Objective To investigate the efficacy and safety of polyethersulfone highflux dialyzer for uremic patients. Methods Forty eligible uremic patients were randomized into two groups, i.e. polyethersulfone (PES) group and polysulfone(PSF) group, according to a random number table. The PES group received hemodialysis for 4 hours with polyethersulfone highflux dialyzer (Chengdu OCI Medical Device Co., Ltd), and the PSF group with polysulfone highflux dialyzers (Fresenius Polysulfones, Fresenius Medical Care, Bad Homburg, Germany). Changes in serum creatinine, urea, β2-microglobulin, hemoglobin and albumin levels were determined for efficacy and safety evaluation. Results All the 40 patients completed the trial. The serum creatinine, urea, β2-microglobulin levels of all the patients in the two groups decreased (gt;30%) after the hemodialysis with different highflux dialyzers, and no significant difference was observed between the two groups (Pgt;0.05). Changes in solute clearance index (KT/V) value, hemoglobin and albumin levels were also comparable between the two groups (Pgt;0.05). Conclusions The efficacy and safety of the PES hollow fiber membrane hemodialyzer is equivalent to that of the PSF hemodialyzer in hemodialysis for uremic patients.
ObjectiveTo explore the value of ultrasound evaluation and marking before arteriovenous internal fistula in end-stage renal disease hemodialysis patients. MethodsTwenty-five uremia end-stage patients were admitted into our nephrology department from January 2012 to July 2012. All of the patients had encountered several times of fistula failure or had difficulty in establishing the forearm arteriovenous fistula. We focused on observing the brachial artery, radial artery, cephalic vein, the basilica vein and great saphenous vein. We measured the diameter of the vessels and marked the trend of arteries and veins in the body surface under the ultrasonic navigation. Our goal was to look for appropriate bypass vessels in the elbow and the upper arm. ResultsFourteen patients had endured several times of fistula failure. Among the 14 patients, 9 patients completed the surgery of reengineering fistula and autogenous great saphenous vein transplantation, 2 accepted artificial vascular transplantation, 1 completed the removal of blood clots in the left upper limb artificial blood vessels and arteriovenous internal fistula molding, and 2 gave up surgery. Eleven patients could not complete the arteriovenous fistula operation for the fine forearm superficial vein. Of them, 2 patients accepted artificial vascular operation, 6 underwent autogenous great saphenous vein transplantation, 1 with slender radial artery in diameter completed higher position fistula between the brachial artery and median cubital vein, and 2 gave up surgery. ConclusionArteriovenous internal fistula preoperative ultrasound assessment and marking have very important value in improving the success rate of operation in end-stage uremia patients.
Objective To investigate the change of cardiac structure and function in patients with uremia before and after peritoneal dialysis (PD). Methods Eighty three standard continuous ambulatory peritoneal dialysis (CAPD) patients treated between October 2009 and October 2014 were selected in this study. According to the ultrasound cardiogram before and 6 months after the PD, we analyzed the influence of age, diabetes mellitus, dialysis interval, hemoglobin, serum albumin, serum creatinine, serum calcium and phosphate and parathyroid hormone (PTH) on the cardiac structure and function. Results Hemoglobin increased significantly after PD (P <0.01), while albumin and PTH decreased significantly (P <0.01). The changes in creatinine, triglyceride and cholesterol were not statistically significant (P > 0.05). For CAPD patients, cardiac systolic function did no t obviously change before and after dialysis, while the diastolic function improved obviously after dialysis. Conclusion PD may improve cardiac diastolic function of CAPD patients.
Objective To observe the treatment efficacy and safety of glucosamine hydrochloride tablets on uremia patients with knee osteoarthritis (OA). Methods A total of 118 uremia patients with knee OA were selected and randomly divided into the glucosamine hydrochloride tablets treatment group (treatment group) and the coated aldehyde oxystarch capsules group (control group) with 59 cases in each group. The course was 8 weeks. The Lequesne Index was assessed for curative effect evaluation, and the change of blood indexes was observed to evaluate drug safety. Results The total effective rate of Lequesne Index in the treatment group was 72.9%, while that in the control group was 13.6%; the difference was statistically significant (χ2=42.303, P<0.001). There was no significant change in the two groups before and after treatment in terms of the patients’ dialysis adequacy, routine blood, blood electrolytes, liver and kidney function (P>0.05). Conclusion Glucosamine hydrochloride tablets is curative and safe in the treatment of uremia patients with OA.
ObjectiveTo explore the changes of serum irisin in maintenance hemodialysis (MHD) patients with sarcopenia.MethodsFrom January to June 2019, 56 MHD patients from Shanxi Provincial People’s Hospital were selected. Judging by the results of body composition analyzer, the MHD patients were divided into the sarcopenia group (n=31) and the non-sarcopenia group (n=25). The serum irisin level was detected by enzyme-linked immunosorbent assay. The muscle cross-sectional area at the third lumbar level was measured by CT. SPSS 21.0 software was used for inter-group comparison, correlation analysis, and regression analysis.ResultsThe serum irisin concentration in the sarcopenia group was lower than that in the non-sarcopenia group [medium (lower quartile, upper quartile): 175.46 (126.00, 220.52) vs. 459.10 (233.83, 616.91) pg/mL; Z=−4.195, P<0.001]. The results of Spearman correlation analysis showed that serum irisin level was positively correlated with lean tissue index (rs=0.265, P=0.048), however negatively correlated with serum creatinine level (rs=−0.311, P=0.020). The results of logistic regression analysis showed that serum irisin level [odds ratio (OR)=0.957, 95% confidence interval (CI) (0.925, 0.990), P=0.012], walking speed [OR=0.000, 95%CI (0.000, 0.050), P=0.031], and grip strength [OR=0.658, 95%CI (0.434, 0.997), P=0.048] were protective factors of sarcopenia in MHD patients.ConclusionsThe level of circulating irisin in MHD patients with sarcopenia is lower than that in MHD patients without sarcopenia. Irisin is a protective factor of sarcopenia in MHD patients.