Publications (69)115.98 Total impact
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Article: Experiences with Establishing the First Self-Care Hemodialysis Program in a Hospital in Mainland China.
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ABSTRACT: There has never been a home hemodialysis (HHD) program or self-care hemodialysis (SC-HD) program in Mainland China, and it may be plausible starting from an SC-HD program. This study describes the systems for, and the initial results of, starting an SC-HD program. A program for SC-HD was instituted at the Peking University Third Hospital. A working group had designed the patient education program and water quality assurance. The patient's education program was established, which consisted of a handbook and a video for training. In May 2009, two patients were recruited and trained for HD. They were adequately dialyzed with satisfactory Kt/V, both the patients could perform all of the self-care procedures after training for 12 weeks. More difficult procedures, such as the self-cannulation, were successfully handled. Significant improvement was found in six of the eight short form (SF)-36 health scales after 6 months for SC-HD treatment. For the past year, there were no severe complications resulting from SC-HD. In summary, our first SC-HD program in Mainland China is feasible and safe. It promotes rehabilitation, increases self-esteem, and improves health-related quality of life. It is also a first attempt for starting an HHD program.Renal Failure 12/2012; · 0.82 Impact Factor -
Article: Heart rate variability in peritoneal dialysis patients: what is the role of residual renal function?.
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ABSTRACT: Background: The relationship between heart rate variability (HRV) and residual renal function (RRF) has not been elucidated previously. Methods: In this cross-sectional study, HRV was evaluated in 71 peritoneal dialysis patients. Patients were divided into RRF decline group, RRF stable group and anuric group. Results: RRF was negatively correlated with SDNN (r = -0.284, p = 0.017), TP (r = -0.247, p = 0.039), and HF (r = -0.238, p = 0.047). Significant sympathetic nerve activation was found in the RRF decline group (significantly lower SDNN, SDSD, RMSSD, pNN50, LF, HF, TP and higher LF/HF ratio) as compared to the RRF stable and anuric groups. Besides, significantly parasympathetic activation was found in the anuric group (the lowest LF/HF ratio as compared to the other groups (both p < 0.05). Multivariate stepwise regression analysis showed that the status of RRF was an independent factor associated with HRV parameters. Conclusion: This study showed autonomic nervous function in peritoneal dialysis patients was associated with a different status of RRF.Blood Purification 08/2012; 34(1):58-66. · 2.10 Impact Factor -
Article: Effects of beta-blocker use on volume status in hemodialysis patients.
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ABSTRACT: Removal and control of excess fluid with dialysis is considered critical for protection against cardiovascular sequelae. Antihypertensive agents including beta-blockers may influence hemodynamics, which may limit fluid removal during hemodialysis (HD). Fifty chronic HD patients underwent bioimpedance measurement before and after a midweek dialysis session. Data on volume status, blood pressure, antihypertensive medications, and bioimpedance were analyzed. Patients in the high-volume status group used a significantly higher percentage of beta-blockers than patients in the low-volume status group (54.2 vs. 19.2%, respectively, p = 0.01). Multivariable regression revealed that the use of beta-blockers was independently positively associated with fluid overload (p < 0.05). Intradialytic muscle cramping occurred more often in the beta-blocker group than the control group (44.4 vs. 12.5%, respectively, p = 0.02). Our results suggest that the use of beta-blockers was associated with fluid overload in HD patients, and patients being treated with them experienced more intradialytic muscle cramping during dialysis.Blood Purification 06/2012; 33(4):311-6. · 2.10 Impact Factor -
Article: The study of spectral analysis of heart rate variability in different blood pressure types in euvolemic peritoneal dialysis patients.
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ABSTRACT: Heart rate variability (HRV) is an useful noninvasive tool to assess autonomic nervous system (ANS) function and may provide an insight into the understanding of the role of ANS in the pathogenesis of blood pressure (BP) abnormality in euvolemic continuous ambulatory peritoneal dialysis (CAPD) patients. In this cross-sectional study, 62 CAPD patients with normal hydration values (assessed by a bioimpedance spectroscopy device) were enrolled from our peritoneal dialysis (PD) unit. Patients were divided into three groups according to their BP: normotension (NT), hypertension (HT), and hypotension (HyT). Spectral analysis of HRV was measured by examination of the average heart rate using standard electrocardiogram in 5 min. The HyT group had the lowest serum urea nitrogen among the three groups (all p < 0.05), and a lower serum potassium and albumin as compared with the NT group (p < 0.05). The HyT group also had the highest total power (TP) and highest frequency power (HF) among the three groups (all p < 0.05), and a lower normalized low frequency power (LF), LF/HF ratio, and a higher normalized HF as compared with the HT group (all p < 0.05). Our study suggested that autonomic insufficiency was present in euvolemic PD patients, and hypotensives had a relatively higher parasympathetic activity and blunted sympathetic activity.Renal Failure 05/2012; 34(6):722-6. · 0.82 Impact Factor -
Article: Roles of human urotensin II in volume resistance hypertension in peritoneal dialysis patients.
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ABSTRACT: Human urotensin II (hUII) is a newly discovered substance that can dilate small blood vessels to decrease the blood pressure (BP). Our previous studies showed that some volume-overloaded patients on peritoneal dialysis can maintain normal BP (congestive heart failure excluded), suggesting that these patients have volume resistance capacity. This study is to investigate whether hUII plays an important role in this subgroup of patients on peritoneal dialysis. In this study, 105 patients on continuous ambulatory peritoneal dialysis were enrolled. Volume load was evaluated by the overhydration (OH) value obtained by bioimpedance analysis. OH < 2.0 kg was defined as normal volume (NV), and OH ≥ 2.0 kg as high volume (HV). Systolic blood pressure (SBP) <130 mmHg was defined as normotension (NT) and ≥130 mmHg as hypertension (HT). The patients were thus divided into four subgroups: (1) normotension with normal volume (NT-NV), (2) normotension with high volume (NT-HV), (3) normal volume with hypertension (HT-NV), and (4) high volume with hypertension (HT-HV). hUII was measured using radioimmunoassay method. hUII was significantly higher in normal SBP group than that in high SBP group (p < 0.05). hUII was higher in the NT-HV group compared with that in the HT-HV group (p < 0.05). Our study suggests that hUII may be involved in the pathogenesis of the volume resistance HT in peritoneal dialysis patients.Renal Failure 04/2012; 34(6):713-7. · 0.82 Impact Factor -
Article: Metabolic syndrome is associated with better nutritional status, but not with cardiovascular disease or all-cause mortality in patients on haemodialysis.
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ABSTRACT: Metabolic syndrome increases the risk of cardiovascular disease (CVD) and all-cause mortality in the general population. To investigate whether metabolic syndrome affects CVD and all-cause mortality in chronic haemodialysis patients. This prospective, observational cohort study was carried out at Peking university third hospital from June 2006 to June 2010. Baseline anthropometric and laboratory parameters were evaluated, and causes and times of mortality were documented. Nutritional status of the patients was assessed using subject global assessment (SGA) and serum albumin levels. Of 162 haemodialysis patients recruited, five were lost to follow-up, leaving 157 in the final cohort, who were followed for 36-42 months. Mean age was 62 ± 11 years and 55.4% were men. Forty-six patients (30%) had metabolic syndrome. In the metabolic syndrome versus the non-metabolic syndrome group, there were fewer patients with malnutrition (by SGA) (15.2% vs. 55.0%; P < 0.001), but there were no significant differences in CVD mortality (8.7% vs. 10.8%; P = 0.9) or all-cause mortality (15.2% vs. 22.5%; P = 0.39), nor in mean observed survival time (30.8 ± 7.3 vs. 29.8 ± 8.5 months; P = 0.49) or total survival time (67 ± 43 vs. 78 ± 48 months; P = 0.20). Cox regression analysis showed that independent mortality risk factors were pre-existing CVD, age more than or equal to 66 years and serum albumin less than 37 g/L (indicating malnutrition). Metabolic syndrome was associated with a better nutritional status, but not with CVD or all-cause mortality in the haemodialysis patients in this prospective cohort study.Archives of cardiovascular diseases 04/2012; 105(4):211-7. · 0.66 Impact Factor -
Article: Gastrointestinal symptoms predict peritonitis rates in CAPD patients.
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ABSTRACT: Peritonitis is still one of the major causes of peritoneal dialysis (PD) patients' dropout. In the present study, we analyzed the relationship between gastrointestinal (GI) problems and peritonitis in our CAPD patients. It is a prospective observational study. In December, 2008, 158 patients on continuous ambulatory peritoneal dialysis (CAPD) for more than 3 months from our PD unit were included in this study. A questionnaire was used to evaluate their GI symptoms score (GISS). All patients were followed up for 24 months or until they dropped out from our PD program. All peritonitis events were recorded. The patients' PD duration was 22 (4 - 132) months before the study. During the 24 months follow-up, 37 patients dropped out. And 37 patients had 46 episodes of peritonitis (peritonitis group) whereas the other 121 patients did not have peritonitis (peritonitisfree group). The overall peritonitis rate was one episode per 75.87 patient months. The peritonitis free group had lower GISS (1.35 ± 1.94 vs. 2.95 ± 3.19, p = 0.006), higher albumin level and longer dialysis duration at baseline as compared to the peritonitis group. Multivariate Cox-regression analysis showed that only GISS (OR 1.206, 95% CI 1.093 - 1.330) and dialysis duration (OR 1.018, 95% CI 1.006 - 1.031) were the risk factors for the time to first peritonitis episodes during the follow-up. Further analysis identified 2 GISS components, belching and constipation, as the strongest predictors of peritonitis during the follow-up period (p < 0.005). Our study showed that GI symptoms could predict peritonitis in CAPD patients. Prevention and treatment for GI problems may thus be helpful to decrease peritonitis rate.Clinical nephrology 04/2012; 77(4):267-74. · 1.17 Impact Factor -
Article: Role of arachidonoylethanolamine in blood pressure regulation in volume-resistant patients on peritoneal dialysis.
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ABSTRACT: In this study we explored the possible role of arachidonoylethanolamine (AEA) in regulating blood pressure in patients on continuous ambulatory peritoneal dialysis (CAPD). One hundred and five patients on CAPD were enrolled. Volume status was evaluated by the overhydration (OH) value obtained by bioimpedance analysis. OH < 2.0 kg was defined as normal volume (NV) and OH ≥ 2.0 kg as high volume (HV). Home mean systolic blood pressure <130 mmHg was defined as controlled hypertension (CHT) and ≥130 mmHg as uncontrolled hypertension (UHT). The patients were divided into four subgroups: (1) controlled hypertension with normal volume (CHT-NV), (2) controlled hypertension with high volume (CHT-HV), (3) uncontrolled hypertension with normal volume (UHT-NV), and (4) uncontrolled hypertension with high volume (UHT-HV). AEA was measured by ultra performance liquid chromatography-tandem mass spectrometry. AEA was significantly higher in the HV group as compared with the NV group (P < 0.05). In addition, AEA was also significantly higher in the CHT-HV group as compared with the UHT-NV group (P < 0.05). These results may suggest a compensatory function of AEA and TRPV1 pathway to lower blood pressure during volume expansion in CAPD patients.International Urology and Nephrology 03/2012; · 1.47 Impact Factor -
Article: Metabolic syndrome and its components associated with endothelial dysfunction in chronic kidney disease patients.
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ABSTRACT: Cardiovascular disease is more common in patients with chronic kidney disease (CKD) than in the general population. Endothelial dysfunction is an early predictor of cardiovascular events. We conducted a cross-sectional study in CKD patients to explore the association of metabolic syndrome (MetS) components with endothelial cell function. We evaluated clinical and laboratory data in 161 CKD patients from stage 1 to stage 5. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. Patients were grouped into two groups according to whether or not they had MetS. FMD was significantly lower in the MetS group than in the group without MetS (P = 0.012). In a Pearson's correlation analysis, FMD was significantly negatively correlated with waist circumference in women (r = -0.223, P = 0.03) and fasting blood glucose (r = -0.186, P = 0.001). Multiple linear regression analysis showed that fasting blood glucose was an independently associated factor for FMD. MetS and some components of MetS (waist circumference in women and fasting blood glucose) are closely associated with a decreased FMD in CKD patients.Vascular Health and Risk Management 01/2012; 8:15-21. -
Article: Effect of multi-dimensional education on disease progression in pre-dialysis patients in China.
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ABSTRACT: There is an increasing body of evidence showing that educational interventions aiming at empowering patients are successful in chronic disease management. The aim of this study was to conduct an evaluation of the systematic effectiveness of a multi-dimensional education intervention program in a group of pre-dialysis chronic kidney disease (CKD) patients. In addition, we investigated whether the outcome of the program was related with the amount of education. We collected data retrospectively from 302 patients with CKD stages 3, 4, and 5, who were followed up from February 2006 to March 2008. The patients were divided into long-time education group and short-time education group depending on the number of provided hours of education. Survival analysis was undertaken to see if the progression of the kidney function differed between these two groups. The percentage of patients receiving long-time education was highest with severe degree of impairment of renal function (45.5%, 61.3%, and 66.7% in CKD stages 3, 4, and 5 groups, respectively). In a multivariate regression analysis, adjusting for age, gender, Charlson comorbidity index, and other traditional risk factors of renal failure, such as smoking, hypertension, and renal function (glomerular filtration rate), the length of time until a decline of renal function by 25% was noted and was significantly shorter in the short-time education group as compared to the long-time education group (p = 0.0334). Multi-component structured empowerment intervention is effective in pre-dialysis CKD patients and may lead to a delay in the progression of kidney disease.Renal Failure 01/2012; 34(1):47-52. · 0.82 Impact Factor -
Article: Peripheral arterial disease predicts overall and cardiovascular mortality in peritoneal dialysis patients.
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ABSTRACT: Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis and is common among dialysis patients. Cardiovascular disease (CVD) accounts for the leading cause of mortality in dialysis patients, and PAD has been found as a predictor for cardiovascular as well as overall mortality in general population. However, the study on the role of PAD in the prognosis of peritoneal dialysis patients is rather limited. Prevalent continuous ambulatory peritoneal dialysis patients over 60 years old were recruited in this study and were followed-up regularly to death or the end of the study. The diagnosis of PAD was based on ankle-brachial pressure index (ABI) < 0.9 or intermittent claudication. Univariate and multivariate Cox proportional hazard models were used to identify the risk factors for cardiovascular and overall mortality. Survival curves were estimated by the Kaplan-Meier method followed by log-rank test to compare the mortality rate between PAD and non-PAD patients. One hundred and seventy-one patients were included and 62 (36%) had PAD complication. In the follow-up of 24.4 (median 34.6) months, 36 deaths were recorded: 19 from PAD group and 17 from non-PAD group. Twenty-one patients died due to CVD: 13 from PAD group and 8 from non-PAD group. The presence of PAD and serum albumin was found independently associated with cardiovascular and overall mortality using Cox proportional hazards model. PAD is very common in aged peritoneal dialysis patients and independently associated with both cardiovascular and overall mortality.Renal Failure 01/2012; 34(8):1010-4. · 0.82 Impact Factor -
Article: [Cross-sectional study of relation between blood pressure and heart rate variability in patients with peritoneal dialysis].
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ABSTRACT: To analyze the possible relationship between heart rate variability (HRV) and blood pressure in peritoneal dialysis patients. In this cross-sectional study, 93 continuous ambulatory peritoneal dialysis patients (CAPD) patients were enrolled. Patients were divided into three groups according blood pressure. HRV which reflects autonomic nerve function (ANF) were measured by using 5-minutes recordings of a stationary system by a standardized method. Both time-domain and frequency domain parameters were analyzed. HRV time domain indices [the standard deviation of all normal RR intervals (SDNN), the square root of the mean of the squared differences between adjacent normal RR intervals (rMSSD), the standard deviation of differences between adjacent NN intervals (SDSD), the percentage of differences between adjacent normal RR intervals that were >50 ms computed (PNN50)] and frequency domain indices [the low-frequency energy in the power spectrum 0.04-0.15 Hz (LF), the high-frequency energy in the power spectrum 0.15-0.4 Hz (HF)] were significantly lowest in hypertensive group (P<0.05) whereas LF/HF was highest as compared to normal BP group (P<0.05). Univariable correlation analysis showed that both systolic and diastolic blood pressure were negatively correlated with SDNN (r=-0.386, P<0.001; r=-0.399, P<0.001), rMSSD (r=-0.373, P<0.001; r=-0.426, P<0.001), SDSD (r=-0.375, P<0.001; r=-0.425, P<0.001), PNN50 (r=-0.223, P=0.032; r=-0.245, P=0.018), TP (r=-0.328, P=0.001; r=- 0.312, P=0.002), LF (r=-0.260, P= 0.012; r=-0.194, P=0.063), HF (r=-0.394, P<0.001; r=-0.365, P<0.001), and positively correlated with LF/HF (r=0.275, P=0.008; r=0.171, P=0.1). Multivariable regression analysis showed that HRV indicators were independently factor affecting both systolic and diastolic blood pressure in PD patients. ANF assessed by HRV were significantly different in PD patients with blood status, parasympathetic nerve were activated in hypotension group whereas sympathetic nerve were activated in hypertension group. ANF was independently factors associated with blood pressure.Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 12/2011; 43(6):849-54. -
Article: What is the upper limitation of volume in Chinese peritoneal dialysis patients?
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ABSTRACT: Overhydration (OH) is a well-recognized problem in peritoneal dialysis (PD) patients and is an independent risk factor of mortality in this patient population. Achieving normohydration remains an important issue in dialysis therapy. The present study tries to compare clinical signs and find the optimal range for PD patients in China. A new bioimpedance spectroscopy device [body composition monitor (BCM)], which allows quantitative determination of how much the hydration status deviates from normal ranges (ΔHS), was selected. Blood pressure and ΔHS were analyzed in 92 PD patients from 1 dialysis center and compared with a matched healthy population (n = 45). Statistical analysis was performed using SPSS software, version 16.0 (SPSS Inc., Chicago, Ill., USA). We took different OH values as cutoff thresholds; predictive accuracy was evaluated with sensitivity and specificity, and a receiver-operating characteristics curve and Youden's index were adopted. Our data suggest that 2.0 liters is a reasonable cutoff value for ΔHS. This represents an important step towards a more objective choice of strategies for the optimal treatment of hypertension and fluid overload.Blood Purification 01/2011; 31(4):289-95. · 2.10 Impact Factor -
Article: Volume control in peritoneal dialysis patients guided by bioimpedance spectroscopy assessment.
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ABSTRACT: Volume overload is a common problem in peritoneal dialysis patients and may contribute to the high cardiac mortality in this patient population. Controlling volume status is difficult due to the lack of appropriate and accurate assessment of dry weight. This randomized, controlled study was conducted to test if the recent use of overhydration value (OH) provided by bioimpedance spectroscopy and patients' education would help to control overhydration. 160 continuous ambulatory peritoneal patients were included in this study. All the patients were randomly allocated to 2 groups: in Group 1 the patients and their primary nurses were informed of the OH values provided by bioimpedance spectroscopy whereas in Group 2 the values were not revealed and patients' volume was measured by the standard methods. Fluid status was evaluated by means of repeated bioimpedance analysis and clinical assessment. Urine volume, blood pressure and use of antihypertensive medications were recorded. There were no differences in gender, age, diabetes, height, weight and clinical hydration status between the 2 groups at the baseline. In Group 1, OH (p < 0.05), extracellular volume and the extracellular volume to intracellular volume ratio decreased steadily during the 3-month follow-up. On the contrary, all 3 parameters increased significantly in Group 2. SBP decreased significantly in Group 1 but increased significantly in Group 2. Our study shows that the use of OH as determined by bioimpedance spectroscopy may facilitate volume control in peritoneal dialysis patients.Blood Purification 01/2011; 31(4):296-302. · 2.10 Impact Factor -
Article: Refractory ascites due to portal hypertension in autosomal dominant polycystic kidney disease (ADPKD) patients successfully treated with peritoneal dialysis.
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ABSTRACT: Refractory ascites is uncommon in autosomal dominant polycystic kidney disease (ADPKD) but it usually makes the patient physically and psychologically handicapped. Two uremic ADPKD patients in our hospital developed refractory ascites after 1 year on hemodialysis. The refractory ascites was due to portal hypertension, which was caused primarily by portal outflow obstruction due to the numerous enlarged cysts in the liver and secondarily by increased portal inflow. We attempted continuous ambulatory peritoneal dialysis (CAPD) to treat the 2 patients and obtained satisfactory results. Not only was the refractory ascites well controlled, but also the portal hypertension disappeared. Based on our experience, we think CAPD could serve as a very effective therapy to treat the refractory ascites of portal hypertension due to polycystic liver in uremic ADPKD patients.Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. 02/2010; 30(2):151-5. -
Article: Prevalence and risk factors for peripheral artery disease among patients on maintenance peritoneal dialysis.
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ABSTRACT: Cardiovascular disease is common in end-stage renal disease patients and accounts for more than half of the mortalities. Peripheral artery disease (PAD) is frequently found in this population and is an independent predictor of cardiovascular mortality. However, there have been limited studies reporting the prevalence and risk factors for PAD among patients on maintenance continuous ambulatory peritoneal dialysis (CAPD) therapy. 343 CAPD patients from our clinic were recruited, and PAD was diagnosed using a value of ankle-brachial index <0.9. Both traditional and dialysis-related factors were evaluated. The prevalence of PAD was 27.4% in all patients, which increased to 45% in patients aged >70 years. In age- and gender-adjusted logistic regression, diabetes mellitus (OR 2.354, 95% CI 1.288-4.3), diastolic blood pressure (OR 0.964, 95% CI 0.939-0.989), extracellular/intracellular water ratio (OR 2.504, 95% CI 1.067-5.804), and lnCRP (OR 1.251, 95% CI 1.031-1.518) were independently associated with PAD. Our study suggested that PAD is a common problem in patients on maintenance peritoneal dialysis, especially in elderly dialysis subjects. Diabetes mellitus, elevated hsCRP level, and extracellular/intracellular water ratio are all independent risk factors for PAD. It also suggested that aggressive risk factor management for PAD should be undertaken in CAPD patients.Blood Purification 01/2010; 30(1):50-5. · 2.10 Impact Factor -
Article: Implementing continuous quality improvement process in potassium management in peritoneal dialysis patients.
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ABSTRACT: Abnormal plasma potassium levels are not uncommon in peritoneal dialysis (PD) patients. Here, we implemented a continuous quality improvement (CQI) approach that mainly focused on dietary management to improve potassium control in PD patients. All clinically stable patients who visited the PD clinic monthly were included in this study. A CQI team that included nephrologists, primary nurses, dietician, patients, and their family members was organized, and it monitored patients for 6 months. Patients were asked to provide their dialysis records and 3-day dietary records at each visit. Dialysis adequacy, including potassium and phosphorus removals, was checked before and after the implementation of CQI. Changes in dietary prescription, without altering dialysis prescriptions and potassium supplementation, were made monthly, according to patients' dietary information and blood potassium levels. In total, 84 patients (28 male and 56 female) were included in this study. At baseline, the prevalence of hyperkalemia and hypokalemia was 14.3% each. After the intervention, the prevalence of hyperkalemia dropped to 10.7% and 6% at 3 months and 6 months, respectively. The prevalence of hypokalemia dropped to 8.3% and 7.1% at 3 months and 6 months, respectively. Our data suggest that implementing CQI, with a focus on dietary intervention, could significantly reduce the prevalence of potassium abnormality in PD patients.Journal of Renal Nutrition 11/2009; 19(6):469-74. · 1.57 Impact Factor -
Article: Residual renal function and arterial stiffness mediated the blood pressure change during interdialytic weight gain in hemodialysis patients.
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ABSTRACT: Volume overload is thought to be the main cause of hypertension in dialysis patients. However, the effect of interdialytic weight gain (IDWG) in hemodialysis (HD) patients, which was considered as an increase in extracellular water (ECW), on blood pressure (BP) change, was controversial. Our aim was to examine the changes in hemodynamics and arterial stiffness during IDWG in HD patients and attempt to explore the possible mechanism of diverse BP change. Thirty prevalent patients on HD were enrolled. The height, weight, BP, blood chemistry, volume status assessed by bioelectrical impedance analysis, hemodynamic parameters obtained by echocardiography, and pulse wave velocity (PWV) were collected within 1 hour postdialysis and again just before the next dialysis session. Meanwhile, blood samples were drawn to analyze vasoactive hormones, including renin, angiotensin II, catecholamine, and endothelin. The patients' weights and ECWs during the next predialysis were significantly higher than those during the postdialysis. The BP showed no difference between postdialysis and the next predialysis. There was an obvious increase in cardiac output and decrease in total peripheral resistance as a whole during the next predialysis than that during postdialysis. When patients were divided into the BP increase group (BPI group, 13 patients) and BP decrease group (BPD group, 11 patients) according to the change in systolic BP higher than 10 mmHg, both groups displayed a significant increase in weight, ECW, cardiac output, and a decrease in total peripheral resistance. As compared with the BPI group, patients in the BPD group had significantly lower IDWG, shorter time on dialysis treatment, and higher residual renal function. A decrease in catecholamine and endothelin in the next predialysis was obvious in the BPD group. There was a significant decrease in PWV at the next predialysis in the BPD group while the PWV did not change significantly in the BPI group. Our results showed that the diverse BP change during IDWG was significantly affected by residual renal function, PWV, and vasoactive substances.Hemodialysis International 10/2009; 13(4):479-86. · 1.54 Impact Factor -
Article: Promoting self-management improves the health status of patients having peritoneal dialysis.
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ABSTRACT: This paper is a report of a study conducted to explore the effects of promoting self-management on the well-being of patients having peritoneal dialysis. Peritoneal dialysis is a home-based treatment for end-stage renal disease. Promoting self-management has been shown to improve the health status of people with diabetes mellitus and other chronic diseases. However, little is known about the effects of self-management support for patients having peritoneal dialysis. Thirty patients who had received peritoneal dialysis for at least 6 months and were clinically stable were enrolled in the study in 2006. A multidisciplinary team was built to support the patients' self-management. Various forms of education such as group discussion and individual consultation were used to improve patients' self-efficacy and all were followed up for 6 months. We compared the volume status, adequacy of dialysis, nutritional status, quality of life, rehabilitation status, self-management capacity and self-efficacy levels at baseline, 3 and 6 months after enrolment. During follow-up, patients' urine volume and residual renal function decreased, while the adequacy of dialysis (Kt/v and Ccr) did not change. Volume status, quality of life and rehabilitation status all improved, whereas nutritional status did not deteriorate. Both self-management capacity and self-efficacy level increased statistically significantly. A team approach needs to be taken to achieve successful self-management in patients having peritoneal dialysis, as with other chronic disease treatments. Nurses should use multiple strategies based on self-efficacy theory to improve patients' self-efficacy levels and self-management capacities.Journal of Advanced Nursing 05/2009; 65(7):1381-9. · 1.48 Impact Factor -
Article: Correlation between pulse wave velocity and fluid distribution in hemodialysis patients.
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ABSTRACT: In this study, we focused on whether volume overload plays a role in the development of arterial stiffness. Seventy-three prevalent hemodialysis patients were enrolled in a cross-sectional study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV), and volume overload was assessed by bioimpedance analysis. Patients were divided into a high PWV group and a low PWV group based on the median of PWV. Age, systolic blood pressure, pulse pressure (PP), extracellular water/total body water ratio (ECW/TBW), diabetic status (all p < 0.01), and history of cardiac events (p < 0.05) were significantly higher in the high PWV group (n = 37) than in the low PWV group. In the correlation analysis, PWV was positively associated with PP, systolic blood pressure, ECW/TBW, age, history of cardiac events, and diabetes (all p < 0.01). Multiple regression analysis showed that PWV was independently related to PP and ECW/TBW (p < 0.01). Volume overload plays an important role in the development of arterial stiffness in hemodialysis patients.Blood Purification 02/2009; 27(3):248-52. · 2.10 Impact Factor
Top co-authors
Top Journals
Institutions
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2007–2012
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Peking University Third Hospital
Beijing, Beijing Shi, China
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2006–2007
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Beijing Medical University
Beijiang, Zhejiang Sheng, China
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2005–2007
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Peking University
- Institute of Urology
Beijing, Beijing Shi, China
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2004–2007
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Beijing Union University
Beijing, Beijing Shi, China
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