The value of bioimpedance analysis in the assessment of hydration and nutritional status in children on chronic peritoneal dialysis.

Bioimpedance analysis (BIA)-body composition monitoring (BCM) has been used to evaluate the hydration and nutritional status of adults and children on dialysis. However, its clinical application still has challenges, so further exploration is valuable. We used BIA-BCM to evaluate the hydration and nutritional status of children undergoing chronic peritoneal dialysis from 1 July 2021 to 31 December 2022 in the Children's Hospital of Fudan University to explore the clinical value of this method. A total of 84 children on chronic peritoneal dialysis (PD) were included. In the PD group, 16 (19.05%) and 31 (36.90%) had mild and severe overhydration (OH), respectively; 41.27% (26/63) had a low lean tissue index (LTI). In the PD group, patients with relative OH (Re-OH) > 5.6% had significantly higher systolic blood pressure (SBP) and SBP z score (SBPz). Patients with LTI > 12% had significantly higher body mass index (BMI) and BMI z score (BMIz). Canonical correlation analysis indicated a linear relationship (ρ = 0.708) between BIA-BCM hydration and the clinical hydration indicator and a linear relationship (ρ = 0.995) between the BIA-BCM nutritional indicator and the clinical nutritional indicator. A total of 56% of children on chronic peritoneal dialysis had OH, and 41% had a low LTI. In PD patients, SBP and SBPz were correlated with BIA-BCM Re-OH, and BMI and BMIz were correlated with BIA-BCM LTI. BIA-BCM indicators have good clinical value in evaluating hydration and nutrition.

Disparities in Healthcare Accessibility and Discrimination Faced by Black Quebecers: a Race and Language Perspective.

The Black population in Canada is characterized by its long-established history and diversity. The present study aims to expand our current understanding of the relation between discrimination and disparities in healthcare by including race and language as determinants of health. We recruited 531 Black adults who are currently living in Quebec, Canada, to complete a survey measuring socio-demographic characteristics, mental and physical health, accessibility to healthcare, and experiences of discrimination. Results showed that being a racialized and linguistic minority population in Quebec, English-speaking Black participants experienced more discrimination, fewer healthcare providers, less access to COVID-19 information during the COVID-19 pandemic, and were more dissatisfied with the healthcare system than French-speaking Black participants. Furthermore, the negative impacts of healthcare access associated with being a racialized and linguistic minority population in Quebec (e.g., the English-speaking Black population) were shown to be mediated by experiences of discrimination and dissatisfaction with the healthcare system.

The Impact of Language on the Mental Health of Black Quebecers.

Quebec's English-speaking Black community finds itself at the intersection of racial and linguistic discrimination, which presents challenges to mental wellness. The present study aims to add necessary detail to the conversations surrounding racism and mental health in Canada while including language as a determinant of health and intersecting element affecting the wellbeing of English-speaking Black Quebecers. We recruited 531 Black adults who are currently living in Quebec to complete a survey on various community-relevant items, including their mental and physical health, their experiences of discrimination, and barriers to accessing mental healthcare. Our analyses revealed that English-speaking participants experience more discrimination across all types and report more barriers to mental healthcare and lower mental health than their French-speaking counterparts. Furthermore, we found that language also had a mediated effect on mental health through discrimination and barriers to mental healthcare. Our study adds to the sparse race-based and intersectional literature about Black people in Canada and substantiates a mechanism by which language affects mental health by exposing Black Quebecers to more discrimination and thus higher barriers to care.

COVID-19 Outbreak and Management Approach for Families with Children on Long-Term Kidney Replacement Therapy.

BACKGROUND AND OBJECTIVES: During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively. RESULTS: Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported. CONCLUSIONS: The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.

Assessment of subclinical left ventricular changes in essential hypertensive patients with hyperuricemia: A three-dimensional speckle-tracking echocardiography study.

OBJECTIVE: To evaluate the effect of hyperuricemia (HU) on subclinical changes of left ventricle (LV) function and structure in patients with hypertension (HT) using three-dimensional speckle-tracking echocardiography (3DSTE) and to explore the relationships between serum uric acid (SUA) levels and three-dimensional speckle tracking echocardiography (3DSTE) parameters in hypertensive and nonhypertensive patients with HU. METHODS: Four age- and sex-matched groups were studied: I: healthy controls, HT- HU- (n = 40); II: HT- HU+ (n = 40); III: HT+ HU- (n = 40); IV: HT+ HU+ (n = 44). Conventional echocardiography and 3DSTE were recorded. Relative wall thickness (RWT) and left ventricular mass index assessed by M-mode echocardiography (LVMi-M) were calculated. 3DSTE parameters including LV volumes and ejection fraction (EF), LVMi-3D, global longitudinal strain (GLS), and global circumferential strain (GCS) were compared. The relationships between SUA levels and 3DSTE parameters were investigated. RESULTS: Despite LV diameters, LV volumes and EF were similar among groups (all p > 0.05), GLS decreased and LVMi-3D increased from controls (group I) to patients with HU or HT alone (group II or III), and patients with both HU and HT (group IV) (all p < 0.05). SUA levels were significantly correlated with the absolute value of GLS (r = -0.461, p < 0.05) and LVMi-3D (r = 0.504, p < 0.05) in hypertensive and nonhypertensive patients with HU. CONCLUSIONS: HU may exacerbate LV systolic dysfunction and remodeling in hypertensive patients, which can be detected by 3DSTE. Early uric acid lowing treatment may be beneficial for hypertensive patients with HU.