BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can signif...BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.展开更多
Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
Objective:We used meta-analysis to explore the clinical efficacy of auricular point therapy combined with modern medicine in improving depression/anxiety in maintenance hemodialysis patients.Methods:We searched CNKI,W...Objective:We used meta-analysis to explore the clinical efficacy of auricular point therapy combined with modern medicine in improving depression/anxiety in maintenance hemodialysis patients.Methods:We searched CNKI,Wanfang,Weipu,CBM,The Cochrane Library,PubMed,Web of Science,Embase through computer to build a randomized controlled trials of auricular therapy combined with modern medicine in the treatment of depression/anxiety disorders in China and abroad since 2022.Two evaluators independently screened the studies,extracted and cross-checked the key data in the studies independently after determining the included studies,and then evaluated the quality of the studies respectively.Finally,we used RevMan 5.3 platform for statistical processing of data.Results:This meta-analysis included a total of 12 clinical randomized controlled trials,including a total of 899 patients.The results showed that the observation group was more effective in reducing the scores of Hamilton Anxiety Scale,self rating Anxiety Scale,self rating Depression Scale,Pittsburgh sleep quality index score of maintenance hemodialysis patients.In addition,there was no statistical difference between the observation group and the control group in improving the total clinical effective rate.Conclusion:The observation group has a more obvious effect on the improvement of anxiety or depression in maintenance hemodialysis patients.However,due to the limitation of the quantity and quality of the included studies,the real efficacy of auricular therapy combined with modern medicine in improving anxiety or depression disorder after maintenance hemodialysis still needs to be supported by more carefully designed and standardized multi-center,large-sample clinical studies.展开更多
Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progress...Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-Aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: All patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.展开更多
Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually te...Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.展开更多
Background Coronary artery calcification(CAC)is common in end-stage renal disease(ESRD)patients,and the extent of CAC is closely related to cardiovascular outcomes in ESRD patients.Cartilage oligomeric matrix protein(...Background Coronary artery calcification(CAC)is common in end-stage renal disease(ESRD)patients,and the extent of CAC is closely related to cardiovascular outcomes in ESRD patients.Cartilage oligomeric matrix protein(COMP),as a component of the vascular matrix,has been found to be an inhibitor of arterial calcification in basic studies.However,there is no clinical research on the correlation between COMP and CAC in maintenance hemodialysis(MHD)patients.The aim of this study was to explore the relationship between serum COMP levels and CAC and cardiovascular events in MHD patients.Methods Serum COMP levels were compared between 54 MHD patients and 66 healthy people.MHD patients were then divided into three groups according to the tertiles of the concentration of COMP level and were followed up for major adverse cardiac events(MACEs),which were defined as a combined end point of new onset angina pectoris,nonfatal myocardial infarction,heart failure,coronary artery revascularization,hospitalization due to angina pectoris and all-cause deaths.The CAC score was calculated based on computed tomography scans.Results The serum COMP level in MHD patients was significantly higher than that in the general population[984.23(248.43-1902.61)ng/mL vs.219.01(97.26-821.92)ng/mL,P<0.01].Serum COMP levels were positively correlated with CAC(r=0.313,P=0.021)and serum parathyroid hormone in MHD patients(r=0.359,P<0.01).Linear regression suggested that after adjusting for age,fasting blood glucose(Glu)and glycosylated hemoglobin(HbAlc),CAC score was an independent predictor in the final model for COMP level(β=0.424,t=3.130,P<0.01).The receiver operating characteristic(ROC)curve showed that COMP≥994 mg/mL had 68.0%sensitivity and 72.4%specificity for the prediction of severe CAC[area under the curve(AUC):0.674,P=0.030,95%CI:0.526-0.882].After a median follow-up of 16 months(8-24 months),there was no difference in the incidence rate of MACEs between the upper,middle and lower serum COMP groups.Conclusions Our study found that MHD patients have higher levels of circulating COMP than controls.The serum COMP level is positively correlated with CAC score and could be used as a biomarker of severe CAC in MHD patients.However,there is no obvious correlation between serum COMP levels and the incidence of cardiovascular events.展开更多
Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis(MHD)patients and possible mechanism.Methods A total of 40 MHD patients [mean age(53.5±7....Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis(MHD)patients and possible mechanism.Methods A total of 40 MHD patients [mean age(53.5±7.1)years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups,Levocarnitine supplemented group(LS-G)(n=20;Levocarnitine supplementation after each normal hemodialysis session,at a dose of 1.0 g/day by intravenous administration)and control group(C-G)(n=20;normal hemodialysis).Before treatment,one month and three months after treatment we respectively measured or observed the following items,the tolerance to hemodialysis,carnitine level in plasma,C-reactive protein,IL-6,TNF-α,percentage of neutrophil,and some relevant nutritional parameters,such as lipid profile,transferrin,total protein,albumin and prealbumin levels.Comparative analysis was conducted between the two groups.Results In LS-G three months after treatment,the levels of carnitine,hemoglobin,and prealbumin in plasma were significantly increased(P<0.05),but C-reactive protein,neutrophil percentage,low-density lipoprotein and triglyceride were significantly decreased(P<0.05)in contrast to those in C-G and before treatment.Transferrin,total protein,and albumin were elevated in LS-G,with no statistical significance.Conclusion There was a significant improvement of lipid metabolism and nutritional status for the long-term maintenance hemodialysis patients with Levocarnitine supplementation.And this improvement is related to the decrease of inflammatory factors.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at t...BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease,a group of patients known to be particularly susceptible to infectious complications.AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODS We searched PubMed/MEDLINE,EMBASE,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Web of Science databases for relevant terms and imported the results into the Covidence platform.From there,studies were assessed in two stages for relevance and quality,and data from studies that satisfied all the requirements were extracted into a spreadsheet.The data was then analyzed descriptively and statistically.RESULTS Of the 920 studies identified through the initial database search,only 17 were included in the final analysis.The studies included in the analysis were mostly carried out during the first wave.We found that COVID-19 incidence among patients on hemodialysis was significant,over 10%in some studies.Those who developed COVID-19 infection were most likely going to be hospitalized,and over 1 in 5 died from the infection.Intensive care unit admission rate was lower than the infection lethality rate.Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections,and a significant proportion was infected during the first wave.Their prognosis is overall much worse than in the general population,and every effort needs to be made to decrease their exposure.展开更多
Objective:This study aimed to evaluate the effects of mindfulness-based stress reduction therapy on anxiety and depression in patients with maintenance hemodialysis.Methods:CNKI,VIP,WanFang,CBM,Embase,the Cochrane Lib...Objective:This study aimed to evaluate the effects of mindfulness-based stress reduction therapy on anxiety and depression in patients with maintenance hemodialysis.Methods:CNKI,VIP,WanFang,CBM,Embase,the Cochrane Library and PubMed databases were retrieved.Randomized controlled trials of intervention effects of mindfulness-based stress reduction combined with conventional hemodialysis education compared with conventional hemodialysis education on maintenance hemodialysis patients were collected.The retrieval period was from the establishment of the database to December 2019.Two researchers independently screened the literatures,extracted the data and evaluated the risk of bias in the included studies.RevMan 5.3 software was used for analysis.Results:A total of 9 studies,which comprised a total of 664 participants were included in the final meta analysis.The results showed that mindfulness-based stress reduction could reduce the anxiety of patients(SMD=?1.65,95%CI:?2.29 to?1.01),reduce the depression(SMD=?1.44,95%CI:?1.85 to?1.03).Conclusion:Mindfulness-based stress reduction therapy has positive effects on depression,anxiety in patients with maintenance hemodialysis.展开更多
<strong>Introduction:</strong> Hemodialysis is the most common end-stage renal disease treatment worldwide. Several factors may influence treatment outcomes. Adequacy (dose) of hemodialysis remains controv...<strong>Introduction:</strong> Hemodialysis is the most common end-stage renal disease treatment worldwide. Several factors may influence treatment outcomes. Adequacy (dose) of hemodialysis remains controversial;however, investigations on the effectiveness rate (Kt/V ≥ 1.2), which could reflect morbimortality, are preferred. <strong>Objective:</strong> This study aimed to describe the level of adequacy of hemodialysis among patients undergoing treatment in the city of Rio Grande (RS), Brazil. <strong>Method:</strong> In this prospective cohort study, 156 patients undergoing hemodialysis treatment between July 2016 and June 2017 in the two hemodialysis centers in the city of Rio Grande (RS), Brazil, were included. Frequency distribution as per Kt/V stratification was analyzed. Chi-square test was used to compare proportions. <strong>Results:</strong> Adequate hemodialysis (Kt/V ≥ 1.2) was observed in 105 patients (67%), 88% were from the municipality (mean age, 59 years), and 43% had visited the hospital before knowing about their kidney disease. Most of them were referred to a nephrologist (70%). Of the 156 patients, 114 patients (73%) remained in dialysis treatment, 10 (6%) underwent transplantation, 9 (6%) were transferred, and 23 (15%) died at the end of 12 months. <strong>Conclusion:</strong> Primary care should be expanded for early diagnosis of chronic kidney disease, improved venous access preparation, and increased number of patients with hemodialysis adequacy. Hemodialysis adequacy in patients undergoing treatment in the city of Rio Grande (RS), Brazil, needs to be improved.展开更多
Objective:This study aimed to evaluate the effects of progressive relaxation therapy on patients with maintenance hemodialysis.Methods:A literature search was performed using PubMed,Embase,Cochrane Library,China Natio...Objective:This study aimed to evaluate the effects of progressive relaxation therapy on patients with maintenance hemodialysis.Methods:A literature search was performed using PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data from inception to July 2020.Randomized controlled trials on the use of progressive muscle relaxation therapy in maintenance hemodialysis patients were selected.The primary outcomes were the depression and anxiety.Secondary outcomes included fatigue and sleep.Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Results:A total of 8 studies,which comprised a total of 668 participants were included in the final meta-analysis.The results showed that progressive muscle relaxation therapy could reduce the depression of patients(MD=-5.11,95%CI:-6.74 to-3.48,P<0.001),reduce the anxiety(SMD=-1.27,95%CI:-1.73 to-0.82,P<0.001),relieve fatigue symptoms(MD=-0.87,95%CI:-1.20 to-0.53,P<0.001),improve the sleep quality(MD=-1.69,95%CI:-1.95 to-1.42,P<0.001).Conclusion:Progressive muscle relaxation therapy has positive effects on depression,anxiety,fatigue and sleep quality in patients with maintenance hemodialysis.While concurrent evidence is insufficient,and further studies of high quality are needed to strengthen the conclusion.展开更多
Objective:To investigate the clinical significance of FT3 level in predicting the occurrence and development of coronary heart disease in maintenance hemodialysis patients.Methods:95 Patients who underwent maintenance...Objective:To investigate the clinical significance of FT3 level in predicting the occurrence and development of coronary heart disease in maintenance hemodialysis patients.Methods:95 Patients who underwent maintenance hemodialysis in our hospital from January 2016 to December 2017 were selected as subjects. According to whether has coronary heart disease was divided into coronary heart disease group and non coronary heart disease group, the difference of FT3 level and related laboratory indexes was observed. ROC curve analysis and COX multiple factor risk regression were used to analyze the predictive value of FT3 level on the occurrence and development of heart disease in MHD patients.Results:The concentration of FT3, Hb and ALB in CHD group was lower than that of non-CHD group (P<0.05), and the content of TG, TC, LDL-C, Hcy and Hs-CRP were significantly higher than that of non-CHD group (P<0.05). FT3 was positively correlated with Hb and ALB (T=0.821, 0.809,P<0.05), and was negatively correlated with TG, TC, LDL-C, Hcy and Hs-CRP (T=- 0.814, - 0.843, - 0.904, - 0.806, - 0.912,P<0.05). The ROC curve analysis showed that the area of AUC of FT3 was the highest, 0.864 (95%, CI:0.803~0.935), the sensitivity and specificity was 86.5% and 89.3% respectively. The area of combined diagnosis of AUC was 0.904 (95%CI:0.867~0.976), the sensitivity and specificity was 85.6% and 94.5%, respectively. After analyzing the COX risk regression model and correcting the above laboratory indicators, FT3 is an independent risk factor (HR: 0.58, 95%, CI: 0.41~0.72,P<0.05) for the adverse prognosis of MHD patients with coronary heart disease.Conclusion:It is of high clinical value to predict the development of coronary heart disease in MHD patients by FT3 level, and its mechanism may be related to the reduction of thyroxine synthesis, inflammatory reaction and atherosclerosis.展开更多
Objective: To study the correlation of erythropoietin (EPO) resistance with oxidative stress response and inflammatory response in patients with maintenance hemodialysis. Methods: A total of 184 patients with end-stag...Objective: To study the correlation of erythropoietin (EPO) resistance with oxidative stress response and inflammatory response in patients with maintenance hemodialysis. Methods: A total of 184 patients with end-stage renal disease who received maintenance hemodialysis in Shaanxi Provincial People's Hospital between March 2015 and October 2016 were selected as dialysis group, 102 volunteers who received physical examination in Shaanxi Provincial People's Hospital during the same period were selected as control group, the EPO resistance index was assessed, the median was calculated, and serum oxidative stress and inflammatory response indexes were detected. Results: Serum T-AOC, SOD and CAT levels in dialysis group were significantly lower than those in control group while MDA, AOPP, IFN-γ, HMGB-1, ICAM-1, IL-4 and IL-10 levels were significantly higher than those in control group;serum T-AOC, SOD and CAT levels in patients with high ERI were significantly lower than those in patients with low ERI while MDA, AOPP, IFN-γ, HMGB-1, ICAM-1, IL-4 and IL-10 levels were significantly higher than those in patients with low ERI. Conclusion: The degree of EPO resistance in patients with maintenance hemodialysis is closely related to the activation of oxidative stress response and inflammatory response.展开更多
Objective: To study the effect of compound α-ketoacid combined with routine nutritional intervention on the inflammatory response and oxidative stress response in patients with maintenance hemodialysis. Methods: A to...Objective: To study the effect of compound α-ketoacid combined with routine nutritional intervention on the inflammatory response and oxidative stress response in patients with maintenance hemodialysis. Methods: A total of 78 patients with uremia who received maintenance hemodialysis in Dangyang Changbanpo Hospital between February 2014 and November 2016 were collected and divided into control group and observation group according to the random number table method, 39 cases in each group. The control group received routine nutritional intervention, and the observation group underwent compound α-ketoacid combined with routine nutritional intervention. The serum levels of inflammatory factors and oxidative stress indicators in two groups of patients were detected before dialysis and 6 months after dialysis. Results: Before dialysis, differences in serum levels of inflammatory factors and oxidative stress indexes were not statistically significant between two groups of patients. After dialysis, serum CRP, IL-6, TNF-α, MDA and AOPP levels of both groups of patients were significantly higher than those before dialysis while SOD and GSHPx levels were significantly lower than those before dialysis and serum CRP, IL-6, TNF-α, MDA and AOPP levels of observation group after dialysis were significantly lower than those of control group while SOD and GSHPx levels were significantly higher than those of control group. Conclusions:Compound α-ketoacid combined with routine nutritional intervention can effectively reduce the systemic microinflammatory state and inhibit the oxidative stress response in patients with maintenance hemodialysis.展开更多
Objective:To study the effect of nephrotic enteral nutrition preparation on the nutritional status and microinflammatory state in patients with maintenance hemodialysis complicated by malnutrition.Methods: A total of ...Objective:To study the effect of nephrotic enteral nutrition preparation on the nutritional status and microinflammatory state in patients with maintenance hemodialysis complicated by malnutrition.Methods: A total of 68 patients who received maintenance hemodialysis and had malnutrition in our hospital between January 2013 and July 2016 were collected and divided into control group (n=34) and observation group (n=34) according to random number table. Control group received regular dietary intervention, and observation group received nephrotic enteral nutrition preparation based on routine intervention. Nutritional status and microinflammatory state before and after intervention were compared between two groups of patients.Results: Before intervention, the differences in peripheral blood levels of protein indexes and trace elements as well as serum levels of inflammatory factors were not statistically significant between two groups of patients. After intervention, peripheral blood nutrition-related proteins TP, ALB, PA, Hb and TRF levels of observation group were higher than those of control group;peripheral blood trace elements Zn and Fe levels were higher than those of control group while Ca level was lower than that of control group;serum inflammatory factors IL-6, hs-CRP and TNF-α levels were lower than those of control group. Conclusion:Nephrotic enteral nutrition preparation can effectively optimize the nutritional status and reduce the microinflammation degree in patients with maintenance hemodialysis complicated by malnutrition.展开更多
Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter ind...Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter indwelling in our hospital from December 2019 to September 2020 were divided into routine group and study group.The routine group was given routine nursing,and the study group was given fine management nursing.The nursing effect of the two groups was analyzed.Results:After nursing intervention,the incidence of complications in the study group was 14.66%,which was lower than that in the conventional group(53.33%),and the nursing compliance in the study group(98.66%)was higher than that in the conventional group(89.33%),all P<0.05.Conclusion:Fine management plays a significant role in the maintenance of deep venous indwelling catheter in hemodialysis patients,which can reduce the occurrence of complications.展开更多
Objective:This paper mainly analyzes the effect of infrared radiation combined with external application nursing on maintenance of vascular access in hemodialysis patients.Methods:A total of 150 hemodialysis patients ...Objective:This paper mainly analyzes the effect of infrared radiation combined with external application nursing on maintenance of vascular access in hemodialysis patients.Methods:A total of 150 hemodialysis patients in our hospital from December 2019 to September 2020 were divided into the conventional group and the study group,75 cases in each group.The conventional group was given external application nursing alone,and the study group was given infrared radiation combined with external application nursing,and the effect on the maintenance of vascular access was counted.Results:After the intervention,the indexes of URR,kt/V and human albumin in the study group were higher than those in the routine group,and the indexes of β2-mg and MIS in the study group were lower than those in the routine group,P<0.05;The improvement of vascular elasticity and quality of life in the study group was higher than that in the conventional group,and the incidence of complications was lower than that in the conventional group,P<0.05.Conclusion:Infrared radiation combined with external application of nursing care in hemodialysis patients with vascular access maintenance effect is significant,can effectively improve vascular elasticity.展开更多
Objective: To investigate the status of caregiver burden and influencing factors among family caregivers in maintenance hemodialysis (MHD) patients under the background of coronavirus disease 2019, and to provide refe...Objective: To investigate the status of caregiver burden and influencing factors among family caregivers in maintenance hemodialysis (MHD) patients under the background of coronavirus disease 2019, and to provide references for nursing intervention. Methods: From May to August 2020, 237 convenient samples were recruited from the Hemodialysis Centers of The Renmin Hospital of Wuhan University and Zhongnan Hospital of Wuhan University. Questionnaires were conducted with the General Information Questionnaire, Zarit Burden Interview (ZBI), Sense of Coherence-13 (SOC-13) and Perceived Social Support Scale (PSSS). Multiple linear regression was used to analyze the influencing factors of caregiver burden. Results: The score of ZBI among the caregivers was (36.05 ± 14.09). The ZBI of family caregivers was negatively correlated with SOC-13 and PSSS (P < 0.01). Multiple regression results showed that professional status of MHD patients, activity of MHD patients, comprehensibility, manageability and other support were the main influencing factors of their caregiver burden (P < 0.01), which explained 44.4% of the variance. Conclusion: The caregiver burden among family caregivers of MHD patients was above average under the background of COVID-19, which indicated that they felt more burden in the process of caring. Medical staff could give targeted support and guidance in combination with their influencing factors to reduce their caregiver burden further.展开更多
INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefor...INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission展开更多
This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(M...This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.展开更多
基金Supported by the Natural Science Foundation Project of Xinjiang Uygur Autonomous Region,No.2021D01C143.
文摘BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
基金supported by Youth Fund Project of National Natural Science Foundation of China(No.81904141)Hubei Chen Xiaoping Science and Technology Development Foundation 2022 Huaiqi Huang Special Fund for Immune Disease Research(No.CXPJJH122003-09)Kidney Health for All-A Series of Science Popularization Project for Middle aged and Elderly Patients with Chronic Diseases under the Epidemic Situation(No.22KPHDRC00040).
文摘Objective:We used meta-analysis to explore the clinical efficacy of auricular point therapy combined with modern medicine in improving depression/anxiety in maintenance hemodialysis patients.Methods:We searched CNKI,Wanfang,Weipu,CBM,The Cochrane Library,PubMed,Web of Science,Embase through computer to build a randomized controlled trials of auricular therapy combined with modern medicine in the treatment of depression/anxiety disorders in China and abroad since 2022.Two evaluators independently screened the studies,extracted and cross-checked the key data in the studies independently after determining the included studies,and then evaluated the quality of the studies respectively.Finally,we used RevMan 5.3 platform for statistical processing of data.Results:This meta-analysis included a total of 12 clinical randomized controlled trials,including a total of 899 patients.The results showed that the observation group was more effective in reducing the scores of Hamilton Anxiety Scale,self rating Anxiety Scale,self rating Depression Scale,Pittsburgh sleep quality index score of maintenance hemodialysis patients.In addition,there was no statistical difference between the observation group and the control group in improving the total clinical effective rate.Conclusion:The observation group has a more obvious effect on the improvement of anxiety or depression in maintenance hemodialysis patients.However,due to the limitation of the quantity and quality of the included studies,the real efficacy of auricular therapy combined with modern medicine in improving anxiety or depression disorder after maintenance hemodialysis still needs to be supported by more carefully designed and standardized multi-center,large-sample clinical studies.
文摘Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-Aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: All patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.
文摘Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.
基金supported by the National Natural Science Foundation of China(81400262)the Backbone Fund of Peking University Third Hospital(Y72497-04)
文摘Background Coronary artery calcification(CAC)is common in end-stage renal disease(ESRD)patients,and the extent of CAC is closely related to cardiovascular outcomes in ESRD patients.Cartilage oligomeric matrix protein(COMP),as a component of the vascular matrix,has been found to be an inhibitor of arterial calcification in basic studies.However,there is no clinical research on the correlation between COMP and CAC in maintenance hemodialysis(MHD)patients.The aim of this study was to explore the relationship between serum COMP levels and CAC and cardiovascular events in MHD patients.Methods Serum COMP levels were compared between 54 MHD patients and 66 healthy people.MHD patients were then divided into three groups according to the tertiles of the concentration of COMP level and were followed up for major adverse cardiac events(MACEs),which were defined as a combined end point of new onset angina pectoris,nonfatal myocardial infarction,heart failure,coronary artery revascularization,hospitalization due to angina pectoris and all-cause deaths.The CAC score was calculated based on computed tomography scans.Results The serum COMP level in MHD patients was significantly higher than that in the general population[984.23(248.43-1902.61)ng/mL vs.219.01(97.26-821.92)ng/mL,P<0.01].Serum COMP levels were positively correlated with CAC(r=0.313,P=0.021)and serum parathyroid hormone in MHD patients(r=0.359,P<0.01).Linear regression suggested that after adjusting for age,fasting blood glucose(Glu)and glycosylated hemoglobin(HbAlc),CAC score was an independent predictor in the final model for COMP level(β=0.424,t=3.130,P<0.01).The receiver operating characteristic(ROC)curve showed that COMP≥994 mg/mL had 68.0%sensitivity and 72.4%specificity for the prediction of severe CAC[area under the curve(AUC):0.674,P=0.030,95%CI:0.526-0.882].After a median follow-up of 16 months(8-24 months),there was no difference in the incidence rate of MACEs between the upper,middle and lower serum COMP groups.Conclusions Our study found that MHD patients have higher levels of circulating COMP than controls.The serum COMP level is positively correlated with CAC score and could be used as a biomarker of severe CAC in MHD patients.However,there is no obvious correlation between serum COMP levels and the incidence of cardiovascular events.
基金supported by the Science and Technology Fund of Xi'an(No.SF08002)
文摘Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis(MHD)patients and possible mechanism.Methods A total of 40 MHD patients [mean age(53.5±7.1)years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups,Levocarnitine supplemented group(LS-G)(n=20;Levocarnitine supplementation after each normal hemodialysis session,at a dose of 1.0 g/day by intravenous administration)and control group(C-G)(n=20;normal hemodialysis).Before treatment,one month and three months after treatment we respectively measured or observed the following items,the tolerance to hemodialysis,carnitine level in plasma,C-reactive protein,IL-6,TNF-α,percentage of neutrophil,and some relevant nutritional parameters,such as lipid profile,transferrin,total protein,albumin and prealbumin levels.Comparative analysis was conducted between the two groups.Results In LS-G three months after treatment,the levels of carnitine,hemoglobin,and prealbumin in plasma were significantly increased(P<0.05),but C-reactive protein,neutrophil percentage,low-density lipoprotein and triglyceride were significantly decreased(P<0.05)in contrast to those in C-G and before treatment.Transferrin,total protein,and albumin were elevated in LS-G,with no statistical significance.Conclusion There was a significant improvement of lipid metabolism and nutritional status for the long-term maintenance hemodialysis patients with Levocarnitine supplementation.And this improvement is related to the decrease of inflammatory factors.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease,a group of patients known to be particularly susceptible to infectious complications.AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODS We searched PubMed/MEDLINE,EMBASE,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Web of Science databases for relevant terms and imported the results into the Covidence platform.From there,studies were assessed in two stages for relevance and quality,and data from studies that satisfied all the requirements were extracted into a spreadsheet.The data was then analyzed descriptively and statistically.RESULTS Of the 920 studies identified through the initial database search,only 17 were included in the final analysis.The studies included in the analysis were mostly carried out during the first wave.We found that COVID-19 incidence among patients on hemodialysis was significant,over 10%in some studies.Those who developed COVID-19 infection were most likely going to be hospitalized,and over 1 in 5 died from the infection.Intensive care unit admission rate was lower than the infection lethality rate.Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections,and a significant proportion was infected during the first wave.Their prognosis is overall much worse than in the general population,and every effort needs to be made to decrease their exposure.
文摘Objective:This study aimed to evaluate the effects of mindfulness-based stress reduction therapy on anxiety and depression in patients with maintenance hemodialysis.Methods:CNKI,VIP,WanFang,CBM,Embase,the Cochrane Library and PubMed databases were retrieved.Randomized controlled trials of intervention effects of mindfulness-based stress reduction combined with conventional hemodialysis education compared with conventional hemodialysis education on maintenance hemodialysis patients were collected.The retrieval period was from the establishment of the database to December 2019.Two researchers independently screened the literatures,extracted the data and evaluated the risk of bias in the included studies.RevMan 5.3 software was used for analysis.Results:A total of 9 studies,which comprised a total of 664 participants were included in the final meta analysis.The results showed that mindfulness-based stress reduction could reduce the anxiety of patients(SMD=?1.65,95%CI:?2.29 to?1.01),reduce the depression(SMD=?1.44,95%CI:?1.85 to?1.03).Conclusion:Mindfulness-based stress reduction therapy has positive effects on depression,anxiety in patients with maintenance hemodialysis.
文摘<strong>Introduction:</strong> Hemodialysis is the most common end-stage renal disease treatment worldwide. Several factors may influence treatment outcomes. Adequacy (dose) of hemodialysis remains controversial;however, investigations on the effectiveness rate (Kt/V ≥ 1.2), which could reflect morbimortality, are preferred. <strong>Objective:</strong> This study aimed to describe the level of adequacy of hemodialysis among patients undergoing treatment in the city of Rio Grande (RS), Brazil. <strong>Method:</strong> In this prospective cohort study, 156 patients undergoing hemodialysis treatment between July 2016 and June 2017 in the two hemodialysis centers in the city of Rio Grande (RS), Brazil, were included. Frequency distribution as per Kt/V stratification was analyzed. Chi-square test was used to compare proportions. <strong>Results:</strong> Adequate hemodialysis (Kt/V ≥ 1.2) was observed in 105 patients (67%), 88% were from the municipality (mean age, 59 years), and 43% had visited the hospital before knowing about their kidney disease. Most of them were referred to a nephrologist (70%). Of the 156 patients, 114 patients (73%) remained in dialysis treatment, 10 (6%) underwent transplantation, 9 (6%) were transferred, and 23 (15%) died at the end of 12 months. <strong>Conclusion:</strong> Primary care should be expanded for early diagnosis of chronic kidney disease, improved venous access preparation, and increased number of patients with hemodialysis adequacy. Hemodialysis adequacy in patients undergoing treatment in the city of Rio Grande (RS), Brazil, needs to be improved.
文摘Objective:This study aimed to evaluate the effects of progressive relaxation therapy on patients with maintenance hemodialysis.Methods:A literature search was performed using PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data from inception to July 2020.Randomized controlled trials on the use of progressive muscle relaxation therapy in maintenance hemodialysis patients were selected.The primary outcomes were the depression and anxiety.Secondary outcomes included fatigue and sleep.Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Results:A total of 8 studies,which comprised a total of 668 participants were included in the final meta-analysis.The results showed that progressive muscle relaxation therapy could reduce the depression of patients(MD=-5.11,95%CI:-6.74 to-3.48,P<0.001),reduce the anxiety(SMD=-1.27,95%CI:-1.73 to-0.82,P<0.001),relieve fatigue symptoms(MD=-0.87,95%CI:-1.20 to-0.53,P<0.001),improve the sleep quality(MD=-1.69,95%CI:-1.95 to-1.42,P<0.001).Conclusion:Progressive muscle relaxation therapy has positive effects on depression,anxiety,fatigue and sleep quality in patients with maintenance hemodialysis.While concurrent evidence is insufficient,and further studies of high quality are needed to strengthen the conclusion.
文摘Objective:To investigate the clinical significance of FT3 level in predicting the occurrence and development of coronary heart disease in maintenance hemodialysis patients.Methods:95 Patients who underwent maintenance hemodialysis in our hospital from January 2016 to December 2017 were selected as subjects. According to whether has coronary heart disease was divided into coronary heart disease group and non coronary heart disease group, the difference of FT3 level and related laboratory indexes was observed. ROC curve analysis and COX multiple factor risk regression were used to analyze the predictive value of FT3 level on the occurrence and development of heart disease in MHD patients.Results:The concentration of FT3, Hb and ALB in CHD group was lower than that of non-CHD group (P<0.05), and the content of TG, TC, LDL-C, Hcy and Hs-CRP were significantly higher than that of non-CHD group (P<0.05). FT3 was positively correlated with Hb and ALB (T=0.821, 0.809,P<0.05), and was negatively correlated with TG, TC, LDL-C, Hcy and Hs-CRP (T=- 0.814, - 0.843, - 0.904, - 0.806, - 0.912,P<0.05). The ROC curve analysis showed that the area of AUC of FT3 was the highest, 0.864 (95%, CI:0.803~0.935), the sensitivity and specificity was 86.5% and 89.3% respectively. The area of combined diagnosis of AUC was 0.904 (95%CI:0.867~0.976), the sensitivity and specificity was 85.6% and 94.5%, respectively. After analyzing the COX risk regression model and correcting the above laboratory indicators, FT3 is an independent risk factor (HR: 0.58, 95%, CI: 0.41~0.72,P<0.05) for the adverse prognosis of MHD patients with coronary heart disease.Conclusion:It is of high clinical value to predict the development of coronary heart disease in MHD patients by FT3 level, and its mechanism may be related to the reduction of thyroxine synthesis, inflammatory reaction and atherosclerosis.
文摘Objective: To study the correlation of erythropoietin (EPO) resistance with oxidative stress response and inflammatory response in patients with maintenance hemodialysis. Methods: A total of 184 patients with end-stage renal disease who received maintenance hemodialysis in Shaanxi Provincial People's Hospital between March 2015 and October 2016 were selected as dialysis group, 102 volunteers who received physical examination in Shaanxi Provincial People's Hospital during the same period were selected as control group, the EPO resistance index was assessed, the median was calculated, and serum oxidative stress and inflammatory response indexes were detected. Results: Serum T-AOC, SOD and CAT levels in dialysis group were significantly lower than those in control group while MDA, AOPP, IFN-γ, HMGB-1, ICAM-1, IL-4 and IL-10 levels were significantly higher than those in control group;serum T-AOC, SOD and CAT levels in patients with high ERI were significantly lower than those in patients with low ERI while MDA, AOPP, IFN-γ, HMGB-1, ICAM-1, IL-4 and IL-10 levels were significantly higher than those in patients with low ERI. Conclusion: The degree of EPO resistance in patients with maintenance hemodialysis is closely related to the activation of oxidative stress response and inflammatory response.
文摘Objective: To study the effect of compound α-ketoacid combined with routine nutritional intervention on the inflammatory response and oxidative stress response in patients with maintenance hemodialysis. Methods: A total of 78 patients with uremia who received maintenance hemodialysis in Dangyang Changbanpo Hospital between February 2014 and November 2016 were collected and divided into control group and observation group according to the random number table method, 39 cases in each group. The control group received routine nutritional intervention, and the observation group underwent compound α-ketoacid combined with routine nutritional intervention. The serum levels of inflammatory factors and oxidative stress indicators in two groups of patients were detected before dialysis and 6 months after dialysis. Results: Before dialysis, differences in serum levels of inflammatory factors and oxidative stress indexes were not statistically significant between two groups of patients. After dialysis, serum CRP, IL-6, TNF-α, MDA and AOPP levels of both groups of patients were significantly higher than those before dialysis while SOD and GSHPx levels were significantly lower than those before dialysis and serum CRP, IL-6, TNF-α, MDA and AOPP levels of observation group after dialysis were significantly lower than those of control group while SOD and GSHPx levels were significantly higher than those of control group. Conclusions:Compound α-ketoacid combined with routine nutritional intervention can effectively reduce the systemic microinflammatory state and inhibit the oxidative stress response in patients with maintenance hemodialysis.
文摘Objective:To study the effect of nephrotic enteral nutrition preparation on the nutritional status and microinflammatory state in patients with maintenance hemodialysis complicated by malnutrition.Methods: A total of 68 patients who received maintenance hemodialysis and had malnutrition in our hospital between January 2013 and July 2016 were collected and divided into control group (n=34) and observation group (n=34) according to random number table. Control group received regular dietary intervention, and observation group received nephrotic enteral nutrition preparation based on routine intervention. Nutritional status and microinflammatory state before and after intervention were compared between two groups of patients.Results: Before intervention, the differences in peripheral blood levels of protein indexes and trace elements as well as serum levels of inflammatory factors were not statistically significant between two groups of patients. After intervention, peripheral blood nutrition-related proteins TP, ALB, PA, Hb and TRF levels of observation group were higher than those of control group;peripheral blood trace elements Zn and Fe levels were higher than those of control group while Ca level was lower than that of control group;serum inflammatory factors IL-6, hs-CRP and TNF-α levels were lower than those of control group. Conclusion:Nephrotic enteral nutrition preparation can effectively optimize the nutritional status and reduce the microinflammation degree in patients with maintenance hemodialysis complicated by malnutrition.
文摘Objective:This paper mainly explores the effect of fine management application in maintenance of deep venous indwelling catheter in hemodialysis patients.Methods:150 hemodialysis patients with deep venous catheter indwelling in our hospital from December 2019 to September 2020 were divided into routine group and study group.The routine group was given routine nursing,and the study group was given fine management nursing.The nursing effect of the two groups was analyzed.Results:After nursing intervention,the incidence of complications in the study group was 14.66%,which was lower than that in the conventional group(53.33%),and the nursing compliance in the study group(98.66%)was higher than that in the conventional group(89.33%),all P<0.05.Conclusion:Fine management plays a significant role in the maintenance of deep venous indwelling catheter in hemodialysis patients,which can reduce the occurrence of complications.
文摘Objective:This paper mainly analyzes the effect of infrared radiation combined with external application nursing on maintenance of vascular access in hemodialysis patients.Methods:A total of 150 hemodialysis patients in our hospital from December 2019 to September 2020 were divided into the conventional group and the study group,75 cases in each group.The conventional group was given external application nursing alone,and the study group was given infrared radiation combined with external application nursing,and the effect on the maintenance of vascular access was counted.Results:After the intervention,the indexes of URR,kt/V and human albumin in the study group were higher than those in the routine group,and the indexes of β2-mg and MIS in the study group were lower than those in the routine group,P<0.05;The improvement of vascular elasticity and quality of life in the study group was higher than that in the conventional group,and the incidence of complications was lower than that in the conventional group,P<0.05.Conclusion:Infrared radiation combined with external application of nursing care in hemodialysis patients with vascular access maintenance effect is significant,can effectively improve vascular elasticity.
基金This research has received support from Health Commission of Hubei Provincial(No.LHHL2020ZD-02)Renmin Hospital of Wuhan University(No.HL2021ZC-02).
文摘Objective: To investigate the status of caregiver burden and influencing factors among family caregivers in maintenance hemodialysis (MHD) patients under the background of coronavirus disease 2019, and to provide references for nursing intervention. Methods: From May to August 2020, 237 convenient samples were recruited from the Hemodialysis Centers of The Renmin Hospital of Wuhan University and Zhongnan Hospital of Wuhan University. Questionnaires were conducted with the General Information Questionnaire, Zarit Burden Interview (ZBI), Sense of Coherence-13 (SOC-13) and Perceived Social Support Scale (PSSS). Multiple linear regression was used to analyze the influencing factors of caregiver burden. Results: The score of ZBI among the caregivers was (36.05 ± 14.09). The ZBI of family caregivers was negatively correlated with SOC-13 and PSSS (P < 0.01). Multiple regression results showed that professional status of MHD patients, activity of MHD patients, comprehensibility, manageability and other support were the main influencing factors of their caregiver burden (P < 0.01), which explained 44.4% of the variance. Conclusion: The caregiver burden among family caregivers of MHD patients was above average under the background of COVID-19, which indicated that they felt more burden in the process of caring. Medical staff could give targeted support and guidance in combination with their influencing factors to reduce their caregiver burden further.
基金Scientific Research Foundation,State Health Commission,No.96-2-128
文摘INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission
文摘This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.
