Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 wer...Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.展开更多
BACKGROUND Patients with uremia undergoing colorectal cancer surgery face an increased risk of postoperative complications due to impaired renal function,challenges in fluid balance,and the complexities of anesthetic ...BACKGROUND Patients with uremia undergoing colorectal cancer surgery face an increased risk of postoperative complications due to impaired renal function,challenges in fluid balance,and the complexities of anesthetic management.Effective anesthesia and fluid strategies are critical to reducing complications and improving outcomes.Total intravenous anesthesia(TIVA)and goal-directed fluid therapy(GDT)have been suggested to enhance perioperative stability compared with inhalational anesthesia and standard fluid therapy.However,evidence supporting their efficacy in patients with uremia remains limited.AIM To evaluate the effects of different anesthetic techniques on postoperative complications in patients with uremia undergoing colorectal cancer surgery.METHODS This retrospective cohort study included 120 patients with stage 3-5 uremia who underwent elective colorectal cancer surgery between January 2022 and December 2024.Patients received either inhalational anesthesia or TIVA,combined with either standard fluid therapy or GDT.The primary outcome measure was the incidence of postoperative complications.Secondary outcomes included length of hospital stay,major complications,and 30-day mortality.RESULTS Postoperative complications occurred in 23.3%(28/120)of patients.TIVA was associated with a lower complication rate than that of inhalational anesthesia(20.0%vs 26.7%,P=0.045).GDT resulted in significantly reduced fluid administration(2400 mL vs 3100 mL,P<0.001)and lower complication rates(19.5%vs 28.2%,P=0.030)compared with those of standard management.Independent risk factors for complications included age over 75 years(OR:2.40,95%CI:1.60-3.60),stage 5 uremia(OR:1.85,95%CI:1.20-2.85),and cumulative fluid balance exceeding 2000 mL(OR:1.70,95%CI:1.10-2.65).Patients with complications had longer hospital stays(median,15 days vs 11 days;P<0.001)and higher rates of major complications(27.8%vs 13.5%;P=0.003).CONCLUSION In patients with uremia undergoing colorectal cancer surgery,TIVA and GDT are associated with a lower incidence of postoperative complications compared with that of inhalational anesthesia and standard fluid management.Optimizing anesthetic techniques and fluid management may improve postoperative outcomes in this high-risk population.展开更多
Diabetic patients who underwent long-term dialysis may increase the prevalence of foot ulceration. In addition, diabetic foot ulcer (DFUs) patients with end-stage renal disease (ESRD) do not heal well, and the amputat...Diabetic patients who underwent long-term dialysis may increase the prevalence of foot ulceration. In addition, diabetic foot ulcer (DFUs) patients with end-stage renal disease (ESRD) do not heal well, and the amputation rate is 6.5 - 10 times higher compared to the non-nephropathic diabetic population. Thus, a suitable therapeutic agent was needed. ON101 is a topical cream that promotes diabetic wound healing through a unique macrophage-regulating ability. In this case series, we included 5 diabetes patients (mean age 54.6 ± 8.7 years, 4 mal) with ESRD (mean eGFR 7.4 ± 3.35 mL/min/1.73m<sup>2</sup>) and had experienced dialysis for at least 4.5 years. These patients also have UT (University of Texas) grade 2A DFUs that have existed for at least 1.5 months (mean ulcer duration 8.3 ± 8.97 months). These subjects were applied ON101 twice daily for up to 20 weeks, and wound size was recorded during treatment. Among these subjects, three ulcers (patient No. 1, 2, and 3) completely healed within 10 weeks upon ON101 application, and one ulcer was 99% reduced at 20<sup>th</sup> weeks (patient No. 4). Only one ulcer didn’t show an obvious response that may due to poor compliance in wound care and glucose control. In summary, the overall healing rate was 60%, suggesting ON101 performed equivalence healing efficacy in dialysis patients compared with those who did not have dialysis.展开更多
Objective:To investigate the clinical effectiveness of need-based nursing interventions for hemodialysis patients with uremia.Methods:A double-blind,randomized controlled trial was conducted from January 2020 to June ...Objective:To investigate the clinical effectiveness of need-based nursing interventions for hemodialysis patients with uremia.Methods:A double-blind,randomized controlled trial was conducted from January 2020 to June 2024,including a sample of 100 hemodialysis patients with uremia.The patients were randomly assigned into a test group(n=50)and a control group(n=50)using a random number table based on their medical record numbers.The control group received standard basic nursing care,while the test group received need-based nursing intervention.The two groups were compared based on self-care ability scores,resilience scores using the CD-RISC-10 scale,complication incidence rates,and nursing satisfaction.Results:After the nursing intervention,the test group showed significantly higher scores in self-care ability(P<0.05)and CD-RISC-10 resilience(P<0.05)than the control group.The incidence of complications was significantly lower(P<0.05),and nursing satisfaction was notably higher(P<0.05)in the test group compared to the control group.Conclusion:Need-based nursing for hemodialysis patients with uremia can enhance self-care abilities,improve psychological resilience,reduce complication rates,and increase nursing satisfaction,making it worthy of broader implementation.展开更多
Objective:To evaluate the application effect of psychological nursing intervention on maintenance hemodialysis(MHD)patients with uremia.Methods:Sixty cases of uremic patients admitted to the hospital between May 2023 ...Objective:To evaluate the application effect of psychological nursing intervention on maintenance hemodialysis(MHD)patients with uremia.Methods:Sixty cases of uremic patients admitted to the hospital between May 2023 and May 2024 were selected for MHD treatment and divided using the random number table method into 30 cases in each group.The observation group implemented psychological nursing intervention,while the reference group received conventional nursing intervention,after which the nursing effects were compared.Results:After nursing,the psychological state score of the observation group was lower than that of the reference group;the treatment compliance of the observation group was higher than that of the reference group;the self-care ability score of the observation group was higher than that of the reference group,and the quality-of-life score of the observation group was higher than that of the reference group(P<0.05).Conclusion:Psychological nursing intervention for uremic MHD patients can improve their negative psychology,enhance treatment compliance,and comprehensively improve patients’self-care ability and quality of life.展开更多
Since traditional nail diagnosis is susceptible to objective factors such as illumination,medical experience,etc.,a nail diagnosis system of traditional Chinese medicine which combines objective nail image acquisition...Since traditional nail diagnosis is susceptible to objective factors such as illumination,medical experience,etc.,a nail diagnosis system of traditional Chinese medicine which combines objective nail image acquisition with information analysis is proposed and applied to the clinical research of nail diagnosis of uremia patients.Fifteen nail pictures of uremic patients were collected and segmented.The color information of nails was extracted.The relationship between the hemoglobin values of uremic patients and the values of color space before and after maintenance hemodialysis was analyzed by correlation analysis and multiple regression analysis.The experimental results show that the hemoglobin value of uremic patients have certain correlations with multiple color channels;before and after dialysis,there are significant changes in multiple channels;and the related multiple regression equation is established.展开更多
Many observers have noted that the morphological changes that occur in chronic kidney disease(CKD) patients resemble those seen in the geriatric population, with strikingly similar morbidity and mortality profiles and...Many observers have noted that the morphological changes that occur in chronic kidney disease(CKD) patients resemble those seen in the geriatric population, with strikingly similar morbidity and mortality profiles and rates of frailty in the two groups, and shared characteristics at a pathophysiological level especially in respect to the changes seen in their vascular andimmune systems. However, whilst much has been documented about the shared physical characteristics of aging and uremia, the molecular and cellular similarities between the two have received less attention. In order to bridge this perceived gap we have reviewed published research concerning the common molecular processes seen in aging subjects and CKD patients, with specific attention to altered proteostasis, mitochondrial dysfunction, post-translational protein modification, and senescence and telomere attrition. We have also sought to illustrate how the cell death and survival pathways apoptosis, necroptosis and autophagy are closely interrelated, and how an understanding of these overlapping pathways is helpful in order to appreciate the shared molecular basis behind the pathophysiology of aging and uremia. This analysis revealed many common molecular characteristics and showed similar patterns of cellular dysfunction. We conclude that the accelerated aging seen in patients with CKD is underpinned at the molecular level, and that a greater understanding of these molecular processes might eventually lead to new much needed therapeutic strategies of benefit to patients with renal disease.展开更多
Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who w...Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who were treated in our hospital between March 2013 and October 2015 were collected and divided into observation group and control group (n=35) according to double-blind randomized control method. Observation group of patients received hemodialysis combined with hemoperfusion, control group of patients received hemodialysis alone, and the treatment lasted for 6 months. After 6 months of intervention, automatic biochemical analyzer was used to detect renal function indexes and lipid metabolism indexes, and the two-dimensional ultrasound was used to quantitatively determine the carotid atherosclerosis parameters.Results:Before intervention, differences in renal function, lipid metabolism and atherosclerosis levels were not statistically significant between two groups of patients;after 6 months of intervention, renal function indexes blood urea nitrogen (BUN), serum creatinine (Scr),β2-microglobulin (β2-MG) and blood uric acid (BUA) levels of observation group were lower than those of control group, lipid metabolism indexes total cholesterol (TC), triglyceride (TG), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) levels were lower than those of control group, and differences between groups were statistically significant;quantitative carotid ultrasound parameters gray-scale median (GSM) of observation group was higher than that of control group, enhanced intensity (EI) and enhanced density (ED) were lower than those of control group, and differences between groups were statistically significant.Conclusion:Hemodialysis combined with hemoperfusion can improve the dialysis efficiency, also reduce lipid metabolism disturbance and delay the formation of atherosclerosis in patients with uremia.展开更多
Summary： The different sera proteomic components between uremia patients and normal subjects were studied through two-dimensional gel electrophoresis technique. Immobilized pH gradient two- dimensional polyacrylamide...Summary： The different sera proteomic components between uremia patients and normal subjects were studied through two-dimensional gel electrophoresis technique. Immobilized pH gradient two- dimensional polyacrylamide gel electrophoresis （2DE）, silver staining, ImageMaster 2D 5.0 analysis software, matrix assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF-TOF-MS） and IPI human database searching were used to separate and identify the proteome of the sera from the patients with uremia. The results showed that satisfactory 2DE patterns of the serum proteins were obtained. Twenty-six protein spots showed significant difference in quantity in uremia patients, and 20 protein spots were identified by MALDI-TOF-TOF-MS. It was concluded that good reproducibility could be obtained by applying immobilized pH gradient 2DE to separate and identify the proteome in serum, which provided the foundation for the further study on uremia toxins oertaining to orotein.展开更多
Objective:To study the clinical significance of troponinI(TnI),high sensitivity C reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the diagnosis of myocardial damage in uremia patients...Objective:To study the clinical significance of troponinI(TnI),high sensitivity C reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the diagnosis of myocardial damage in uremia patients.Methods:114 uremia patients treated in our hospital from January 2017 to February 2019 were selected.According to whether myocardial damage occurred,patients were divided into two groups including uremia group(63 cases)anduremia myocardial damage group(51 cases).50 hospitalized patients with non-chronic kidney disease and non-cardiovascular disease in our hospital were selected as control group.The levels of TnI,hs-CRP and NT-proBNP in 1,3 and 7 days after admission were detected and compared.Meanwhile,the ecg indexes of left?ventricular?ejection?fraction(LVEF)and Thickness of the posterior wall of the left ventricle(LVPWd)were recorded and compared.Person correlation was used to analyze the correlation between the levels of TnI,hs-CRP,NT-proBNP and ecg indexes including LVEF and LVPWd.COX regression analysis was used to analyze the independent riskfactors affecting the clinical prognosis of uremia patients.Results:The levels of TnI,hs-CRP,NT-proBNP in the three groups were significantly different on 1,3,7 days after admission.The levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group and uremia group were decreased with treatment.However,the levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group were the highest(P<0.05).Compared with the other two groups,the LVEF of uremia combined with myocardial damage group was the lowest,while the LVPWd was the thickest,showing a significant difference(P<0.05).There was negativecorrelation between LVEF and TnI,hs-CRP,NT-proBNP levels.However,LVPWd was positively correlated with TnI,hs-CRP and NT-proBNP levels(P<0.05).COX regression analysis showed that TnI,hs-CRP,NT-proBNP levels,LVEF and LVPWd were the independent factors affecting the clinical prognosis of uremia patients Conclusion:The level of TnI,hs-CRP,NT-proBNP was dynamic change in the onset and treatment process in uremia combined with myocardial damage patients,which could be used for early diagnosis of uremia combined with myocardial damage.展开更多
Objective:To study the effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia.Methods: A total of 50 patients with uremia who accepted high-flux hemodialysis and 14...Objective:To study the effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia.Methods: A total of 50 patients with uremia who accepted high-flux hemodialysis and 140 patients with uremia who accepted low-flux hemodialysis in our hospital between March 2015 and March 2016 were selected and included in high-flux group and low-flux group respectively. Before and after dialysis, serum was collected respectively to determine the levels of side metabolites, calcium-phosphorus metabolism indexes and cytokines.Results: 3 months after dialysis, serum Ca levels of two groups of patients were not significantly different from those before dialysis while BUN, Scr,β2-MG, sTfR, P, PTH and AKP levels were significantly lower than those before dialysis;3 months after dialysis, serum BUN, Scr and Ca levels of high-flux group were not significantly different from those of low-flux group whileβ2-MG, sTfR, P, PTH, AKP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 levels were significantly lower than those of low-flux group.Conclusion:Compared with low-flux hemodialysis, high-flux hemodialysis treatment of uremia can more effectively remove middle molecular and macromolecular toxins, correct calcium-phosphorus metabolism disorder and relieve micro-inflammatory state.展开更多
Objective:To explore the effect of hemodialysis (HD) in combined with hemoperfusion (HP) on the toxin clearance rate and carotid intima in patients with uremia.Methods: A total of 40 patients with uremia who were admi...Objective:To explore the effect of hemodialysis (HD) in combined with hemoperfusion (HP) on the toxin clearance rate and carotid intima in patients with uremia.Methods: A total of 40 patients with uremia who were admitted in our hospital from May, 2015 to February, 2017 were included in the study and randomized into the control group (n=20) and the study group (n=20). The patients in the two groups were given routine HD treatment. On the above basis, the patients in the study group were given HP treatment, continuously for 3 months. The toxin content, clearance rate, and serum inflammatory cytokines before and after treatment in the two groups were detected and compared. The ultrasound diagnostic apparatus was used to detect the carotid IMT before and after treatment in the two groups. Results: Scr and BUN after treatment in the two groups, and PTH andβ2-MG contents in the study group were significantly reduced when compared with before treatment. PTH andβ2-MG contents after treatment in the study group were significantly lower than those in the control group, while PTH andβ2-MG clearance rate was significantly higher than that in the control group. The serum MDA, hs-CRP, IL-6, and TNF-α levels after treatment in the two groups were significantly reduced when compared with before treatment. The serum hs-CRP, IL-6, and TNF-α levels after treatment in the study group were significantly lower than those in the control group. IMT and plaque area after treatment in the control group were significantly increased when compared with before treatment, while IMT and plaque area in the study group were not significantly changed. The plaque area after treatment in the study group was significantly less than that in the control group.Conclusions: HD in combined with HP can significantly enhance the toxin clearance rate of large molecules in patients with uremia, alleviate the inflammatory reaction, and meanwhile effectively delay the occurrence of atherosclerosis and other cardiovascular complications.展开更多
Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data ...Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data analysis was used to obtain the nursing effect of patients. Results: after the follow-up analysis of 22 patients, the symptoms of 8 cases improved after one treatment, 10 cases improved after two treatments, and 4 cases alleviated 4-6 times after treatment. One of the 22 patients stopped, and the other 21 patients had no adverse reactions. Conclusion: nursing intervention in the treatment of uremic skin pruritus with hemoperfusion and hemodialysis is effective and worthy of clinical recommendation.展开更多
Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and compr...Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and comprehensive nursing intervention were adopted respectively. Results: in the comparison of treatment compliance and complication rate between the basic group and the comprehensive group, the basic group was 78.04% and 14.63% respectively, while the comprehensive group was 97.56% and 4.87% respectively (χ2 = 6.197, p=0.000). There was a difference between the two groups. Conclusion: the effect of hemodialysis combined with hemoperfusion and comprehensive nursing intervention in the treatment of uremia is significant and worthy of clinical recommendation.展开更多
Objective: to carry out stratified nursing care for uremic patients undergoing hemodialysis, and analyze the effect of nursing care on nutritional status and quality of life of patients. Methods: a total of 80 patient...Objective: to carry out stratified nursing care for uremic patients undergoing hemodialysis, and analyze the effect of nursing care on nutritional status and quality of life of patients. Methods: a total of 80 patients admitted in this study were uremic patients treated with hemodialysis in Tongji hospital from May 2020 to May 2021. All patients were equally divided into two groups according to the ball-touching grouping method: observation group (40 cases) and control group (40 cases). Patients in the control group received routine care during the treatment, while patients in the observation group received stratified care during the treatment. After completing the nursing, the data of the two groups of patients were collected, including the patients' nutritional status, emotional status, quality of life and patients' compliance with the treatment. Results: the nutritional status of the patients in the observation group was significantly higher than that of the patients in the control group (P < 0.05). The scores of emotional state indexes in the observation group were significantly lower than those in the control group (P < 0.05). The quality of life index of the observation group was significantly higher than that of the control group (P < 0.05). The total treatment compliance of the observation group was 97.5%, which was higher than 82.5% of the control group (P < 0.05). Conclusion: layered nursing model can help uremic patients to improve their quality of life, and is worthy of promotion.展开更多
Objective: To explore the value of combined intervention for nursing patients with uremia, namely HD (hemoperfusion) combined with HP (hemodialysis). Methods: Choose in February 2020 - February 2022 as A case study ra...Objective: To explore the value of combined intervention for nursing patients with uremia, namely HD (hemoperfusion) combined with HP (hemodialysis). Methods: Choose in February 2020 - February 2022 as A case study range, object to enter the HD joint HP treated in our hospital and uremic patients, quantity statistics for 100 cases, included in the category mode can be identified as double-blind principle, into group A and group B 50 cases respectively, which choose the mode of conventional intervention, the former seamless nursing intervention mode selection, Compare the two groups how to reflect the specific nursing effect. Results: Before and after intervention, the indexes of the two groups were compared, including quality of life, psychological level, inflammatory factors, etc., which showed that the observation group was better than the control group after nursing, indicating P value 0.05. Conclusion: Through the implementation of seamless nursing measures for HP combined with HD in the treatment of uremia patients, committed to physiological and physiological dual quality assurance, improve patients nursing satisfaction, the results of the study confirmed that it can be used for clinical promotion.展开更多
Objective: to explore the effect of different hemodialysis methods on uremia patients. Methods: 68 patients with uremia were selected and randomly divided into experimental group and control group, 34 cases in each gr...Objective: to explore the effect of different hemodialysis methods on uremia patients. Methods: 68 patients with uremia were selected and randomly divided into experimental group and control group, 34 cases in each group. The therapeutic effects and toxic and side effects of two dialysis methods were compared. Results: after treatment, the difference between groups was significant (P < 0.05). Conclusion: high-flux hemodialysis treatment can play a good role in uremic patients, is conducive to promoting the discharge of small molecular substances, and has no serious adverse reactions, high safety, and is worthy of promotion and application.展开更多
Objective: to explore the nursing and treatment of patients with chronic renal failure and uremia. Conclusion: regularly monitor the indicators reflecting the nutritional status of patients, such as serum albumin leve...Objective: to explore the nursing and treatment of patients with chronic renal failure and uremia. Conclusion: regularly monitor the indicators reflecting the nutritional status of patients, such as serum albumin level and hemoglobin, monitor the changes of serum electrolytes, observe and timely judge whether patients have signs of hyperkalemia, determine the symptoms of patients and observe them. If your fingers have hypocalcemia, etc. If you have symptoms such as numbness or convulsions, please inform your doctor in time. For patients with hypocalcemia and hyperphosphatemia, the dietary guidelines provide for intake of high calcium foods such as milk, as well as calcium, active vitamin D and other drugs. Pay close attention to signs of infection, and inform the doctor in time of abnormal conditions such as temperature rise, heart rate increase or abnormal blood leukocytes.展开更多
文摘Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.
文摘BACKGROUND Patients with uremia undergoing colorectal cancer surgery face an increased risk of postoperative complications due to impaired renal function,challenges in fluid balance,and the complexities of anesthetic management.Effective anesthesia and fluid strategies are critical to reducing complications and improving outcomes.Total intravenous anesthesia(TIVA)and goal-directed fluid therapy(GDT)have been suggested to enhance perioperative stability compared with inhalational anesthesia and standard fluid therapy.However,evidence supporting their efficacy in patients with uremia remains limited.AIM To evaluate the effects of different anesthetic techniques on postoperative complications in patients with uremia undergoing colorectal cancer surgery.METHODS This retrospective cohort study included 120 patients with stage 3-5 uremia who underwent elective colorectal cancer surgery between January 2022 and December 2024.Patients received either inhalational anesthesia or TIVA,combined with either standard fluid therapy or GDT.The primary outcome measure was the incidence of postoperative complications.Secondary outcomes included length of hospital stay,major complications,and 30-day mortality.RESULTS Postoperative complications occurred in 23.3%(28/120)of patients.TIVA was associated with a lower complication rate than that of inhalational anesthesia(20.0%vs 26.7%,P=0.045).GDT resulted in significantly reduced fluid administration(2400 mL vs 3100 mL,P<0.001)and lower complication rates(19.5%vs 28.2%,P=0.030)compared with those of standard management.Independent risk factors for complications included age over 75 years(OR:2.40,95%CI:1.60-3.60),stage 5 uremia(OR:1.85,95%CI:1.20-2.85),and cumulative fluid balance exceeding 2000 mL(OR:1.70,95%CI:1.10-2.65).Patients with complications had longer hospital stays(median,15 days vs 11 days;P<0.001)and higher rates of major complications(27.8%vs 13.5%;P=0.003).CONCLUSION In patients with uremia undergoing colorectal cancer surgery,TIVA and GDT are associated with a lower incidence of postoperative complications compared with that of inhalational anesthesia and standard fluid management.Optimizing anesthetic techniques and fluid management may improve postoperative outcomes in this high-risk population.
文摘Diabetic patients who underwent long-term dialysis may increase the prevalence of foot ulceration. In addition, diabetic foot ulcer (DFUs) patients with end-stage renal disease (ESRD) do not heal well, and the amputation rate is 6.5 - 10 times higher compared to the non-nephropathic diabetic population. Thus, a suitable therapeutic agent was needed. ON101 is a topical cream that promotes diabetic wound healing through a unique macrophage-regulating ability. In this case series, we included 5 diabetes patients (mean age 54.6 ± 8.7 years, 4 mal) with ESRD (mean eGFR 7.4 ± 3.35 mL/min/1.73m<sup>2</sup>) and had experienced dialysis for at least 4.5 years. These patients also have UT (University of Texas) grade 2A DFUs that have existed for at least 1.5 months (mean ulcer duration 8.3 ± 8.97 months). These subjects were applied ON101 twice daily for up to 20 weeks, and wound size was recorded during treatment. Among these subjects, three ulcers (patient No. 1, 2, and 3) completely healed within 10 weeks upon ON101 application, and one ulcer was 99% reduced at 20<sup>th</sup> weeks (patient No. 4). Only one ulcer didn’t show an obvious response that may due to poor compliance in wound care and glucose control. In summary, the overall healing rate was 60%, suggesting ON101 performed equivalence healing efficacy in dialysis patients compared with those who did not have dialysis.
文摘Objective:To investigate the clinical effectiveness of need-based nursing interventions for hemodialysis patients with uremia.Methods:A double-blind,randomized controlled trial was conducted from January 2020 to June 2024,including a sample of 100 hemodialysis patients with uremia.The patients were randomly assigned into a test group(n=50)and a control group(n=50)using a random number table based on their medical record numbers.The control group received standard basic nursing care,while the test group received need-based nursing intervention.The two groups were compared based on self-care ability scores,resilience scores using the CD-RISC-10 scale,complication incidence rates,and nursing satisfaction.Results:After the nursing intervention,the test group showed significantly higher scores in self-care ability(P<0.05)and CD-RISC-10 resilience(P<0.05)than the control group.The incidence of complications was significantly lower(P<0.05),and nursing satisfaction was notably higher(P<0.05)in the test group compared to the control group.Conclusion:Need-based nursing for hemodialysis patients with uremia can enhance self-care abilities,improve psychological resilience,reduce complication rates,and increase nursing satisfaction,making it worthy of broader implementation.
文摘Objective:To evaluate the application effect of psychological nursing intervention on maintenance hemodialysis(MHD)patients with uremia.Methods:Sixty cases of uremic patients admitted to the hospital between May 2023 and May 2024 were selected for MHD treatment and divided using the random number table method into 30 cases in each group.The observation group implemented psychological nursing intervention,while the reference group received conventional nursing intervention,after which the nursing effects were compared.Results:After nursing,the psychological state score of the observation group was lower than that of the reference group;the treatment compliance of the observation group was higher than that of the reference group;the self-care ability score of the observation group was higher than that of the reference group,and the quality-of-life score of the observation group was higher than that of the reference group(P<0.05).Conclusion:Psychological nursing intervention for uremic MHD patients can improve their negative psychology,enhance treatment compliance,and comprehensively improve patients’self-care ability and quality of life.
文摘Since traditional nail diagnosis is susceptible to objective factors such as illumination,medical experience,etc.,a nail diagnosis system of traditional Chinese medicine which combines objective nail image acquisition with information analysis is proposed and applied to the clinical research of nail diagnosis of uremia patients.Fifteen nail pictures of uremic patients were collected and segmented.The color information of nails was extracted.The relationship between the hemoglobin values of uremic patients and the values of color space before and after maintenance hemodialysis was analyzed by correlation analysis and multiple regression analysis.The experimental results show that the hemoglobin value of uremic patients have certain correlations with multiple color channels;before and after dialysis,there are significant changes in multiple channels;and the related multiple regression equation is established.
文摘Many observers have noted that the morphological changes that occur in chronic kidney disease(CKD) patients resemble those seen in the geriatric population, with strikingly similar morbidity and mortality profiles and rates of frailty in the two groups, and shared characteristics at a pathophysiological level especially in respect to the changes seen in their vascular andimmune systems. However, whilst much has been documented about the shared physical characteristics of aging and uremia, the molecular and cellular similarities between the two have received less attention. In order to bridge this perceived gap we have reviewed published research concerning the common molecular processes seen in aging subjects and CKD patients, with specific attention to altered proteostasis, mitochondrial dysfunction, post-translational protein modification, and senescence and telomere attrition. We have also sought to illustrate how the cell death and survival pathways apoptosis, necroptosis and autophagy are closely interrelated, and how an understanding of these overlapping pathways is helpful in order to appreciate the shared molecular basis behind the pathophysiology of aging and uremia. This analysis revealed many common molecular characteristics and showed similar patterns of cellular dysfunction. We conclude that the accelerated aging seen in patients with CKD is underpinned at the molecular level, and that a greater understanding of these molecular processes might eventually lead to new much needed therapeutic strategies of benefit to patients with renal disease.
文摘Objective:To study the effect of hemodialysis (HD) combined with hemoperfusion (HP) on dialysis efficiency, lipid metabolism and atherosclerosis in patients with uremia.Methods:A total of 70 patients with uremia who were treated in our hospital between March 2013 and October 2015 were collected and divided into observation group and control group (n=35) according to double-blind randomized control method. Observation group of patients received hemodialysis combined with hemoperfusion, control group of patients received hemodialysis alone, and the treatment lasted for 6 months. After 6 months of intervention, automatic biochemical analyzer was used to detect renal function indexes and lipid metabolism indexes, and the two-dimensional ultrasound was used to quantitatively determine the carotid atherosclerosis parameters.Results:Before intervention, differences in renal function, lipid metabolism and atherosclerosis levels were not statistically significant between two groups of patients;after 6 months of intervention, renal function indexes blood urea nitrogen (BUN), serum creatinine (Scr),β2-microglobulin (β2-MG) and blood uric acid (BUA) levels of observation group were lower than those of control group, lipid metabolism indexes total cholesterol (TC), triglyceride (TG), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) levels were lower than those of control group, and differences between groups were statistically significant;quantitative carotid ultrasound parameters gray-scale median (GSM) of observation group was higher than that of control group, enhanced intensity (EI) and enhanced density (ED) were lower than those of control group, and differences between groups were statistically significant.Conclusion:Hemodialysis combined with hemoperfusion can improve the dialysis efficiency, also reduce lipid metabolism disturbance and delay the formation of atherosclerosis in patients with uremia.
文摘Summary： The different sera proteomic components between uremia patients and normal subjects were studied through two-dimensional gel electrophoresis technique. Immobilized pH gradient two- dimensional polyacrylamide gel electrophoresis （2DE）, silver staining, ImageMaster 2D 5.0 analysis software, matrix assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF-TOF-MS） and IPI human database searching were used to separate and identify the proteome of the sera from the patients with uremia. The results showed that satisfactory 2DE patterns of the serum proteins were obtained. Twenty-six protein spots showed significant difference in quantity in uremia patients, and 20 protein spots were identified by MALDI-TOF-TOF-MS. It was concluded that good reproducibility could be obtained by applying immobilized pH gradient 2DE to separate and identify the proteome in serum, which provided the foundation for the further study on uremia toxins oertaining to orotein.
基金Scientific research project of Nantong municipal health and family planning commission(No.MB2019009)Nantong science and technology planning project(No.MSZ18258)
文摘Objective:To study the clinical significance of troponinI(TnI),high sensitivity C reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the diagnosis of myocardial damage in uremia patients.Methods:114 uremia patients treated in our hospital from January 2017 to February 2019 were selected.According to whether myocardial damage occurred,patients were divided into two groups including uremia group(63 cases)anduremia myocardial damage group(51 cases).50 hospitalized patients with non-chronic kidney disease and non-cardiovascular disease in our hospital were selected as control group.The levels of TnI,hs-CRP and NT-proBNP in 1,3 and 7 days after admission were detected and compared.Meanwhile,the ecg indexes of left?ventricular?ejection?fraction(LVEF)and Thickness of the posterior wall of the left ventricle(LVPWd)were recorded and compared.Person correlation was used to analyze the correlation between the levels of TnI,hs-CRP,NT-proBNP and ecg indexes including LVEF and LVPWd.COX regression analysis was used to analyze the independent riskfactors affecting the clinical prognosis of uremia patients.Results:The levels of TnI,hs-CRP,NT-proBNP in the three groups were significantly different on 1,3,7 days after admission.The levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group and uremia group were decreased with treatment.However,the levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group were the highest(P<0.05).Compared with the other two groups,the LVEF of uremia combined with myocardial damage group was the lowest,while the LVPWd was the thickest,showing a significant difference(P<0.05).There was negativecorrelation between LVEF and TnI,hs-CRP,NT-proBNP levels.However,LVPWd was positively correlated with TnI,hs-CRP and NT-proBNP levels(P<0.05).COX regression analysis showed that TnI,hs-CRP,NT-proBNP levels,LVEF and LVPWd were the independent factors affecting the clinical prognosis of uremia patients Conclusion:The level of TnI,hs-CRP,NT-proBNP was dynamic change in the onset and treatment process in uremia combined with myocardial damage patients,which could be used for early diagnosis of uremia combined with myocardial damage.
文摘Objective:To study the effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia.Methods: A total of 50 patients with uremia who accepted high-flux hemodialysis and 140 patients with uremia who accepted low-flux hemodialysis in our hospital between March 2015 and March 2016 were selected and included in high-flux group and low-flux group respectively. Before and after dialysis, serum was collected respectively to determine the levels of side metabolites, calcium-phosphorus metabolism indexes and cytokines.Results: 3 months after dialysis, serum Ca levels of two groups of patients were not significantly different from those before dialysis while BUN, Scr,β2-MG, sTfR, P, PTH and AKP levels were significantly lower than those before dialysis;3 months after dialysis, serum BUN, Scr and Ca levels of high-flux group were not significantly different from those of low-flux group whileβ2-MG, sTfR, P, PTH, AKP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 levels were significantly lower than those of low-flux group.Conclusion:Compared with low-flux hemodialysis, high-flux hemodialysis treatment of uremia can more effectively remove middle molecular and macromolecular toxins, correct calcium-phosphorus metabolism disorder and relieve micro-inflammatory state.
文摘Objective:To explore the effect of hemodialysis (HD) in combined with hemoperfusion (HP) on the toxin clearance rate and carotid intima in patients with uremia.Methods: A total of 40 patients with uremia who were admitted in our hospital from May, 2015 to February, 2017 were included in the study and randomized into the control group (n=20) and the study group (n=20). The patients in the two groups were given routine HD treatment. On the above basis, the patients in the study group were given HP treatment, continuously for 3 months. The toxin content, clearance rate, and serum inflammatory cytokines before and after treatment in the two groups were detected and compared. The ultrasound diagnostic apparatus was used to detect the carotid IMT before and after treatment in the two groups. Results: Scr and BUN after treatment in the two groups, and PTH andβ2-MG contents in the study group were significantly reduced when compared with before treatment. PTH andβ2-MG contents after treatment in the study group were significantly lower than those in the control group, while PTH andβ2-MG clearance rate was significantly higher than that in the control group. The serum MDA, hs-CRP, IL-6, and TNF-α levels after treatment in the two groups were significantly reduced when compared with before treatment. The serum hs-CRP, IL-6, and TNF-α levels after treatment in the study group were significantly lower than those in the control group. IMT and plaque area after treatment in the control group were significantly increased when compared with before treatment, while IMT and plaque area in the study group were not significantly changed. The plaque area after treatment in the study group was significantly less than that in the control group.Conclusions: HD in combined with HP can significantly enhance the toxin clearance rate of large molecules in patients with uremia, alleviate the inflammatory reaction, and meanwhile effectively delay the occurrence of atherosclerosis and other cardiovascular complications.
文摘Objective: to analyze the nursing methods in the treatment of uremia. Methods: from February 2020 to February 2021, patients with uremic skin pruritus in our department were selected. The method of retrospective data analysis was used to obtain the nursing effect of patients. Results: after the follow-up analysis of 22 patients, the symptoms of 8 cases improved after one treatment, 10 cases improved after two treatments, and 4 cases alleviated 4-6 times after treatment. One of the 22 patients stopped, and the other 21 patients had no adverse reactions. Conclusion: nursing intervention in the treatment of uremic skin pruritus with hemoperfusion and hemodialysis is effective and worthy of clinical recommendation.
文摘Objective: to apply comprehensive nursing to hemodialysis and observe its effect. Methods: the patients in our department were divided into basic group and comprehensive group, and basic nursing intervention and comprehensive nursing intervention were adopted respectively. Results: in the comparison of treatment compliance and complication rate between the basic group and the comprehensive group, the basic group was 78.04% and 14.63% respectively, while the comprehensive group was 97.56% and 4.87% respectively (χ2 = 6.197, p=0.000). There was a difference between the two groups. Conclusion: the effect of hemodialysis combined with hemoperfusion and comprehensive nursing intervention in the treatment of uremia is significant and worthy of clinical recommendation.
文摘Objective: to carry out stratified nursing care for uremic patients undergoing hemodialysis, and analyze the effect of nursing care on nutritional status and quality of life of patients. Methods: a total of 80 patients admitted in this study were uremic patients treated with hemodialysis in Tongji hospital from May 2020 to May 2021. All patients were equally divided into two groups according to the ball-touching grouping method: observation group (40 cases) and control group (40 cases). Patients in the control group received routine care during the treatment, while patients in the observation group received stratified care during the treatment. After completing the nursing, the data of the two groups of patients were collected, including the patients' nutritional status, emotional status, quality of life and patients' compliance with the treatment. Results: the nutritional status of the patients in the observation group was significantly higher than that of the patients in the control group (P < 0.05). The scores of emotional state indexes in the observation group were significantly lower than those in the control group (P < 0.05). The quality of life index of the observation group was significantly higher than that of the control group (P < 0.05). The total treatment compliance of the observation group was 97.5%, which was higher than 82.5% of the control group (P < 0.05). Conclusion: layered nursing model can help uremic patients to improve their quality of life, and is worthy of promotion.
文摘Objective: To explore the value of combined intervention for nursing patients with uremia, namely HD (hemoperfusion) combined with HP (hemodialysis). Methods: Choose in February 2020 - February 2022 as A case study range, object to enter the HD joint HP treated in our hospital and uremic patients, quantity statistics for 100 cases, included in the category mode can be identified as double-blind principle, into group A and group B 50 cases respectively, which choose the mode of conventional intervention, the former seamless nursing intervention mode selection, Compare the two groups how to reflect the specific nursing effect. Results: Before and after intervention, the indexes of the two groups were compared, including quality of life, psychological level, inflammatory factors, etc., which showed that the observation group was better than the control group after nursing, indicating P value 0.05. Conclusion: Through the implementation of seamless nursing measures for HP combined with HD in the treatment of uremia patients, committed to physiological and physiological dual quality assurance, improve patients nursing satisfaction, the results of the study confirmed that it can be used for clinical promotion.
文摘Objective: to explore the effect of different hemodialysis methods on uremia patients. Methods: 68 patients with uremia were selected and randomly divided into experimental group and control group, 34 cases in each group. The therapeutic effects and toxic and side effects of two dialysis methods were compared. Results: after treatment, the difference between groups was significant (P < 0.05). Conclusion: high-flux hemodialysis treatment can play a good role in uremic patients, is conducive to promoting the discharge of small molecular substances, and has no serious adverse reactions, high safety, and is worthy of promotion and application.
文摘Objective: to explore the nursing and treatment of patients with chronic renal failure and uremia. Conclusion: regularly monitor the indicators reflecting the nutritional status of patients, such as serum albumin level and hemoglobin, monitor the changes of serum electrolytes, observe and timely judge whether patients have signs of hyperkalemia, determine the symptoms of patients and observe them. If your fingers have hypocalcemia, etc. If you have symptoms such as numbness or convulsions, please inform your doctor in time. For patients with hypocalcemia and hyperphosphatemia, the dietary guidelines provide for intake of high calcium foods such as milk, as well as calcium, active vitamin D and other drugs. Pay close attention to signs of infection, and inform the doctor in time of abnormal conditions such as temperature rise, heart rate increase or abnormal blood leukocytes.
