center has significantly improved the quality of patient training and follow-up in peritoneal dialysis through measures such as benchmarking, information technology empowerment, and hierarchical supervision. It is recommended to establish a "dynamic quality control - resource matching" linkage mechanism to promote the homogenization development of peritoneal dialysis nursing quality. Metrics