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Objective To investigate the relationship between serum phosphorus variability and mortality in maintenance hemodialysis (MHD) patients. Methods A total of 502 MHD cases from Renji hospital hemodialysis center were registered in Shanghai Registry Network from January 2007 to April 2015. They were recruited with general information, laboratory results and outcomes. According to their median of coefficient of variation (CV) of blood phosphorus, the patients were divided into high variation group (CV≥0.226 mmol/L) and low variation group (CV60 years of age (HR=2.762, 95%CI 1.707?4.468, P60 years of age (HR=2.666, 95%CI 1.469?4.837, P=0.001), low hemoglobin (HR=0.480, 95%CI 0.238?0.801, P=0.005), and high CV of phosphorus (HR=1.655, 95%CI 1.003?2.729, P=0.049) were independent risk factors for cardiovascular disease mortality. There was no significant statistical difference between patients phosphorus on target and patients phosphorus below target in all?cause disease mortality (P=0.065) and cardiovascular disease mortality (P=0.425). High variation group whose phosphorus on target had higher all?cause mortality and cardiovascular disease mortality than those in low variation group (29.2% vs 16.9%, P=0.047; 15.0% vs 6.0%, P=0.033). Kaplan?Meier method showed that patients with high phosphorus variation had higher all?cause (P=0.023) and cardiovascular disease mortality (P=0.047) than patients with low phosphorus variation. Conclusions The high CV of phosphorus is independently correlated with all?cause and cardiovascular disease mortality. Patients with standard ? reaching phosphorus in the low variation group have a lower mortality. A serum phosphorus level sustainably reaching the standard may improve the survival in MHD patients.
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Objective To investigate the clinical characteristics of twice-weekly hemodialysis patients.Methods Data were collected from Shanghai Renal Registry.A total of 1288 patients undergoing regular hemodialysis (HD) with dialysis adequacy index and other biochemical parameters in Shanghai in January 2007 were enrolled into the cohort study with 2 years follow-up.Clinical characteristics and outcome of twice-weekly HD patients were analyzed as compared with thrice-weekly HD patients.Results Compared with patients on thrice-weekly HD,the twice-weekly HD patients were significantly younger and had significantly shorter HD vintage,smaller body surface area,longer HD session time,higher single-pool Kt/V (spKt/V) and serum albumin but lower weekly Kt/V (P＜0.05).There was no statistical difference in ultrafiltration volume between two groups.Kaplan-Meier survival analysis indicated that both groups had similar two-year survival.Multivariate Cox regression analysis showed that age,body mass index,serum albumin and weekly Kt/V were predictors of patient mortality.Conclusion It is acceptable for some hemodialys patients with twice-weekly HD,and close monitor of dialysis adequacy and volume status is necessary for this therapy model.
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Objective To investigate the association between angiopoietin-2 (Angpt-2) and peritoneal angiogenesis in a uremic peritoneal dialysis (PD) rat model. Methods Uremic (subtotal nephrectomy) rats were established and divided into non-PD, 10 d-PD, 28 d-PD and 56 d-PD groups. Standard PD solution was applied in the study. Rats undergone sham operation without PD were used as control group. Vessel density of the peritoneum was detected and quantified with anti-CD31 immunohistochemical staining. Expressive levels of Angpt-2 and vascular endothelial growth factor (VEGF) were examined in the peritoneum by real-time PCR and Western blotting. Results The non-PD group was characterized by increased vessel density in the peritoneum compared with that of the control group [(5±3)/HP vs (1±1)/HP]. Progressive angiogenesis was found in 10 d-PD, 28 d-PD and 56 d-PD groups [(10±5)/HP, (17±5)/HP, (19±4)/HP]. Furthermore, expressive levels of Angpt-2 and VEGF increased significantly in the non-PD group compared with the control (P<0.01), and such expressions were significantly higher in the PD groups as compared to non-PD group (P<0.01), but no difference was found among the PD groups. Both VEGF and Angpt-2 levels were positively correlated with vessel density(r=0.7756, P<0.01; r=0.5223, P<0.05). Conclusions Uremia and PD promote peritoneal angiogenesis in rats. Increased expression level of Angpt-2 in peritoneum is positively correlated with peritoneal angiogenesis. Angpt-2 may be a new therapeutic target of peritoneal angiogenesis.
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ObjectiveTo evaluate the characteristics of patients on long-term peritoneal dialysis (PD). MethodsPatients who started PD since 1994 and received PD for at least one year were included in this study. According to dialysis duration, patients were divided into two groups. Group A (long-term) was defined as patients survived on PD for more than 5 years. Group B (short-term) was defined as patients who died or switched to bemodialysis within less than 5 years. Demography, biochemical indexes, dialysis prescription and adequacy were compared between two groups. ResultsThere were 68 patients in group A and 98 patients in group B. Mean followed-up period of group A and B was (84.80±19.42) months and (27.25±12.31) months, respectively. Younger, fewer episodes of diabetic comorbidity (group A 3/68 vs group B 18/98, P ＜0.05) and coronary heart disease (group A 6/68 vs group B 22/98, P＜0.05) were found in group A. Compared to group B, the level of serum albumin at the beginning of PD was much higher in group A [(35.56±4.74) g/L vs (33.69±5.45) g/L, P＜0.01). The levels of blood sugar, TC, TG, hemoglobin, calcium, phosphate and iPTH were not significantly different between two groups. Estimated GFR, renal Kt/V and renal Ccr at the beginning of dialysis were much higher in group A, however there was no significant difference in urinary volume between two groups. Both estimated GFR and urinary volume decreased more slowly in group A compared to group B. Peritonitis mobidity was lower in group A (1/81.22 months vs 1/29.03 months, P＜0.01). Conclusions In comparison to short-term survivors, long-term PD patients are characterized by being younger, less diabetic and coronary heart disease, fewer episodes of peritonitis, higher level of serum albumin, higher estimated GFR and less loss of residual renal function.
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Objective To analysis the clinical outcomes in long-term peritoneal dialysis (PD) patients. Methods The data of 58 PD patients survived more than 3 years from January 1994 to August 2003 in our hospital were reviewed. According to their different clinical outcomes, the patients were divided into four groups:continuous PD group, transplant group,hemodialysis (HD) group and death group. The recent nutritional index, such as serum albumin, and the recent dialysis adequacy index, including fluid removal and residual renal function, were evaluated. The "predeath values" of 1/2 year and 1 year prior to death in the death group were compared. 12-month PD indices in continuous PD patients were reviewed retrospectively and the same indices over a 12-month period of time were followed up. Results The recent total Kt/V in death group was significantly lowered than that in the other three groups (P
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AIM: To investigate the role of brainstem auditory evoked potential(BAEP) in the early diagnosis of diabetic central neuropathy (DCN) and to probe into the relationship between plasma nitric oxide (NO) and DCN. METHODS: Experimental diabetes(ED) rat model was used. BAEP and plasma NO were measured dynamically after ED modeling. RESULTS: The peak latency (PL) of Ⅰ, Ⅲ, Ⅳ and V and the interpeak latency (IPL) of I-III and III-V of BAEP in ED group prolonged after 4 weeks of ED modeling (P＜0.05). All PL and IPL of BAEP prolonged after 6 weeks、8 weeks and 10 weeks (P＜0.01). The plasma NO increased to the top in ED group at 2 weeks and then decreased gradually. There was negative correlation between plasma NO and PL and IPL of BAEP. CONCLUSION: BAEP was sensitive and valuable in the early diagnosis of DCN. Reduction of plasma NO may play a role in the pathogenesis of DCN.
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AIM: To study the change in cognitive function in derogative state of different neurotransmitter by mensurating P300 amplitude and latency. METHODS: Acetylcholine (ACh) system was disfunctioned by severing fimbrial-fornix(FF) transaction and Norepinephrine (NE) system impaired by injection of 6-hydroxysopamine into the bilateral dorsal noradrenergic bundle in DG. Then Y-type maze test and elicitation of P3-like latency were carried out separately before and after the all models were built. RESULTS: In both experimental groups, P3-like latency was prolonged significantly compared with the control and had positive correlation with indices of Y-maze test(EN,TRT). CONCLUSION: ACh and NE are important in the production and conformity of P300.
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AIM: To investigate the role of brainstem auditory evoked potential(BAEP) in the early diagnosis of diabetic central neuropathy (DCN) and to probe into the relationship between plasma nitric oxide (NO) and DCN. METHODS: Experimental diabetes(ED) rat model was used. BAEP and plasma NO were measured dynamically after ED modeling. RESULTS: The peak latency (PL) of Ⅰ, Ⅲ, Ⅳ and V and the interpeak latency (IPL) of I-III and III-V of BAEP in ED group prolonged after 4 weeks of ED modeling (P
