Chinese Journal of Blood Purification

12 January 2026, Volume 25 Issue 01 Previous Issue   

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Standard interpretation of YY 0267-2025 “ extracorporeal systems for blood purification - extracorporeal blood and fluid circuits for haemodialysers, haemodiafilters, haemofilters and haemoconcentrators” HU Xiang-hua, XIE Yan, YING Huan-yan, QU Ya-nan 2026, 25 (01):  1-4.  doi: 10.3969/j.issn.1671-4091.2026.01.001 Abstract ( 73 )   Standard YY 0267-2025, “Extracorporeal systems for blood purification - Extracorporeal blood and fluid circuits for haemodialysers, haemodiafilters, haemofilters and haemoconcentrators” was released on February 26, 2025, and will be implemented from March 1, 2028. This article provides an overview of YY 0267-2025, introduces its application scope, and interprets the main changes of technical items. Furthermore, it  analyzes the differences and connections among YY 0267-2025，YY 0267-2016 and ISO 8637-2:2024, aiming to facilitate the application and implementation of the updated standard in production, supervision and clinical practice. Metrics

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The efficacy and safety of enarodustat in patients with non-dialysis-dependent chronic kidney disease combined with renal anemia LU Hai-jing, LIU Bo-yin, DONG Feng-ming, CAO Xi-ming, SHUAI Lin, WANG Yao, WANG Bin, CAO Jing-yuan 2026, 25 (01):  5-10.  doi: 10.3969/j.issn.1671-4091.2026.01.002 Abstract ( 60 )   Objective  To evaluate the efficacy and safety of enarodustat in patients with stage 3-5 non-dialysis dependent chronic kidney disease (NDD-CKD) with concurrent renal anemia.  Methods  This retrospective study analyzed clinical data from NDD-CKD stage 3～5 patients with renal anemia treated at the Department of Nephrology, The Affiliated Taizhou People's Hospital of Nanjing Medical University between June 1, 2024 and February 1 2025. Serial laboratory parameters were compared before and after treatment, and adverse events were systematically documented.  Results  The study included 89 patients (69±10 years old, 39 males) with NDD-CKD stage 3～5 combined with renal anemia. After 4～16 weeks of observation (median follow-up was 8 weeks), hemoglobin (Hb) significantly increased from (87.70±13.65) g/L to (100.83±16.28) g/L (t= -5.403, P＜0.001). Date from 21 patients who underwent reassessment of hematopoietic parameters showed that ferritin decreased from 197.12 (73.89, 272.93) μg/L to 116.74 (51.78, 242.35) μg/L (Z=         -2.374, P=0.018), while soluble transferrin receptor levels increased from 1.29 (0.89, 2.12) μg/L to 1.78 (1.01, 2.38)μg/L (Z=-2.052, P=0.040). Notably, in patients with malignancies (n=9), Hb increased from (80.89±14.19)g/L to （96.67±18.24）g/L (t=-3.784, P=0.005). Among patients with parathyroid hormone (PTH) ＞300 pg/mL, Hb increased from (82.50±18.20)g/L to (95.50±12.50)g/L (t=-3.227, P=0.006). During treatment and follow-up, 10 patients required intensification of antihypertensive medication, 8 developed hyperkalemia, and 1 experienced arteriovenous fistula thrombotic embolism; no treatment discontinuations due to adverse reactions occurred. No additional clinically significant adverse events were observed.  Conclusion  Enarodustat safely and effectively increases Hb levels in NDD-CKD patients with renal anemia, with consistent efficacy in subgroups with malignancies or secondary hyperparathyroidism. These findings support its potential as a therapeutic option for anemia management in complex clinical settings. Metrics

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Comparison of pre-/post-hemodiafiltration and medium cut-off hemodialysis in clearance of uremic toxins XU Zhuo-jia, CHENG Dan, WANG Dong-dong 2026, 25 (01):  11-15.  doi: 10.3969/j.issn.1671-4091.2026.01.003 Abstract ( 53 )   Objective  To compare the clearance of small, medium, and larger medium-sized molecular toxins in patients undergoing pre-dilution/post-dilution hemodiafiltration (Pre-/Post-HDF) versus medium cut-off hemodialysis (MCO-HD). Methods 22 hemodialysis patients were treated with Pre-HDF, Post-HDF and MCO-HD respectively. The urea reduction rate (URR), as well as the serum reduction rates (RR) of β2-microglobulin (β2-MG) and α1-microglobulin (α1-MG), were compared among the three modalities. Additionally, the total clearance of β2-MG, α1-MG, and albumin (ALB) in the collected dialysate was evaluated. Results The URR in the MCO-HD group was significantly higher than that in the Pre-HDF group (q=13.151, P＜0.001) and Post-HDF group (q=19.063, P＜0.001). The reduction rate of β2-MG was higher in the Post-HDF group than that in the MCO-HD group (q=4.753, P=0.005) and the Pre-HDF group (q=11.022, P＜0.001). Conversely, the reduction rate of α1-MG was significantly higher in the MCO-HD group than that in the Pre-HDF group (q=11.647, P＜0.001) and the Post-HDF group (q=7.642, P＜0.001). Regarding total removal in dialysate, the Pre HDF group showed significantly lower β2-MG clearance than the Post-HDF group (q=5.691, P=0.002) and the MCO-HD group (q =7.058, P＜0.001), whereas no significant difference was observed between the Post-HDF group and MCO-HD group (q=3.252, P=0.083). For α1-MG, total removal was significantly higher in the MCO-HD group than that in the Pre-HDF group (q=22.218, P＜0.001) and Post-HDF group (q=12.286, P＜0.001). Similarly, ALB loss in dialysate was significantly greater in the MCO HD group than in the Pre HDF (q=10.831, P＜0.001) and Post-HDF groups (q = 5.345, P=0.004).  Conclusion  Compared with Pre/Post HDF, MCO HD demonstrates superior clearance of larger medium sized molecules but is associated with more pronounced albumin loss. Metrics

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Nomogram prediction model for rapid decline of residual renal function in peritoneal dialysis patients GUO Xiao-yu, FU Xiao-hui, JIANG Ze-yi, LIU Ying-hong 2026, 25 (01):  16-20.  doi: 10.3969/j.issn.1671-4091.2026.01.004 Abstract ( 35 )   Objective To analyze the risk factors for rapid decline of residual renal function (RRF) in peritoneal dialysis (PD) patients and to establish a predictive model. Methods PD patients who visited the Department of Nephrology at the Second Xiangya Hospital of Central South University from January 1, 2012, to December 31, 2022, were enrolled. Based on the median rate of RRF decline, patients were divided into a rapid decline group and a slow decline group. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed for preliminary variable selection. Independent risk factors associated with rapid RRF decline were then determined via multivariable stepwise logistic regression analysis. A nomogram prediction model was constructed based on the final predictors. The model's performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), calibration curves, the Hosmer-Lemeshow test, and decision curve analysis (DCA). Internal validation of the model was performed using the Bootstrap method. Results A total of 710 patients were included, with 354 in the rapid decline group and 356 in the slow decline group. LASSO regression and multivariable stepwise logistic regression identified that body mass index (BMI)＞28 (OR=2.640，95% CI：1.180～5.926，P=0.018), baseline RRF≥2(OR=3.140，95%CI：1.845～5.342，P＜0.001), and serum magnesium (OR=0.341，95%CI：0.128～0.909，P=0.032) as independent risk factors for rapid RRF decline in PD patients. The nomogram prediction model constructed based on these factors exhibited an  AUC of 0.719 (95%CI：0.682～0.756), and internal validation via 1000 Bootstrap resamples yielded an AUC of 0.722 (95%CI：0.685～0.759).The Hosmer-Lemeshow goodness-of-fit test yielded χ²=5.268 (P=0.729), and DCA indicated clinical applicability across a threshold probability range of 0.01～0.91. Conclusion    BMI, baseline RRF, and serum magnesium are independent risk factors for rapid RRF decline in PD patients. The nomogram prediction model based on these factors demonstrates good discrimination, calibration, and clinical applicability. Metrics

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Effect of enhanced external counterpulsation combined with aerobic and resistance exercise on elderly frail patients undergoing maintenance hemodialysis XIANG Er-qing, BIAN Xiao-lian 2026, 25 (01):  21-26.  doi: 10.3969/j.issn.1671-4091.2026.01.005 Abstract ( 29 )   bjective  To explore the effects of enhanced external counterpulsation (EECP) combined with aerobic and resistance exercise on cardiopulmonary reserve capacity and exercise endurance in MHD patients with frailty.  Methods  Elderly MHD patients with frailty admitted to Nanjing Medical University Affiliated BenQ Hospital from January to December 2023 were prospectively selected as the research subjects. They were randomly divided into the exercise group, EECP group, and combined group using the digital randomization method. All three groups were observed for 3 months, with primary assessment indicators including cardiopulmonary reserve capacity, exercise tolerance, and quality of life.  Result  A total of 129 patients were included, with 43 in each of the exercise, EECP, and combined groups. After treatment, significant differences were observed among the three groups in stroke volume (SV) (F=8.015, P=0.001), left ventricular end-systolic volume (LVESV) (F=7.832, P=0.001), and left ventricular ejection fraction (LVEF) (F=3.992, P=0.021). After treatment, significant differences were found among the three groups in peak expiratory flow (PEF) (F=28.923, P<0.001), forced vital capacity (FVC) (F=56.482, P<0.001), forced expiratory volume in the first second (FEV1) (F=40.780, P<0.001), and tidal volume (VT) (F=71.835, P<0.001). Post-treatment comparisons among the three groups revealed significant differences in peak load power (WR) (F=66.005, P<0.001), peak oxygen pulse (peak VO2/HR) (F=228.830, P<0.001), peak metabolic equivalent of task (METs) (F=88.218, P<0.001), anaerobic threshold (AT) (F=28.485, P<0.001), peak oxygen uptake (peakVO2) (F=20.617, P<0.001), 6-minute walk distance (6MWT) (F=37.617, P<0.001), and 30-second sit-to-stand test (30s-STS) (F=43.287, P<0.001).  After treatment, significant differences were observed among the three groups in the Spitzer Quality of Life Index (SQLI) and Frailty Phenotype (FP) scores (F=44.025, 64.500; both P<0.001).Conclusion  Both EECP and aerobic and resistance exercises have positive effects on improving cardiopulmonary function and exercise endurance in elderly MHD patientswith frailty, with combined intervention yielding better outcomes. Metrics

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Comparison of anticoagulant efficacy and safety between nafamostat mesylate and citrate in hemodialysis for uremic patients at high risk of bleeding HU Yu, YU Wen-hong, HU Zu-hai, ZHAO Hong-wen, XIE Pan, PENG Kan-fu 2026, 25 (01):  27-30.  doi: 10.3969/j.issn.1671-4091.2026.01.006 Abstract ( 44 )   Objective To compare the anticoagulation efficacy, safety, and economic benefits of Nafamostat Mesylate (NM) injection versus Regional Citrate Anticoagulation (RCA) in hemodialysis for uremic patients at high risk of bleeding.  Methods  A retrospective analysis was conducted on uremic patients at high risk of bleeding who underwent hemodialysis in the Department of Nephrology, First Affiliated Hospital of Army Medical University, between January 2016 and December 2023. Patients were divided into the NM group and the RCA group. The effectiveness and safety were compared between the two groups, and the incremental cost-effectiveness ratio (ICER) was calculated.  Results  A total of 91 patients were included, with 59 in the NM group and 32 in the RCA group. No statistically significant difference was found in anticoagulation efficacy between the NM and RCA groups (96.61% vs. 87.50%,  χ²=2.796, P=0.095). The NM group showed lower rates of premature termination due to clotting events (0% vs. 9.38%, χ²=5.720, P=0.017), Grade 3 clotting events (1.69% vs. 12.50%, χ²=4.665, P=0.031), and hypocalcemia (0% vs. 12.50%, χ²=7.714, P=0.005) compared to the RCA group. Compared to RCA, the ICER for NM was -1843.91 Chinese Yuan.  Conclusion  As an anticoagulant for hemodialysis in patients at high risk of bleeding, NM demonstrates favorable efficacy and safety, along with good cost-effectiveness.  Metrics

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Relationship between serum sCD14 and NGAL levels and bacterial infection in patients undergoing maintenance hemodialysis ZHAO Shu-li, BAI Wei-wei, PANG Bo, HU Jun-jie, DU Shu-tong 2026, 25 (01):  31-35.  doi: 10.3969/j.issn.1671-4091.2026.01.007 Abstract ( 21 )   Objective To investigate the relationship between serum levels of soluble CD14 (sCD14), neutrophil gelatinase-associated lipocalin (NGAL), and bacterial infection in maintenance hemodialysis (MHD) patients.  Methods  MHD patients from Cangzhou People's Hospital were selected as the study group (n=106). Based on the presence or absence of respiratory bacterial infection, they were further divided into an infection group and a non-infection group. Additionally, 106 healthy individuals undergoing physical examinations were selected as the control group. Serum levels of sCD14 and NGAL were measured by ELISA. Their correlations with laboratory parameters were analyzed. Logistic regression was used to identify influencing factors. The diagnostic value of these markers for bacterial infection in MHD patients was analyzed.  Results  Serum levels of sCD14 and NGAL in the study group were higher than those in the control group (t=28.866, 7.963, both P ＜0.001). The infection group had higher serum levels of sCD14, NGAL, hematocrit (HCT), and procalcitonin (PCT) compared to the non-infection group (t=37.476, 8.740, 6.086, 7.944, all P＜0.001), and lower albumin (ALB) levels (t=37.298, P＜0.001). Pearson analysis showed a positive correlation between sCD14 and NGAL (r=0.594, P <0.001). Serum sCD14 and NGAL were positively correlated with HCT (r=0.501, 0.512, both P＜0.001) and PCT (r=0.510, 0.511, both P＜0.001), and negatively correlated with ALB (r=-0.524, -0.534, both P＜0.001). Logistic regression analysis indicated that sCD14 (OR=3.148, 95% CI: 1.590～6.076, P＜0.001), NGAL (OR=4.378, 95% CI: 2.011～9.533, P＜0.001), HCT (OR=2.058, 95% CI: 1.429～2.963, P＜0.001), and PCT (OR=3.420, 95% CI: 1.452～8.054, P=0.005) were risk factors for bacterial infection in MHD patients, while ALB was a protective factor (OR=0.521, 95% CI: 0.329～0.824, P=0.005). ROC curve analysis revealed that the combined application of serum sCD14 and NGAL had higher diagnostic value compared to either marker alone (Z=2.643, 2.664, P=0.024, 0.021).  Conclusion  Serum levels of sCD14 and NGAL are elevated in MHD patients and are associated with bacterial infection. Combined detection of their levels holds clinical value for diagnosing bacterial infection in these patients. Metrics

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Early predictive value of the systemic immune-inflammation index for first episode peritoneal dialysis-associated peritonitis FAN Lu-lu, LUO Yang-yan, XIANG Hong-yu, GAO Fang 2026, 25 (01):  36-39,63.  doi: 10.3969/j.issn.1671-4091.2026.01.008 Abstract ( 27 )   Objective  To investigate the early predictive value of the systemic immune-inflammation index (SII) for the first episode of peritoneal dialysis-associated peritonitis (PDAP) in patients undergoing peritoneal dialysis (PD). Methods  PD patients treated in the Department of Nephrology at the First Affiliated Hospital of Chengdu Medical College from November 2010 to November 2023 were selected. Based on the occurrence of the first PDAP, patients were divided into a peritonitis group and a non-peritonitis group. Correlation analysis and Logistic regression were used to study the relationship between SII and the first PDAP, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of SII for the first PDAP. Results A total of 302 patients were included, with 137 in the peritonitis group and 165 in the non-peritonitis group. Compared to the non-peritonitis group, the peritonitis group had longer dialysis vintage, higher SII values, neutrophil counts, monocyte counts, and higher low-density lipoprotein cholesterol levels (Z=-4.641, -5.221, -7.446, -2.114, -2.305; P ＜0.001, ＜0.001, ＜0.001, 0.034, 0.021). Correlation analysis showed a positive correlation between SII levels and the first PDAP (r = 0.231, P＜0.001). Multivariate Logistic regression analysis indicated that a high SII (OR = 1.001, 95% CI: 1.000～1.001, P＜0.001) and longer dialysis vintage (OR = 1.020, 95% CI: 1.011～1.029, P ＜0.001) were independent risk factors for the first PDAP. The ROC curve showed that the area under the curve (AUC) for SII in predicting the first PDAP was 0.674 (95% CI: 0.615～0.734), with an optimal cut-off value of 780.51, sensitivity of 70.8%, and specificity of 58.2%.  Conclusion  Elevated SII and  longer dialysis  vintage are independent risk factors for first episode PDAP, and SII can serve as an early predictive marker. Metrics

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Research status about the mechanism and risk factors of thrombosis in autologous arteriovenous fistula in maintenance hemodialysis patients YANG Yu-tao, LI Wen, RUAN Lin, YANG Yan-li, REN Guang-wei, ZHANG Li-hong 2026, 25 (01):  40-43.  doi: 10.3969/j.issn.1671-4091.2026.01.009 Abstract ( 47 )   Nowadays maintenance hemodialysis (MHD) uses the vascular access of autologous arteriovenous fistula (AVF), graft arteriovenous fistula (AVG) or central venous catheter (CVC), in which AVF is the preferred vascular access route recommended by various guidelines and is also the main method for MHD patients in China. Well-functioning vascular access is essential to hemodialysis, while adverse events in AVF including late maturation, stenosis, occlusion and thrombosis often disturb the hemodialysis. Thrombosis in AVF directly leads to lower hemodialysis efficiency or even completely interrupts the hemodialysis. Here we summarize the mechanism and influencing factors of thrombosis in AVF in order to prevent this event from happening. Metrics

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Machine learning in the diagnosis and research of arteriovenous fistula stenosis TANG Kai-wen, ZHAO Qian, SHEN Hui-li, LIU Hui-min, JIN Xue-qin 2026, 25 (01):  44-47.  doi: 10.3969/j.issn.1671-4091.2026.01.010 Abstract ( 47 )   Arteriovenous fistula (AVF) stenosis is a leading cause of vascular access dysfunction in hemodialysis patients. Early and accurate diagnosis is crucial for reducing thrombotic risk and prolonging access lifespan. Traditional diagnostic methods have the limitation of invasiveness and the dependence of specific equipment. Machine learning enables non-invasive and objective diagnosis of AVF stenosis through extracting and quantifying acoustic features of normal and abnormal blood flow signals to establish recognition criteria. This article integrates machine learning with other four diagnostic tools to explain their principles, advantages and challenges, contributing to the shift toward precision medicine in vascular access management. Metrics

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The controversy and progresses of postoperative exercise for autogenous arteriovenous fistula XU Yuan-kai, DUAN Qing-qing, ZHANG Li-hong 2026, 25 (01):  48-50.  doi: 10.3969/j.issn.1671-4091.2026.01.011 Abstract ( 40 )   Autogenous arteriovenous fistula for vascular access is recommended by the guidelines and expert consensus. Activity and exercise are beneficial for improving the quality of life of maintenance hemodialysis patients, but are controversial for postoperative maturation of arteriovenous fistula. This article summarizes relevant viewpoints on postoperative exercise for autologous arteriovenous fistula, providing references for further improving the guidelines and expert consensus. Metrics

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Research progresses in the application of artificial intelligence for peritoneal dialysis LI An-lan, YAN Jin, YU Man-shu, SHAN Yun, SHENG Mei-xiao 2026, 25 (01):  51-54.  doi: 10.3969/j.issn.1671-4091.2026.01.012 Abstract ( 38 )   Peritoneal dialysis (PD) has been promoted in many countries due to its advantages of treatment at home, lower cost and better protection of residual renal function. However, PD still faces many constraints including lower patient awareness, medical resource shortages, excessive care pressure, and insufficient professionals. Artificial intelligence (AI) offers a broad prospect of optimizing PD. In this paper, we review the research progresses in AI for PD from four aspects: screening high-risk patients, optimizing PD prescription, predicting prognosis, and management of PD. Metrics

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Recent advances in aldosterone and  vascular calcification in chronic kidney disease WAN Ting-ting, YAO Jiao, SUN Fu-yun, MA Xiao-ying, YANG Xing-meng 2026, 25 (01):  55-58.  doi: 10.3969/j.issn.1671-4091.2026.01.013 Abstract ( 20 )   Chronic kidney disease (CKD) patients often complicate with vascular calcification, which threatens cardiovascular health and long-term prognosis. Recent research has shown that aldosterone potentially functions as a pivotal driver in vascular calcification. Aldosterone is a mineralocorticoid hormone, regulating fluid and electrolyte balance and blood pressure. Aldosterone is often elevated in CKD. Aldosterone binds mineralocorticoid receptors on vascular smooth-muscle cells to trigger an osteogenic phenotypic switch that fosters vascular calcification. In addition, aldosterone may indirectly amplify vascular calcification by enhancing inflammation and oxidative stress. A positive correlation between serum aldosterone level and vascular calcification severity in CKD has been reported by several clinical studies, but other studies could not confirm the correlation, representing the heterogeneity of the investigations. Moreover, the molecular mechanisms by which aldosterone promotes vascular calcification in CKD remain unknown. Here we summarize current evidences on the correlation between aldosterone and vascular calcification in CKD patients. Metrics

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Effects of different urokinase thrombolysis methods on patency of tunneled-cuffed central venous catheters WANG Fang-yuan, SONG Li, YIN Yan, XU Qing-xiu, CUI Dong-mei, ZHAO Li-yan, ZHOU Qing-hua, LIAO Jun-jie, CHEN Cheng, HU Yu-hang, HUANG Xin, FENG Zhong-lin 2026, 25 (01):  59-63.  doi: 10.3969/j.issn.1671-4091.2026.01.014 Abstract ( 29 )   Objective  To explore the effects of different urokinase thrombolysis methods on the four-year patency rate of tunneled-cuffed catheters (TCC).  Methods  Clinical data of the 96 patients undergoing maintenance hemodialysis using TCC in the Blood Purification Center of Guangdong Provincial People's Hospital from June 2021 to May 2024 were retrospectively analyzed. According to the method of urokinase thrombolysis therapy when the patients first showed insufficient flow or embolism in TCC, they were divided into two groups: the lock-tube thrombolysis group and the pre-hemodialysis intravenous bolus thrombolysis group. In the lock-tube thrombolysis group, each side of the catheter was configured with 1 ml of normal saline + 125,000 units of urokinase + 1 ml (6,250 units) of heparin sodium, and locked according to the lumen volume. In the pre-hemodialysis intravenous bolus thrombolysis group, each side of the catheter was treated with 10 ml of normal saline + 125,000 units of urokinase, and pumped in at a constant speed of 30-60 minutes with a constant speed pump before hemodialysis. The four-year secondary patency rate of TCC was observed in the two groups.  Results  We collected the data of urokinase thrombolysis therapies for TCC in 96 patients, including 11 cases (14.5%) in the pre-hemodialysis intravenous bolus thrombolysis group and 85 cases (85.5%) in the lock-tube thrombolysis group. COX univariate Kaplan-Meier survival analysis showed that there was no statistically significant difference in the four-year secondary patency rate of TCC between the two groups (HR=0.333, 95% CI: 0.044～2.530, P=0.239). The one-year, two-year, three-year, and four-year secondary patency rates of TCC were 90.9%, 72.7%, 54.5%, and 27.3% respectively in the pre-hemodialysis intravenous bolus thrombolysis group, and were 64.7%, 42.4%, 22.4%, and 15.3% respectively in the lock-tube thrombolysis group.  Conclusion  There is no significant difference in the secondary patency rate between the lock-tube thrombolysis group and the pre-hemodialysis intravenous bolus thrombolysis group. Survival curve analysis shows that the pre-hemodialysis intravenous bolus thrombolysis method using 10 ml of normal saline+125,000 units of urokinase has a tendency of better secondary patency rate of TCC, but no statistical significance existed between the two groups probably due to insufficient sample size. Further verification of this hypothesis requires prospective research in the future. Metrics

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Application of internal jugular vein catheterization at sitting position in hemodialysis with acute left heart failure: a retrospective cohort study WANG Hai-xin, FU Yong-sheng 2026, 25 (01):  64-67.  doi: 10.3969/j.issn.1671-4091.2026.01.015 Abstract ( 20 )   Objective To systematically evaluate the safety and effectiveness of sitting position internal jugular vein catheterization (SP-IJVC) in patients with acute left heart failure (ALHF) and to compare SP-IJVC with traditional femoral vein catheterization (FVC).  Methods The patients with ALHF admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to May 2024 were retrospectively divided into SP-IJVC group (n=17) and FVC group (n=20). The main outcome includes success rate of operation and incidence of complications, and the secondary outcome included patency period of the catheters and incidence of thrombosis. Python 3.8 was used for statistical analysis. Independent sample t-test was used for comparison of numerical data between groups, and Fisher's exact test or chi-square test was used for comparison of counting data between groups.  Results  A total of 37 patients were included in this study. In SP-IJVC group, the operation success rate was 100%, and the complication rate was 11.8% (2/17), lower than the rate of 25.0% (5/20) in FVC group (χ²=4.682, P=0.032); the average catheter patency period was 16.2±3.5 days, longer than the period of 10.8±2.1 days in FVC group (t=5.573, P＜0.001); the thrombosis rate was 5.9% (1/17), lower than the rate of 22.1% (4/18) in FVC group (χ²=4.021, P=0.045). Subgroup analysis of SP-IJVC group showed that the complication rate was 8.3% (1/12) in ultrasound-guided subgroup (n=12) and was 20.0% (1/5) in blind puncture subgroup (n=5), without statistically significant difference between the two groups (χ²=0.578, P=0.447); the operation time  was 8.5±2.1 minutes for posterior approach (n=11), shorter than the time of 11.2±3.4 minutes for anterior approach (n=6) (t=2.531, P=0.021).  Conclusion  SP-IJVC provides a safe and effective vascular access option for patients with ALHF who can't lie flat, and the catheter function and safety are superior to FVC method. We recommend SP-IJVC as the first choice for these ALHF patients. Metrics

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Clinical study on the correlation between calcification in abdominal aorta and radial artery and autogenous arteriovenous fistula maturation#br# HE Cong-shuang, YANG Tao, MU Guang-qin, GAO Tong-xin, GE Gui-zhen, LYU Ai-qing 2026, 25 (01):  68-72.  doi: 10.3969/j.issn.1671-4091.2026.01.016 Abstract ( 22 )   Objective  To investigate the relationship and influencing factors between abdominal aortic calcification (AAC), radial artery calcification (RAC), and arteriovenous fistula (AVF) maturation in patients with end-stage renal disease (ESRD).  Methods  A total of 75 ESRD patients undergoing AVF surgery were enrolled in this study. Preoperative X-ray was used to assess the degree of AAC and RAC, and end-to-side anastomosis of radial artery to cephalic vein was performed for AVF construction, with intraoperative recording of arterial calcification. Based on the degree of AAC, patients were divided into a control group (n=44) and a calcification group (n=31). After the surgery, AVF maturation was evaluated and maturation time was recorded every month for 3 months.  Results  The AVF maturation rate was significantly higher in the control group than in the calcification group (84.1% vs. 58.1%, χ²=6.300, P=0.012), and the maturation time was significantly longer in the calcification group (69.33±26.502 days vs. 46.54±17.925 days, t=-3.300, P=0.003) than in the control group. Univariate analysis showed that gender (OR=13.180, 95% CI: 0.038～0.376, P＜0.001), age (OR=2.961, 95% CI: 0.995～1.086, P=0.085), cephalic vein dilatation (OR=4.766, 95% CI: 0.053～0.854, P=0.029), intraoperative RAC (OR=5.669, 95% CI: 1.258～10.629, P=0.017), and AAC (OR=3.817, 95% CI: 1.229～11.216, P=0.015) were the risk factors for delayed AVF maturation. Multivariate analysis revealed that female gender (OR=11.477, 95% CI: 0.024～0.370, P=0.001), cephalic vein dilatation (OR=4.664, 95% CI: 0.032～0.847, P=0.031), intraoperative RAC (OR=5.788, 95% CI: 1.362～20.618, P=0.016), and AAC (OR=0.149, 95% CI: 0.028～0.786, P=0.025) were the independent risk factors for delayed AVF maturation.  Conclusion  AAC, intraoperative RAC, poor cephalic vein dilatation and female are the independent risk factors for delayed AVF maturation. Metrics

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The relationship between serum soluble lectin-like oxidized low density lipoprotein receptor-1 and complement C1q/TNF-related protein 9 levels and arteriovenous fistula thrombosis in maintenance hemodialysis patients LIU Cui-yin, RUI Fan-ding, HUANG Yang-yang, BI Chun-sheng 2026, 25 (01):  73-77.  doi: 10.3969/j.issn.1671-4091.2026.01.017 Abstract ( 19 )   Objective  To investigate the relationship between serum soluble lectin-like oxidized low density lipoprotein receptor-1(sLOX-1) and complement C1q/tumor necrosis factor related protein 9 (CTRP9) levels and arteriovenous fistula (AVF) thrombosis in maintenance hemodialysis (MHD) patients.  Methods  From November 2022 to March 2024, a total of 124 patients who underwent hemodialysis in our hospital and developed thrombosis in AVF were recruited as the observation group. Moreover, a total of 120 patients who underwent hemodialysis in our hospital but did not develop AVF thrombosis were recruited as the control group. These patients had received MHD for more than 3 years at the time of investigation. Serum sLOX-1 and CTRP9 levels were determined by ELISA. Pearson correlation analysis was used for the correlation between serum sLOX-1 and CTRP9 levels and AVF thrombosis, logistic regression for the influencing factors for AVF thrombosis, and ROC curve for the efficacy of serum sLOX-1 and CTRP9 levels in predicting the occurrence of AVF thrombosis.  Results There were statistically significant differences between the observation group and the control group in mean arterial pressure (t=5.964, P＜0.001) and low-density lipoprotein cholesterol levels (t=20.356, P＜0.001). In the observation group, serum CTRP9 was lower (t=9.703, P＜0.001) and serum sLOX-1 was higher (t=9.747, P＜0.001) as compared those in the control group; serum CTRP9 level was negatively correlated with serum sLOX-1 level (r=-0.422, P＜0.001). Higher serum sLOX-1 level (OR=2.371, 95% CI: 1.386～4.057, P=0.002) was the independent risk factor for AVF thrombosis in patients, whereas higher serum CTRP9 level (OR=0.746, 95% CI: 0.570～0.976, P=0.032) was the independent protective factor against AVF thrombosis. The AUCs using serum sLOX-1, CTRP9 and combination of sLOX-1 and CTRP9 levels to predict the occurrence of AVF thrombosis were 0.832, 0.807 and 0.894 respectively, demonstrating that combination of the two levels is better than serum sLOX-1 or serum  CTRP9 for the prediction (sLOX-1–the combination: Z=2.021, P=0.043; CTRP9–the combination: Z=2.458, P=0.014).  Conclusion  Determination of serum sLOX-1 and CTRP9 levels can assess the risk of AVF thrombosis in MHD patients, and can also provide reference values for early intervention of AVF thrombosis in clinical practice. Metrics

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The needs of peritoneal dialysis patients for medical institutions from the perspective of self-management: a qualitative study LIU Ting-ting, FU Jing-jing, ZHANG Xiao-hong, ZHANG Hai-fen, WANG Ya-wen, HUANG Jia-ying, GU Le-yi, FANG Wei, XI Hui-qin 2026, 25 (01):  82-86.  doi: 10.3969/j.issn.1671-4091.2026.01.019 Abstract ( 64 )   Objective  To analyze the needs of peritoneal dialysis (PD) patients for medical institutions, in order to provide ideas for optimizing resource allocation and improving PD home management.  Methods  Purposive sampling method was used to select PD patients who were followed up at Renji Hospital, Shanghai JiaoTong University School of Medicine in June 2024, and the recruitment was stopped based on the principle of information saturation. Semi-structured interviews were conducted with the PD patients. The Colaizzi's 7-step analysis method was adopted for data analysis.  Results  A total of fifteen PD patients were ultimately included. Based on the interview results, 3 themes and 8 sub-themes were extracted: self-management difficulties (information perception difficulties; limited work and life; poor accessibility to follow-up; disease and emotional distress), phased change characteristics of needs (hospitalization management needs; home self-management needs), hierarchical needs for medical treatment in medical institutions (hospital treatment needs; community service needs).  Conclusions  During the self-management of home PD, patients encounter multiple obstacles and the service needs present differentiated stages. Medical staff should strengthen the accessibility of medical resources and improve the support systems. Metrics

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Application of indwelling plastic cannulae in the initial use of arteriovenous fistulae in hemodialysis patients LUO Fen-xia, ZHOU Jian-fang, HU Ting, YAO Jie, XU Chun-ying, ZHI Jian-qing 2026, 25 (01):  83-86.  doi: 10.3969/j.issn.1671-4091.2026.01.019 Abstract ( 14 )   Objective  To analyze the needs of peritoneal dialysis (PD) patients for medical institutions, in order to provide ideas for optimizing resource allocation and improving PD home management.  Methods  Purposive sampling method was used to select PD patients who were followed up at Renji Hospital, Shanghai JiaoTong University School of Medicine in June 2024, and the recruitment was stopped based on the principle of information saturation. Semi-structured interviews were conducted with the PD patients. The Colaizzi's 7-step analysis method was adopted for data analysis.  Results  A total of fifteen PD patients were ultimately included. Based on the interview results, 3 themes and 8 sub-themes were extracted: self-management difficulties (information perception difficulties; limited work and life; poor accessibility to follow-up; disease and emotional distress), phased change characteristics of needs (hospitalization management needs; home self-management needs), hierarchical needs for medical treatment in medical institutions (hospital treatment needs; community service needs).  Conclusions  During the self-management of home PD, patients encounter multiple obstacles and the service needs present differentiated stages. Medical staff should strengthen the accessibility of medical resources and improve the support systems. Metrics