DIALYSIS. EPIDEMIOLOGY, OUTCOME RESEARCH, HEALTH SERVICES 2
J. BornsteinK. McCulloughChristian CombeBrian BieberMichel JadoulR. PisoniLaura H. MarianiBruce RobinsonAkihiko SaitoAnanda SenF. TentoriAdrián GuinsburgC. MarelliDaniele MarcelliL. UsvyatDugan MadduxB. CanaudP. KotankoS.-J. HwangHsing‐Mei HsiehHsin‐Fu ChenL.-W. MauMing‐Yen LinC.-C. HsuWancai YangDavid PitcherAnirudh RaoRichard PhelpsB. CanaudC. BarbieriDaniele MarcelliFrancesco BellocchioSudhir K. BowryF MariC. AmatoEmanuele GattiE. ZittHildegard Hafner-GießaufBirgitta WimmerAlexander HerrSabine HornClaudia FriedlHannelore Sprenger-MaehrR KramárAlexander R. RosenkranzK. LhottaM. FerrisDaniele MarcelliC. MarelliMichael EtterXiaoqi XuA. GrassmannGero D. von GersdorffR. Pecoits-FilhoL. SylvestreP. KotankoL. UsvyatM. ConsortiumPavlina Dzekova‐VidimliskiIgor NikolovL. TrajceskaG. SelimS. GelevNadica Matevska-GeshkovskaAleksandar DimovskiA. SikoleG. SuleymanlarCengiz UtaşT. EcderKenan AteşBrian BieberBruce RobinsonR. L. PisoniS. LaplanteF. X. LiuBruce F. CulletonNatalia TomilinaBoris BikbovAnton AndrusevAlexander ZemchenkovBrian BieberBruce RobinsonR. L. PisoniBoris BikbovNatalia TomilinaO. KotenkoAnton AndrusevM. PanayeA. JolivotSandrine LemoineFitsum Guebre-EgziabherMuriel DoretL. JuillardV. FiliopoulosDimitrios HadjiyannakosA. PapakostoulaLamprini TakouliD. BiblakiAlexandros DounavisDimosthenis VlassopoulosBoris BikbovNatalia TomilinaJamal Al WakeelBrian BieberAli ObaidliYaqoob A. AlmaimaniSameer Al-ArrayedBassam AlHelalAshraf FawzyBruce RobinsonR. L. PisoniFilippo AucellaG. GirottiAntonio GesueteAntonio CicchellaChiara SeresinC. VinciGiuseppe ScaparrottaA NasoAlberto PilottoTobias HoffmannVictor FlusserL. SantoroFernando Antônio de AlmeidaFilippo AucellaG. GirottiAntonio GesueteAntonio CicchellaChiara SeresinC. VinciGiuseppe ScaparrottaS. GanugiT. GnerreG. E. RussoM. AmatoA NasoAlberto PilottoKonstantina TrigkaP. DouzdampanisKonstantinos ChouchoulisA. MpimpiMohan KazaC. PipiliIlias KyritsisC. FourtunasVittorio OrtaldaPaola TomeiT. YbarekA. LupoM. TorreggianiVittoria EspositoD. CatucciM. ArazziMarco ColucciG. MontagnaLuca SemeraroE. EfficaceV. PiazzaL. PicardiC. EspositoReza HekmatMehdi MohebiS. AhmadzadehhashemiJay J. ParkE. HwangMin JangHyuntae ParkL. L. ResendeM. A. DantasMárcia MartinsGildete Barreto LopesACC LopesW. EngelenMonique ElseviersE. GheuensCarey ColsonI. MuyshondtR. DaelemansYao HeJenny ChenShen LuanQijun WanAurora CuoghiElisa BelleiEmanuela MonariStefania BergaminiAldo TomasiMarta Luisa Ciofi degli AttiMarialuisa CaiazzoGiuseppe PalladinoFrancesco BruniHikmet TekçeSavaş ÖztürkGülali AktaşBuket Kın TekçeAbdulvahit ErdemUğur ÜyetürkMehmet ÖzyaşarTuba Taslamacıoğlu DumanMehmet YazıcıDouglas E. SchaubelKeith McCulloughHal MorgensternMartin GallagherTakeshi HasegawaR. L. PisoniBruce RobinsonHakan NacakMerel van DiepenM. SuttorpEwout J. HoornJan RotmansFriedo W. DekkerÉlodie SpeyerDavy BeaugerS GentileCorinne Isnard BagnisYvanie CailléChristian BaudelotSylvie MercierChristian JacquelinetS. BriançonT. SosorburamBadamgarav Bat-ErdeneA. DelgerR. DaelemansE. GheuensW. EngelenK. De BoeckJ. MarynissenKoen BoumanMichelle MannDerek V. ExnerBrenda R. HemmelgarnDavid A. HanleyShoker Ahmed
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<i>Background:</i> End-stage renal disease is a major health problem worldwide nowadays. Although conventional hemodialysis is the most widely used modality, short daily hemodialysis has been proposed as a more physiologic treatment. The objective of this article is to compare the quality of life of patients on each hemodialysis modality. <i>Methods:</i> A multicentric cross-sectional study was performed in 9 Spanish hospitals. Patients treated for at least 3 months with conventional or short daily hemodialysis were included and quality of life measured using the Euroqol-5D quality of life questionnaire. Bayesian models were used for analyzing quality of life results. <i>Results:</i> Ninety-three patients were included, 27 were on daily hemodialysis and 66 on conventional hemodialysis. All models demonstrated a better quality of life for daily hemodialysis versus conventional hemodialysis. Only 14% of the patients on conventional hemodialysis were willing to change to a daily schedule. <i>Conclusions:</i> Short daily hemodialysis shows a better quality of life than conventional hemodialysis with all Bayesian approaches considered.
Home hemodialysis
Cross-sectional study
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Objective To investigate the change of IL-17 pre-hemodialysis and post-hemodialysis,and relationship between IL-17and hemodialysis,to find the differentiation direction of CD4+T cells post-hemodialysis.Methods Twenty five CRF patients undergoing hemodialysis treatment more than 1/2 year were chosen in observation group,and 30healthy volunteers were chosen in control group.IL-17,BUN,phosphorus(P)changes were observe in pre-hemodialysis and post-hemodialysis.Results BUN,P,and IL-17 levels of observation group in pre-hemodialysis were significantly higher than those of control group(P0.05),IL-17levels of observation group in pre-hemodialysis were significantly higher than those of observation group in post-hemodialysis(P0.05).BUN,and P levels in pre-hemodialysis were significantly lower than those of observation group in post-hemodialysis(P0.01).Conclusion It suggests that IL-17 may involve in the abnormality of immunity and the pathology of microinflammation in MHD patients after hemodialysis.Uremic symptoms leads to high expression of IL-17.It may suggests that the main differentiation direction of CD4+T cells in post-hemodialysis is IL-17.
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Objective To study the hemodialysis filtration effect on the inflammatory state of hemodialysis patients.Methods We selected 30 cases of maintenance hemodialysis (MHD) patients in hemodialysis room,and randomly divided them into observation group and control group (n=15).Observation group was treated with hemodialysis combined with hemodialysis filtration,the control group was treated with hemodialysis,then observed and recorded the improvement conditions of ALb,BUN,Scr,IL-6,TNF alpha and hs-CRP levels in two groups.Results 12 weeks after treatment IL-6,TNF alpha,hs-CRP levels in observation group patients were significantly lower than those in the control group,ALb propagated level was higher,the comparative differences showed statistical significance (P ＜ 0.05).Conclusion Hemodialysis filtration in treatment for MHD patients can effectively improve the patients' micro inflammatory state,and improve their quality of survival.
Key words:
Hemodialysis filtration; Hemodialysis; Micro inflammation
Filtration (mathematics)
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The aim of the present study was to determine changing in serum iron (Fe), copper (Cu) and ferritin levels in hemodialysis patients and to indicate whether there were any correlations between elements and ferritin levels. The study was carried out on 47 hemodialysis patient with the mean age 50.26±16.36 yr who were dialyzed with a range of 2-16 years. This group called as "Hemodialysis group". Blood samples were taken before (pre-hemodialysis) and after (post-hemodialysis) the hemodialysis session. "Control group" included 23 healthy volunteers with the mean age 39.52±11.54 yr. The findings demonstrated that there were no significant differences between the all groups according to data of serum Fe levels. However, serum Cu levels were higher in pre-hemodialysis than the control group (p<0.05) and serum ferritin levels were higher in group pre and post-hemodialysis than the control group (p<0.001). In pre-hemodialysis a significant positive correlations between ferritin and Fe (r=0.373, p<0.05), Fe and Cu (r=0.410, p<0.01) were determined. Findings obtained from the study deliberate that alterations in the levels of Cu may be important for the hemodialysis patients. In addition to correlation between Fe and Cu suggests that there is association between these elements. Further studies are necessary to clarify the association between Fe and Cu.
Iron group
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Objective:To assess the prophylactic effect of sodium modeling hemodialysis on hypotension during hemodialysis in patients with high risk factors(elderly,diabetic nephropathy and cardiac insufficiency).Methods:30regular hemodialysis patients with above risk factors was employed,Under the conditions of same blood flow and constantul trafiltration volume,all patients were performed conventional hemodialysis(CHD) at the first month wth the sodium concertation of Hemodialysis fluid 138mmol/L(A group) and sodium profile hemodialysis(PHD) at the second month with the sodium concertation of Hemodialysis fluid reduced from 148 mmol/L to 135mmol/L(B group),the serum concertations of sodium were detected pre-Hemodialysis and post-Hemodialysis,respectively,the occurrence of hypotension during Hemodialysis was also observed during Hemodialysis.Results:(1)compared with group B,no obvious difference of serum sodium concertation occurred between pre Hemodialysis and post-Hemodialysis in group A(P0.05),(2)the occurrence rate of hypotension in group B was significantly reduced compared with group A(P0.01),(3) compared with group A,PHD plays its therapeutic role without the increase of sodium burden and body weight.Conclusion:sodium modeling hemodialysis can obviously prevent the occurrence of dialysis hypotension in patients with high risk factors.
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To characterize the determinants of circulating levels of adrenomedullin (AM), the plasma levels of this peptide were measured in 58 patients with end-stage renal disease on hemodialysis. Predialysis plasma levels of AM were more than twice as high in patients on hemodialysis as compared to controls. In hemodialysis patients with heart failure (NYHA classes II–IV) or hypertensive HD patients plasma levels of AM were significantly higher than in patients with end-stage renal disease only. Plasma levels of AM were not altered immediately by hemodialysis but decreased significantly 14–20 h after hemodialysis. AM plasma levels before hemodialysis and 14–20 h after hemodialysis were correlated with the corresponding mean arterial pressure.
Adrenomedullin
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Objective:To evaluate the effects of individualized hemodialysis on lowering the hemodialysis complications.Methods:All together312times of hemodialysis in20chronic renal failure patients were investiˉgated.The clinical effects of two different dialysis methods which included routine dialysis and individualized dialysis were compared.Results:There were a few influences on plasma osmotic pressure and serum natrium in individualized hemodialysis group with good effects and fewer complications.Conclusion:Individualized dialysis could effectively prevent the dialysis complications,promote the dialysis quality together with ensuring the dialysis effects.
Chronic renal failure
Dialysis adequacy
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Objective: To explore the effects of the eating time on blood pressure of patients during hemodialysis. Methods: The clinical data of 25 patients with hypotension during hemodialysis were investigated using self-control method. The patients were treated with fasting during hemodialysis,eating 250 g food within 2 h of hemodialysis and at 3 h after hemodialysis for 2 weeks,respectively. The mean arterial pressure at 30 min before and after eating,and every hour mean arterial pressure before the hemodialysis and during hemodialysis were analyzed. Results: The differences of mean arterial pressure before and after eating and before the hemodialysis and during hemodialysis,the occurrence rates of hypotension and symptomatic hypotension,and nursing intervention between 3 groups were statistically significant( P 0. 01). The differences of all indexes of patients treated with eating at 3 h after hemodialysis and other two groups were statistically significant( P 0. 01). The differences of mean arterial pressure before the hemodialysis and number of stop hemodialysis caused by hypotension between 3 groups were not statistically significant( P 0. 05). Conclusions: For hypotension-prone patients,the eating time should be within 2 h hours of hemodialysis,and prohibit at 3 h after hemodialysis,which can prevent the hypotension.
Mean arterial pressure
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Objective At present dialysis machines provided online assessment of Kt/V.The aim of our study was to assess the effect of hemodialysis time on the rate of urea removal(K),by measuring K at different times of hemodialysis patients.Methods The K during one hemodialysis session were observed chronologically.The relationship between hemodialysis time and K were analyzed.Results There was no correlation between the hemodialysis time and K(P 0.05).Conclusion The rate of urea removal was uncorrelated with hemodialysis time during one hemodialysis session.Kt / V was positively correlated with hemodialysis time.
Dialysis adequacy
Kt/V
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The Quasi-purchase system of research outcome is a research funds' system based upon research outcome. The thesis analyses the characteristics of research outcomes' honour under the quasi-purchase system of research outcome. It researches the evaluation of the follow-up impact of the honoured outcome. And make a greater impact on the honoured outcome for incentives and penalties for false results of the proposal.
Honour
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