BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receivi...BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.展开更多
impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A sy...impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A systematic literature review was conducted in accordance with the Joanna Briggs Institute(JBI)and PRISMA guidelines.Searches were conducted in Medline,CINAHL,the Cochrane Library,Scopus,Web of Science,and grey literature,Studies published between 2018 and 2024,involving patients aged 40 years or more undergoing regular hemodialysis,and available in Portuguese,English,or Spanish,were included.JBI's critical appraisal tools were used to conduct a rigorous analysis and methodological quality assessment of the articles.Results:Out of a total of 738 articles,10 were included for analysis.Five key dimensions of technologydriven self-care interventions were established.1)Mobile applications and digital platforms with features like nutritional databases,food logging,and personalized feedback;2)E-learning and virtual education using social media and chat-based communication;3)Telenursing employing a hybrid follow-up model of face-to-face,telephone,and SMS contact;4)Educational strategies focused on nutritional status,utilizing methods such as teach-back and pictorial learning within a multidisciplinary team;and 5)Comprehensive assessment tools evaluating treatment adherence(hemodialysis,medication,diet,fluid)and laboratory markers.Significant improvements were reported across several outcomes:eight studies showed enhanced biochemical markers(e.g.,phosphorus,sodium,potassium,calcium,iron,albumin,urea,and hemoglobin)and nutritional status,three demonstrated increased selfefficacy,and two reported improved quality of life.Conclusion:Integrating technology and face-to-face education enhances nutritional status,highlighting the importance of comprehensive strategies to improve treatment adherence and prevent malnutrition in hemodialysis patients.展开更多
BACKGROUND During the gradual decline of physical and social functioning associated with end-stage renal disease,patients might experience a premonition of impending death,resulting in a series of pre-mourning grief r...BACKGROUND During the gradual decline of physical and social functioning associated with end-stage renal disease,patients might experience a premonition of impending death,resulting in a series of pre-mourning grief responses called preparatory grief.The preparatory grief in advanced cancer patients(PGAC)scale is the most widely used preparatory grief scale for patients on hemodialysis in China.AIM To verify the reliability and validity of the PGAC scale in patients on hemodialysis.METHODS In total,327 patients undergoing regular hemodialysis in the blood purification center of three grade-A tertiary hospitals in Guangdong and Guizhou provinces were selected by convenience sampling.The assessment was administered using the general information questionnaire and the Chinese version of PGAC.SPSS 25.0 and Amos 24.0 were used for item analysis,confirmatory factor analysis(CFA),convergent validity,and internal consistency reliability estimation.RESULTS In the modified Chinese version of PGAC,7 dimensions covering 27 total items were retained.CFA revealed a good fit of the factor model(chi-square degree of freedom=2.056,standardized root mean square residual=0.0479,root mean square error of approximation=0.0570,GFI=0.872,AGFI=0.841,IFI=0.931,CFI=0.930,TLI=0.919).The factor loadings of the items ranged 0.503-0.884.The composite reliability ranged 0.664-0.914,and the average variance extracted ranged 0.366-0.747.Cronbach’sαof the scale was 0.945,and Cronbach’sαfor various dimensions ranged 0.662-0.914.CONCLUSION The modified PGAC has good reliability and validity,and it can effectively measure preparatory grief in patients on hemodialysis.展开更多
Objective:To evaluate the factors predicting fatigue among patients undergoing hemodialysis(HD).Fatigue is a common health problem in patients receiving HD.Understanding the factors that predict fatigue is crucial for...Objective:To evaluate the factors predicting fatigue among patients undergoing hemodialysis(HD).Fatigue is a common health problem in patients receiving HD.Understanding the factors that predict fatigue is crucial for helping patients to manage their weariness.Methods:A descriptive design was utilized with a convenient sample of 200 subjects who were on HD therapy at the Mansoura University Hospital and Mansoura International Hospital in Mansoura,Egypt,for at least 3 months.Four tools were utilized in collecting data.Results:The study subjects had a moderate level of fatigue regarding all sub-dimensions of the Piper Fatigue Scale(PFS).Among the total subjects,78.5%suffered from anxiety,and 31.0%had depression.A positive correlation was found between fatigue and anxiety,depression,and overall symptoms of distress,while a negative correlation was found between perception of the ability to manage symptoms and fatigue.The factors predicting fatigue included anxiety(β=0.274,P<0.001),depression(β=305,P<0.001),and the overall symptoms of distress(β=0.248,P<0.001),while the perceived ability to manage symptoms did not predicted.Conclusions:Fatigue was ranked as the top distressing symptom among HD patients,with psychological factors such as anxiety,depression,and the overall symptoms of distress predicting fatigue.Regular screenings of these factors and psychological therapies to modulate them might decrease fatigue severity and its related disability in HD clients.Multidimensional nurse-led interventions involving physical and psychological therapies are required to manage fatigue in HD patients.展开更多
BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcome...BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcomes”clinical practice guidelines recommend PTH levels be maintained in the range of two to nine times of the upper normal limit.Maintaining this balance is critical to prevent renal osteodystrophy.When the severity of hyperparathyroidism exceeds the recommended limits,vitamin D receptor agonists may be used for lowering PTH levels.Paricalcitol,as a biologically active vitamin D analog,is a selective activator of vitamin D responsive pathways.Both calcitriol and paricalcitol can be used as PTHlowering agents.There is conflicting data about their comparative effectiveness for controlling hyperparathyroidism in patients undergoing hemodialysis and a meta-analysis revealed no differences between the two.AIM To give real world data comparing paricalcitol and calcitriol as PTH-lowering agents in patients undergoing hemodialysis.METHODS Patients undergoing hemodialysis whose PTH levels exceeded nine times of the upper normal limit were enrolled in the study.Depending on patient preferences,they were either given calcitriol or paricalcitol.Intravenous calcitriol was given 2μg at the end of each dialysis sessions,and intravenous paricalcitol was administered as 5μg twice per week.Demographic data,calcium-phosphorus levels,change in PTH levels in 6 months,and ratios of 25%and 50%reductions in PTH levels were compared between the two groups.RESULTS A total of 21 patients were enrolled in this comparative study,eight patients received paricalcitol and 13 were prescribed calcitriol.A 50%reduction in PTH levels could be achieved in five patients in the paricalcitol group(62.5%);only one patient in the calcitriol group achieved the same reduction(7.6%).The difference was statistically significant(P=0.014).However,there was no difference in the ratio of patients who had a 25%reduction in PTH levels(87.5%vs 38.4%;P=0.067).PTH levels could be maintained in the targeted range in 87.5%of the patients in the paricalcitol group and in 69.2%of the patients in the calcitriol group(P=0.36).However,PTH could be better suppressed under paricalcitol.Clinically important hyperphosphatemia or hypercalcemia was not observed in either the paricalcitol or the calcitriol groups.CONCLUSION Although the PTH lowering effect of paricalcitol is stronger than calcitriol,both may help maintain PTH levels in the targeted range.Paricalcitol may be preferred for patients who have very high levels of PTH because it seems to cause a faster decline.Calcitriol may be preferred for a slower and limited decline.Prospective further studies with larger samples may be needed for a better comparison.展开更多
BACKGROUND The neutrophil-lymphocyte ratio(NLR)has been proposed as a potential prognostic marker for mortality outcomes in various conditions,yet its association with chronic hemodialysis(HD)remains underexplored.We ...BACKGROUND The neutrophil-lymphocyte ratio(NLR)has been proposed as a potential prognostic marker for mortality outcomes in various conditions,yet its association with chronic hemodialysis(HD)remains underexplored.We aim to study its utility by conducting a meta-analysis of this specific population.AIM To determine whether elevated NLR is associated with all-cause mortality(ACM)and cardiovascular mortality(CVM)in patients undergoing chronic HD.METHODS A comprehensive search from PubMed,Google Scholar,and Scopus identified studies showing the association between NLR and mortality outcomes in patients with chronic HD.Random-effects models with 95%CIs were employed to pool adjusted hazard ratios(aHRs),odds ratios(ORs),and I²statistics for evaluating the heterogeneity of findings.Leave-one-out sensitivity and meta-regression analyses assessed changes in overall effects and identified confounders,respectively.The Joanna Briggs Institute(JBI)tool was used to assess the quality of studies.RESULTS 19 studies comprising 9047 patients with a mean age of 59.5±5.86 years and a mean follow-up duration of 46.7 months were included in our study.Our meta-analysis revealed a significant association between NLR>2.5 and increased risks of ACM(aHR:1.25,95%CI:1.14-1.37,P<0.0001)and CVM(aHR:1.24,95%CI:1.02-1.49,P=0.03).Studies reporting outcomes in OR reported similar findings for ACM(OR:4.59,95%CI:1.74-12.11,P=0.002)and CVM(OR:1.11,95%CI:1.01-1.23,P=0.03).Sensitivity analysis revealed no variations.Meta-regression revealed increasing male proportion is positively associated with ACM.Pooled area under the curve(AUC)was 0.71(95%CI:0.63-0.80,P<0.0001).The JBI tool revealed high-quality studies.CONCLUSION This meta-analysis suggests that elevated NLR may serve as a useful prognostic marker for ACM and CVM in patients on chronic HD and can be useful in planning for the prevention of mortality-related strategies.展开更多
BACKGROUND The use of apixaban in chronic hemodialysis(HD)patients for non-valvular atrial fibrillation(NVAF)is still controversial regarding benefit of stroke protection vs risk of bleeding.Rotational thromboelastome...BACKGROUND The use of apixaban in chronic hemodialysis(HD)patients for non-valvular atrial fibrillation(NVAF)is still controversial regarding benefit of stroke protection vs risk of bleeding.Rotational thromboelastometry(ROTEM)is a point of care method that evaluates clot formation in whole blood and has been used as an evaluation tool for bleeding risk assessment in non-HD apixaban users.AIM To determine whether bleeding risk can be predicted using ROTEM activated with tissue factor(EXTEM)in HD patients receiving apixaban for NVAF.METHODS Nineteen HD patients with NVAF treated with apixaban for at least 8 days were enrolled.Four dosing regimens were recorded as prescribed by their physician,from 2.5 mg once daily on a non-dialysis day to 5 mg twice daily.Standard coagulation tests,along with ROTEM and apixaban drug levels(using liquid anti-Xa assay)were performed once on a non-dialysis day before and two hours after apixaban morning pill administration.Patients were subsequently monitored for thrombotic/bleeding events and all-cause mortality.RESULTS Over a median follow-up period of 36 months,six patients experienced a bleeding event(group A)and 13 remained free of bleeding(group B).Six deaths were recorded:Three due to major bleeding,one from thrombotic stroke,and two unrelated to coagulopathy.EXTEM clotting time(CT)-post was the only parameter that significantly differed between group A and group B(P=0.013).Each 1-second increase in CT-post was linked to an 8%higher likelihood of a bleeding event(odds ratio=1.08,95%confidence interval:1.0-1.17;P=0.048).A significant progressive increase was observed with the drug’s trough and peak levels(P<0.05)across the four dosing regimens but no significant relationship was found between CT and apixaban dose groups.CONCLUSION Early detection of bleeding risk in HD patients with NVAF on Apixaban maybe be effectively achieved through frequent monitoring using ROTEM EXTEM post CT,thereby helping to reduce associated morbidity.展开更多
BACKGROUND Hyperphosphatemia(HP)is a common complication in an advanced stage of chronic kidney disease(CKD)and is associated with cardiovascular issues,metabolic bone abnormalities and worsening of secondary hyperpar...BACKGROUND Hyperphosphatemia(HP)is a common complication in an advanced stage of chronic kidney disease(CKD)and is associated with cardiovascular issues,metabolic bone abnormalities and worsening of secondary hyperparathyroidism.Most patients on dialysis require phosphate binders to control HP.Sucroferric oxyhydroxide(SO)(Dynulta^(TM))is a calcium-free,polynuclear iron(III)based oral phosphate binder,for the treatment of HP.In this phase IV,open-label,singlearm,multi-center,12-week,SOLO CKD study evaluated efficacy and safety of Dynulta^(TM)in Indian CKD patients undergoing hemodialysis.AIM To investigate the efficacy,safety and tolerability of SO Chewable Tablet(Dynulta^(TM))in patients with CKD on hemodialysis.METHODS Hyperphosphatemic patients on hemodialysis and fulfilling eligibility criteria were included in the study for at least 12 weeks and received SO 1500 mg chewable tablet per day.The key endpoint was change in mean serum phosphorus levels after 12 weeks.Data were analysed using analysis of variance,Paired test,Wilcoxon test,and post-hoc comparisons,with P<0.05 considered statistically significant,using Graph Pad software.RESULTS A total of 114 patients were enrolled and 94 patients completed the study.The mean±SD serum phosphorous level was reduced from 7.62 mg/dL±2.02 mg/dL at baseline to 5.13 mg/dL±1.88 mg/dL after 12 weeks of treatment.At each follow-up visit,the reduction in mean serum phosphorous levels was statistically significant(P value<0.05)compared to baseline,confirming the efficacy of SO.A total of 33.33%of patients experienced adverse events(AEs).The most frequently reported AEs were pyrexia,nasopharyngitis and headache,which were considered unlikely to be related to the study drug treatment.No serious AEs was reported during the study period and no patients discontinued treatment due to AEs.CONCLUSION This first real-world study in Indian CKD patients on hemodialysis shows SO as a safe,and effective monotherapy for HP,though its small sample size limits generalizability.展开更多
This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’...This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’compliance.A network information management model for MHD patients was constructed around three management schemes:“software reminders+follow-up guidance”,“dietary records+self-management reminders”,and“dialysis plan+precise weight management”.These schemes were respectively used to optimize anemia management,control the risk of hyperphosphatemia,and improve toxin clearance efficiency.A controlled experiment was conducted,with an experimental group and a control group set up for comparative practice.The results showed that the network information management model can effectively improve patients’anemia,help alleviate mineral metabolism disorders and the accumulation of small-molecule toxins,and exert a positive impact on patients’treatment compliance.展开更多
Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhan...Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhancing patient safety and meeting global dialysis water quality standards. Advanced filtration technologies, such as titanium dioxide (TiO₂)-based nanoparticle filters, offer a promising approach to improve water purification processes in renal care. Objectives: This study aimed to develop and evaluate the effectiveness of a TiO₂-based nanoparticle microporous filtration system for hemodialysis water purification. The objectives included analyzing the system’s performance in reducing chemical contaminants (calcium, magnesium, aluminum, and lead) and microbiological contaminants (total viable count [TVC] and endotoxin units [EU]) across multiple renal centers. Methods: Water samples from three renal centers (RC1, RC2, and RC3) were analyzed pre- and post-filtration. TiO₂ nanoparticles were synthesized using the sol-gel method and characterized via Fourier Transform Infrared (FTIR) spectroscopy and Scanning Electron Microscopy with Energy Dispersive X-ray analysis (SEM/EDX). The microporous filter, fabricated with TiO₂ nanoparticles, silicon dioxide, and polyethylene glycol (PEG), was tested for its ability to remove contaminants. Analytical techniques included spectroscopy for chemical analysis and microbiological assays for contaminant quantification. Results: Post-treatment analysis revealed significant reductions in chemical contaminants, with removal efficiencies averaging 78% for calcium, 80% for magnesium, 81% for aluminum, and 76.6% for lead across all centers. Microbiological contamination was also substantially reduced, with 78–80% removal of TVC and 76–84.6% reduction in EU levels. FTIR analysis confirmed the presence of hydroxyl groups critical for adsorption, while SEM/EDX characterization revealed a crystalline structure with a particle size of 1.45 nm, pore size of 4.11 μm, filter height of 2.56 mm, and bulk density of 0.58 g/cm³. Conclusion: The TiO₂-based nanoparticle filtration system demonstrated high efficacy in removing chemical and microbiological contaminants, significantly improving water quality for hemodialysis. These results highlight its potential as a practical solution for renal centers, especially in resource-constrained settings. Further studies are needed to evaluate its long-term performance and feasibility for widespread adoption. Recommendation: Renal centers should consider adopting TiO2-based nanoparticle filters to address persistent water quality challenges. Pilot implementations across diverse settings can provide insights into operational feasibility. Additional research should explore scalability, maintenance requirements, and cost-effectiveness to optimize integration into healthcare systems. Significance Statement: This study introduces a practical and innovative solution to improve hemodialysis water purification. By effectively reducing both chemical and microbiological contaminants, the TiO2-based filtration system has the potential to enhance patient safety and outcomes, particularly in settings where maintaining high water quality standards remains challenging.展开更多
This paper explores the application effect of humanistic care in the nursing of hemodialysis patients.Firstly,it expounds the application value of humanistic care in the nursing of hemodialysis patients.Then,it evalua...This paper explores the application effect of humanistic care in the nursing of hemodialysis patients.Firstly,it expounds the application value of humanistic care in the nursing of hemodialysis patients.Then,it evaluates the effect by constructing an evaluation index system and combining with empirical analysis.Finally,it puts forward specific application measures and draws conclusions.The purpose is to provide reference for improving the nursing quality of hemodialysis patients,so as to enhance patients’quality of life and promote their physical and mental health.展开更多
Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodial...Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 195 patients with MHD and SHPT at Deyang People's Hospital from April 2024 to April 2025 were enrolled.Patients were randomly assigned to a control group receiving standard HD treatment and an experimental group receiving HD combined with HP therapy.The experimental group underwent 1 year of observation(97 cases in the experimental group,98 cases in the control group).During treatment,changes in parathyroid hormone(PTH),serum calcium,serum phosphorus,and inflammatory factors were monitored,along with analysis of treatment-related economic benefits and safety.Results:The experimental group demonstrated significantly better reductions in PTH,serum phosphorus,and inflammatory factors compared to the control group(P<0.05).Although the total treatment cost was slightly higher,the unit cost per therapeutic effect was lower,resulting in a superior cost-effectiveness ratio.Conclusion:Combined HD and HP therapy can significantly improve SHPT-related indicators in MHD patients,demonstrating safety,controllability,and high cost-effectiveness,making it a clinically applicable and recommended treatment option.展开更多
Objective:To evaluate the effectiveness of digital-intelligent health education for patients undergoing maintenance hemodialysis.Methods:From December 2023 to December 2024,82 patients undergoing maintenance hemodialy...Objective:To evaluate the effectiveness of digital-intelligent health education for patients undergoing maintenance hemodialysis.Methods:From December 2023 to December 2024,82 patients undergoing maintenance hemodialysis in our hospital were selected and randomly divided into an observation group(n=41,receiving routine health education)and a control group(n=41,receiving digital health education).The levels of knowledge,belief,and behavior related to dry weight control,as well as changes in dry weight and complications,were compared before and after intervention.Results:After intervention,the observation group had higher scores for knowledge(40.96±6.43),belief(39.11±6.39),behavior(39.66±5.78),and total score(119.04±13.11)compared to the control group(p<0.05).The observation group also showed better dry weight control than the control group(p<0.05).The total incidence of complications in the observation group(4.88%,2/41)was lower than that in the control group(21.95%,9/41)(p<0.05).Conclusion:The rational application of digital-intelligent health education can effectively maintain dry weight in patients undergoing maintenance hemodialysis,reduce complications,and improve patients’knowledge,belief,and behavior levels.This approach is worthy of promotion.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients w...Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.展开更多
Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Met...Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.展开更多
Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodial...Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.展开更多
Objectives:The study assessed the physical and environmental quality of life(QoL)of patients with chronic kidney disease(CKD)undergoing maintenance hemodialysis(HD)therapy at the Benue State University Teaching Hospit...Objectives:The study assessed the physical and environmental quality of life(QoL)of patients with chronic kidney disease(CKD)undergoing maintenance hemodialysis(HD)therapy at the Benue State University Teaching Hospital,Makurdi.Materials and Methods:An exploratory qualitative research design was adopted to conduct research on patients with CKD undergoing HD at the Benue State University Teaching Hospital,Makurdi,between October 2024 and May 2025.A researcher developed a semi-structured open-ended interview guide,and audio tapes were used to purposively collect data from 15 consented participants.The data were analyzed using NVivo version 10.0 for descriptive purposes.Results:The data revealed two(2)major themes:perceived body discomfort(body pain,nausea/vomiting,physical fatigue,physical dependence,life,as subthemes)and constraints(restricted lifestyle and barriers to access to HD therapy as subthemes).Conclusion:Although HD is perceived as a hope for CKD patients,the treatment severely compromises their physical and environmental QoL.展开更多
Hypertension is believed to be a major risk factor that causes cardiovascular disease in patients on hemodialysis （HD）. Removing of excess water during HD, accurate assessment of dry weight and anti-hypertension the...Hypertension is believed to be a major risk factor that causes cardiovascular disease in patients on hemodialysis （HD）. Removing of excess water during HD, accurate assessment of dry weight and anti-hypertension therapeutics are the most com- monly used measures to lower blood pressure in patients on HD.展开更多
Objective To explore the effective therapy for deficiency syndrome in the maintenance hemodialysis patients of end-stage renal disease. Methods Ninety-seven maintenance hemodialysis patients of end-stage renal disease...Objective To explore the effective therapy for deficiency syndrome in the maintenance hemodialysis patients of end-stage renal disease. Methods Ninety-seven maintenance hemodialysis patients of end-stage renal disease were divided into an observation group （51 cases） and a control group （46 cases） randomly, and routine western medicines were used in both groups. On this base, moxibustion was given at Zusanli （足三里 ST 36） and Sanyijiao （三阴交 SP 6） with a paper-tube-moxibustion equipment in the observation group. The therapeutic effects on syndromes were evaluated by comparing the symptom scores in two groups before and after treatment. Results After treatment, all the symptom scores in the observation group were improved significantly （all P〈0.05）, with fatigue and weakness, short breath and aversion to talking, poor appetite, lassitude in loin and knees, aversion to cold, cool extremities and so on most obviously improved, and the total effective rate on the syndrome in observation group （64.7%, 33/51） was significantly higher than that in control group （23.9%, 11/46）, with a significant difference between the two groups （P〈0.05）. Conclusion Moxibustion can improve the clinical symptoms of maintenance hemodialysis patients of end-stage renal disease, and it has some therapeutic effect on the deficiency syndrome.展开更多
基金Supported by Key Research Fund of Wannan Medical College,No.WK2021ZF15Research Foundation for Advanced Talents of Wannan Medical College,No.YR202213+3 种基金Foundation of Anhui Educational Committee,No.2023AH051759Excellent Youth Research Project of Anhui UniversitiesNo.2023AH030107Horizontal Project of Wannan Medical College,No.622202504003 and No.662202404013.
文摘BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.
基金funded by national funds through the Foundation for Science and Technology,under the project UIDB/04923。
文摘impacting quality of life.This study aimed to identify technological nursing interventions that promote self-care and improve the nutritional status of middle-aged and older adults undergoing hemodialysis.Methods:A systematic literature review was conducted in accordance with the Joanna Briggs Institute(JBI)and PRISMA guidelines.Searches were conducted in Medline,CINAHL,the Cochrane Library,Scopus,Web of Science,and grey literature,Studies published between 2018 and 2024,involving patients aged 40 years or more undergoing regular hemodialysis,and available in Portuguese,English,or Spanish,were included.JBI's critical appraisal tools were used to conduct a rigorous analysis and methodological quality assessment of the articles.Results:Out of a total of 738 articles,10 were included for analysis.Five key dimensions of technologydriven self-care interventions were established.1)Mobile applications and digital platforms with features like nutritional databases,food logging,and personalized feedback;2)E-learning and virtual education using social media and chat-based communication;3)Telenursing employing a hybrid follow-up model of face-to-face,telephone,and SMS contact;4)Educational strategies focused on nutritional status,utilizing methods such as teach-back and pictorial learning within a multidisciplinary team;and 5)Comprehensive assessment tools evaluating treatment adherence(hemodialysis,medication,diet,fluid)and laboratory markers.Significant improvements were reported across several outcomes:eight studies showed enhanced biochemical markers(e.g.,phosphorus,sodium,potassium,calcium,iron,albumin,urea,and hemoglobin)and nutritional status,three demonstrated increased selfefficacy,and two reported improved quality of life.Conclusion:Integrating technology and face-to-face education enhances nutritional status,highlighting the importance of comprehensive strategies to improve treatment adherence and prevent malnutrition in hemodialysis patients.
文摘BACKGROUND During the gradual decline of physical and social functioning associated with end-stage renal disease,patients might experience a premonition of impending death,resulting in a series of pre-mourning grief responses called preparatory grief.The preparatory grief in advanced cancer patients(PGAC)scale is the most widely used preparatory grief scale for patients on hemodialysis in China.AIM To verify the reliability and validity of the PGAC scale in patients on hemodialysis.METHODS In total,327 patients undergoing regular hemodialysis in the blood purification center of three grade-A tertiary hospitals in Guangdong and Guizhou provinces were selected by convenience sampling.The assessment was administered using the general information questionnaire and the Chinese version of PGAC.SPSS 25.0 and Amos 24.0 were used for item analysis,confirmatory factor analysis(CFA),convergent validity,and internal consistency reliability estimation.RESULTS In the modified Chinese version of PGAC,7 dimensions covering 27 total items were retained.CFA revealed a good fit of the factor model(chi-square degree of freedom=2.056,standardized root mean square residual=0.0479,root mean square error of approximation=0.0570,GFI=0.872,AGFI=0.841,IFI=0.931,CFI=0.930,TLI=0.919).The factor loadings of the items ranged 0.503-0.884.The composite reliability ranged 0.664-0.914,and the average variance extracted ranged 0.366-0.747.Cronbach’sαof the scale was 0.945,and Cronbach’sαfor various dimensions ranged 0.662-0.914.CONCLUSION The modified PGAC has good reliability and validity,and it can effectively measure preparatory grief in patients on hemodialysis.
文摘Objective:To evaluate the factors predicting fatigue among patients undergoing hemodialysis(HD).Fatigue is a common health problem in patients receiving HD.Understanding the factors that predict fatigue is crucial for helping patients to manage their weariness.Methods:A descriptive design was utilized with a convenient sample of 200 subjects who were on HD therapy at the Mansoura University Hospital and Mansoura International Hospital in Mansoura,Egypt,for at least 3 months.Four tools were utilized in collecting data.Results:The study subjects had a moderate level of fatigue regarding all sub-dimensions of the Piper Fatigue Scale(PFS).Among the total subjects,78.5%suffered from anxiety,and 31.0%had depression.A positive correlation was found between fatigue and anxiety,depression,and overall symptoms of distress,while a negative correlation was found between perception of the ability to manage symptoms and fatigue.The factors predicting fatigue included anxiety(β=0.274,P<0.001),depression(β=305,P<0.001),and the overall symptoms of distress(β=0.248,P<0.001),while the perceived ability to manage symptoms did not predicted.Conclusions:Fatigue was ranked as the top distressing symptom among HD patients,with psychological factors such as anxiety,depression,and the overall symptoms of distress predicting fatigue.Regular screenings of these factors and psychological therapies to modulate them might decrease fatigue severity and its related disability in HD clients.Multidimensional nurse-led interventions involving physical and psychological therapies are required to manage fatigue in HD patients.
文摘BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcomes”clinical practice guidelines recommend PTH levels be maintained in the range of two to nine times of the upper normal limit.Maintaining this balance is critical to prevent renal osteodystrophy.When the severity of hyperparathyroidism exceeds the recommended limits,vitamin D receptor agonists may be used for lowering PTH levels.Paricalcitol,as a biologically active vitamin D analog,is a selective activator of vitamin D responsive pathways.Both calcitriol and paricalcitol can be used as PTHlowering agents.There is conflicting data about their comparative effectiveness for controlling hyperparathyroidism in patients undergoing hemodialysis and a meta-analysis revealed no differences between the two.AIM To give real world data comparing paricalcitol and calcitriol as PTH-lowering agents in patients undergoing hemodialysis.METHODS Patients undergoing hemodialysis whose PTH levels exceeded nine times of the upper normal limit were enrolled in the study.Depending on patient preferences,they were either given calcitriol or paricalcitol.Intravenous calcitriol was given 2μg at the end of each dialysis sessions,and intravenous paricalcitol was administered as 5μg twice per week.Demographic data,calcium-phosphorus levels,change in PTH levels in 6 months,and ratios of 25%and 50%reductions in PTH levels were compared between the two groups.RESULTS A total of 21 patients were enrolled in this comparative study,eight patients received paricalcitol and 13 were prescribed calcitriol.A 50%reduction in PTH levels could be achieved in five patients in the paricalcitol group(62.5%);only one patient in the calcitriol group achieved the same reduction(7.6%).The difference was statistically significant(P=0.014).However,there was no difference in the ratio of patients who had a 25%reduction in PTH levels(87.5%vs 38.4%;P=0.067).PTH levels could be maintained in the targeted range in 87.5%of the patients in the paricalcitol group and in 69.2%of the patients in the calcitriol group(P=0.36).However,PTH could be better suppressed under paricalcitol.Clinically important hyperphosphatemia or hypercalcemia was not observed in either the paricalcitol or the calcitriol groups.CONCLUSION Although the PTH lowering effect of paricalcitol is stronger than calcitriol,both may help maintain PTH levels in the targeted range.Paricalcitol may be preferred for patients who have very high levels of PTH because it seems to cause a faster decline.Calcitriol may be preferred for a slower and limited decline.Prospective further studies with larger samples may be needed for a better comparison.
文摘BACKGROUND The neutrophil-lymphocyte ratio(NLR)has been proposed as a potential prognostic marker for mortality outcomes in various conditions,yet its association with chronic hemodialysis(HD)remains underexplored.We aim to study its utility by conducting a meta-analysis of this specific population.AIM To determine whether elevated NLR is associated with all-cause mortality(ACM)and cardiovascular mortality(CVM)in patients undergoing chronic HD.METHODS A comprehensive search from PubMed,Google Scholar,and Scopus identified studies showing the association between NLR and mortality outcomes in patients with chronic HD.Random-effects models with 95%CIs were employed to pool adjusted hazard ratios(aHRs),odds ratios(ORs),and I²statistics for evaluating the heterogeneity of findings.Leave-one-out sensitivity and meta-regression analyses assessed changes in overall effects and identified confounders,respectively.The Joanna Briggs Institute(JBI)tool was used to assess the quality of studies.RESULTS 19 studies comprising 9047 patients with a mean age of 59.5±5.86 years and a mean follow-up duration of 46.7 months were included in our study.Our meta-analysis revealed a significant association between NLR>2.5 and increased risks of ACM(aHR:1.25,95%CI:1.14-1.37,P<0.0001)and CVM(aHR:1.24,95%CI:1.02-1.49,P=0.03).Studies reporting outcomes in OR reported similar findings for ACM(OR:4.59,95%CI:1.74-12.11,P=0.002)and CVM(OR:1.11,95%CI:1.01-1.23,P=0.03).Sensitivity analysis revealed no variations.Meta-regression revealed increasing male proportion is positively associated with ACM.Pooled area under the curve(AUC)was 0.71(95%CI:0.63-0.80,P<0.0001).The JBI tool revealed high-quality studies.CONCLUSION This meta-analysis suggests that elevated NLR may serve as a useful prognostic marker for ACM and CVM in patients on chronic HD and can be useful in planning for the prevention of mortality-related strategies.
文摘BACKGROUND The use of apixaban in chronic hemodialysis(HD)patients for non-valvular atrial fibrillation(NVAF)is still controversial regarding benefit of stroke protection vs risk of bleeding.Rotational thromboelastometry(ROTEM)is a point of care method that evaluates clot formation in whole blood and has been used as an evaluation tool for bleeding risk assessment in non-HD apixaban users.AIM To determine whether bleeding risk can be predicted using ROTEM activated with tissue factor(EXTEM)in HD patients receiving apixaban for NVAF.METHODS Nineteen HD patients with NVAF treated with apixaban for at least 8 days were enrolled.Four dosing regimens were recorded as prescribed by their physician,from 2.5 mg once daily on a non-dialysis day to 5 mg twice daily.Standard coagulation tests,along with ROTEM and apixaban drug levels(using liquid anti-Xa assay)were performed once on a non-dialysis day before and two hours after apixaban morning pill administration.Patients were subsequently monitored for thrombotic/bleeding events and all-cause mortality.RESULTS Over a median follow-up period of 36 months,six patients experienced a bleeding event(group A)and 13 remained free of bleeding(group B).Six deaths were recorded:Three due to major bleeding,one from thrombotic stroke,and two unrelated to coagulopathy.EXTEM clotting time(CT)-post was the only parameter that significantly differed between group A and group B(P=0.013).Each 1-second increase in CT-post was linked to an 8%higher likelihood of a bleeding event(odds ratio=1.08,95%confidence interval:1.0-1.17;P=0.048).A significant progressive increase was observed with the drug’s trough and peak levels(P<0.05)across the four dosing regimens but no significant relationship was found between CT and apixaban dose groups.CONCLUSION Early detection of bleeding risk in HD patients with NVAF on Apixaban maybe be effectively achieved through frequent monitoring using ROTEM EXTEM post CT,thereby helping to reduce associated morbidity.
文摘BACKGROUND Hyperphosphatemia(HP)is a common complication in an advanced stage of chronic kidney disease(CKD)and is associated with cardiovascular issues,metabolic bone abnormalities and worsening of secondary hyperparathyroidism.Most patients on dialysis require phosphate binders to control HP.Sucroferric oxyhydroxide(SO)(Dynulta^(TM))is a calcium-free,polynuclear iron(III)based oral phosphate binder,for the treatment of HP.In this phase IV,open-label,singlearm,multi-center,12-week,SOLO CKD study evaluated efficacy and safety of Dynulta^(TM)in Indian CKD patients undergoing hemodialysis.AIM To investigate the efficacy,safety and tolerability of SO Chewable Tablet(Dynulta^(TM))in patients with CKD on hemodialysis.METHODS Hyperphosphatemic patients on hemodialysis and fulfilling eligibility criteria were included in the study for at least 12 weeks and received SO 1500 mg chewable tablet per day.The key endpoint was change in mean serum phosphorus levels after 12 weeks.Data were analysed using analysis of variance,Paired test,Wilcoxon test,and post-hoc comparisons,with P<0.05 considered statistically significant,using Graph Pad software.RESULTS A total of 114 patients were enrolled and 94 patients completed the study.The mean±SD serum phosphorous level was reduced from 7.62 mg/dL±2.02 mg/dL at baseline to 5.13 mg/dL±1.88 mg/dL after 12 weeks of treatment.At each follow-up visit,the reduction in mean serum phosphorous levels was statistically significant(P value<0.05)compared to baseline,confirming the efficacy of SO.A total of 33.33%of patients experienced adverse events(AEs).The most frequently reported AEs were pyrexia,nasopharyngitis and headache,which were considered unlikely to be related to the study drug treatment.No serious AEs was reported during the study period and no patients discontinued treatment due to AEs.CONCLUSION This first real-world study in Indian CKD patients on hemodialysis shows SO as a safe,and effective monotherapy for HP,though its small sample size limits generalizability.
文摘This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’compliance.A network information management model for MHD patients was constructed around three management schemes:“software reminders+follow-up guidance”,“dietary records+self-management reminders”,and“dialysis plan+precise weight management”.These schemes were respectively used to optimize anemia management,control the risk of hyperphosphatemia,and improve toxin clearance efficiency.A controlled experiment was conducted,with an experimental group and a control group set up for comparative practice.The results showed that the network information management model can effectively improve patients’anemia,help alleviate mineral metabolism disorders and the accumulation of small-molecule toxins,and exert a positive impact on patients’treatment compliance.
文摘Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhancing patient safety and meeting global dialysis water quality standards. Advanced filtration technologies, such as titanium dioxide (TiO₂)-based nanoparticle filters, offer a promising approach to improve water purification processes in renal care. Objectives: This study aimed to develop and evaluate the effectiveness of a TiO₂-based nanoparticle microporous filtration system for hemodialysis water purification. The objectives included analyzing the system’s performance in reducing chemical contaminants (calcium, magnesium, aluminum, and lead) and microbiological contaminants (total viable count [TVC] and endotoxin units [EU]) across multiple renal centers. Methods: Water samples from three renal centers (RC1, RC2, and RC3) were analyzed pre- and post-filtration. TiO₂ nanoparticles were synthesized using the sol-gel method and characterized via Fourier Transform Infrared (FTIR) spectroscopy and Scanning Electron Microscopy with Energy Dispersive X-ray analysis (SEM/EDX). The microporous filter, fabricated with TiO₂ nanoparticles, silicon dioxide, and polyethylene glycol (PEG), was tested for its ability to remove contaminants. Analytical techniques included spectroscopy for chemical analysis and microbiological assays for contaminant quantification. Results: Post-treatment analysis revealed significant reductions in chemical contaminants, with removal efficiencies averaging 78% for calcium, 80% for magnesium, 81% for aluminum, and 76.6% for lead across all centers. Microbiological contamination was also substantially reduced, with 78–80% removal of TVC and 76–84.6% reduction in EU levels. FTIR analysis confirmed the presence of hydroxyl groups critical for adsorption, while SEM/EDX characterization revealed a crystalline structure with a particle size of 1.45 nm, pore size of 4.11 μm, filter height of 2.56 mm, and bulk density of 0.58 g/cm³. Conclusion: The TiO₂-based nanoparticle filtration system demonstrated high efficacy in removing chemical and microbiological contaminants, significantly improving water quality for hemodialysis. These results highlight its potential as a practical solution for renal centers, especially in resource-constrained settings. Further studies are needed to evaluate its long-term performance and feasibility for widespread adoption. Recommendation: Renal centers should consider adopting TiO2-based nanoparticle filters to address persistent water quality challenges. Pilot implementations across diverse settings can provide insights into operational feasibility. Additional research should explore scalability, maintenance requirements, and cost-effectiveness to optimize integration into healthcare systems. Significance Statement: This study introduces a practical and innovative solution to improve hemodialysis water purification. By effectively reducing both chemical and microbiological contaminants, the TiO2-based filtration system has the potential to enhance patient safety and outcomes, particularly in settings where maintaining high water quality standards remains challenging.
文摘This paper explores the application effect of humanistic care in the nursing of hemodialysis patients.Firstly,it expounds the application value of humanistic care in the nursing of hemodialysis patients.Then,it evaluates the effect by constructing an evaluation index system and combining with empirical analysis.Finally,it puts forward specific application measures and draws conclusions.The purpose is to provide reference for improving the nursing quality of hemodialysis patients,so as to enhance patients’quality of life and promote their physical and mental health.
基金supported by the Deyang City Science and Technology Planning Project[Grant Number 2023SZZ010].
文摘Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 195 patients with MHD and SHPT at Deyang People's Hospital from April 2024 to April 2025 were enrolled.Patients were randomly assigned to a control group receiving standard HD treatment and an experimental group receiving HD combined with HP therapy.The experimental group underwent 1 year of observation(97 cases in the experimental group,98 cases in the control group).During treatment,changes in parathyroid hormone(PTH),serum calcium,serum phosphorus,and inflammatory factors were monitored,along with analysis of treatment-related economic benefits and safety.Results:The experimental group demonstrated significantly better reductions in PTH,serum phosphorus,and inflammatory factors compared to the control group(P<0.05).Although the total treatment cost was slightly higher,the unit cost per therapeutic effect was lower,resulting in a superior cost-effectiveness ratio.Conclusion:Combined HD and HP therapy can significantly improve SHPT-related indicators in MHD patients,demonstrating safety,controllability,and high cost-effectiveness,making it a clinically applicable and recommended treatment option.
文摘Objective:To evaluate the effectiveness of digital-intelligent health education for patients undergoing maintenance hemodialysis.Methods:From December 2023 to December 2024,82 patients undergoing maintenance hemodialysis in our hospital were selected and randomly divided into an observation group(n=41,receiving routine health education)and a control group(n=41,receiving digital health education).The levels of knowledge,belief,and behavior related to dry weight control,as well as changes in dry weight and complications,were compared before and after intervention.Results:After intervention,the observation group had higher scores for knowledge(40.96±6.43),belief(39.11±6.39),behavior(39.66±5.78),and total score(119.04±13.11)compared to the control group(p<0.05).The observation group also showed better dry weight control than the control group(p<0.05).The total incidence of complications in the observation group(4.88%,2/41)was lower than that in the control group(21.95%,9/41)(p<0.05).Conclusion:The rational application of digital-intelligent health education can effectively maintain dry weight in patients undergoing maintenance hemodialysis,reduce complications,and improve patients’knowledge,belief,and behavior levels.This approach is worthy of promotion.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
文摘Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.
文摘Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.
文摘Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.
文摘Objectives:The study assessed the physical and environmental quality of life(QoL)of patients with chronic kidney disease(CKD)undergoing maintenance hemodialysis(HD)therapy at the Benue State University Teaching Hospital,Makurdi.Materials and Methods:An exploratory qualitative research design was adopted to conduct research on patients with CKD undergoing HD at the Benue State University Teaching Hospital,Makurdi,between October 2024 and May 2025.A researcher developed a semi-structured open-ended interview guide,and audio tapes were used to purposively collect data from 15 consented participants.The data were analyzed using NVivo version 10.0 for descriptive purposes.Results:The data revealed two(2)major themes:perceived body discomfort(body pain,nausea/vomiting,physical fatigue,physical dependence,life,as subthemes)and constraints(restricted lifestyle and barriers to access to HD therapy as subthemes).Conclusion:Although HD is perceived as a hope for CKD patients,the treatment severely compromises their physical and environmental QoL.
文摘Hypertension is believed to be a major risk factor that causes cardiovascular disease in patients on hemodialysis （HD）. Removing of excess water during HD, accurate assessment of dry weight and anti-hypertension therapeutics are the most com- monly used measures to lower blood pressure in patients on HD.
基金Supported by the second lot TCM superior diseases clinical research items of China Academy of Chinese Medical Sciences: CACMS07Y0019
文摘Objective To explore the effective therapy for deficiency syndrome in the maintenance hemodialysis patients of end-stage renal disease. Methods Ninety-seven maintenance hemodialysis patients of end-stage renal disease were divided into an observation group （51 cases） and a control group （46 cases） randomly, and routine western medicines were used in both groups. On this base, moxibustion was given at Zusanli （足三里 ST 36） and Sanyijiao （三阴交 SP 6） with a paper-tube-moxibustion equipment in the observation group. The therapeutic effects on syndromes were evaluated by comparing the symptom scores in two groups before and after treatment. Results After treatment, all the symptom scores in the observation group were improved significantly （all P〈0.05）, with fatigue and weakness, short breath and aversion to talking, poor appetite, lassitude in loin and knees, aversion to cold, cool extremities and so on most obviously improved, and the total effective rate on the syndrome in observation group （64.7%, 33/51） was significantly higher than that in control group （23.9%, 11/46）, with a significant difference between the two groups （P〈0.05）. Conclusion Moxibustion can improve the clinical symptoms of maintenance hemodialysis patients of end-stage renal disease, and it has some therapeutic effect on the deficiency syndrome.
