The large prevalence of respiratory acid-base disordersoverlapping metabolic acidosis in hemodialysis popu-lation should prompt nephrologists to deal with the partial pressure of carbon dioxide （pCO2） complying with...The large prevalence of respiratory acid-base disordersoverlapping metabolic acidosis in hemodialysis popu-lation should prompt nephrologists to deal with the partial pressure of carbon dioxide （pCO2） complying with the reduced bicarbonate concentration. What the most suitable formula to compute pCO2 is reviewed. Then, the neglected issue of CO2 content in the dialysis fluid is under the spotlight. In fact, a considerable amount of CO2 comes to patients’ bloodstream every hemodialysis treatment and “acidosis by dialysate” may occur if lungs do not properly clear away this burden of CO2. Moreover, vascular access recirculation may be easy diagnosed by detecting CO2 in the arterial line of extracorporeal circuit if CO2-enriched blood from the flter reenters arterial needle.展开更多
Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We inves...Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We investigated whether the dialysis adequacy （Kt/v） and serum hemoglobin level had any correlation with depression severity. Psychiatric interview was performed on 30 HD and 30 CAPD patients. Hamilton depression rating scale （HAMD） was used to evaluate depression symptoms. Kt/v and serum hemoglobin level were detected. Half of HD patients were depressive, while depression wasn＇t found in any CAPD patient. Hemoglobin was in positive correlation with the HAMD, while Kt/v was in negative correlation with the HAMD. Patients on CAPD had less depressive symptoms. Good dialysis adequacy diminish depressive symptoms.展开更多
Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during ...Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis. Results The average age of the six patients was 52.3±19.3 years old. Four were males. Vascular accesses at the onset of infective endocarditis were as follows： permanent catheters in three, temporary catheters in two, and arteriovenous fistula in one. Three were fbund with mitral valve involvement, two with aor tic valve involvement, and one with both. Five vegetations were found by transthoracic echocardiography, and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment, in which two were still on hemodialy sis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery, but died of heart failure alter further hemodialysis for three months. One was well on maintenance hemodi alvsis for three months after surgery. Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever, for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiography produces negative findings. With catheters removed, lull course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective cndocarditis.展开更多
Objective:The aim of this study was to investigate renal insufficiency in patients with chemotherapy.Methods:Prescribing chemotherapy in a regular hemodialysis patient with renal failure,and monitoring of serum drug c...Objective:The aim of this study was to investigate renal insufficiency in patients with chemotherapy.Methods:Prescribing chemotherapy in a regular hemodialysis patient with renal failure,and monitoring of serum drug concentrations to determine its safety and effectiveness.Results:Chemotherapy assessment efficiency:SD(better),hemodialysis did not affect THP treatment,their safety was guaranteed.Conclusion:The chemotherapy of renal dysfunction is not an absolute contraindication to fully assess the patient's adverse effects and tolerability,the reasonable arrangements for hemodialysis and the timing of administration can be safe and effective chemotherapy.展开更多
文摘The large prevalence of respiratory acid-base disordersoverlapping metabolic acidosis in hemodialysis popu-lation should prompt nephrologists to deal with the partial pressure of carbon dioxide （pCO2） complying with the reduced bicarbonate concentration. What the most suitable formula to compute pCO2 is reviewed. Then, the neglected issue of CO2 content in the dialysis fluid is under the spotlight. In fact, a considerable amount of CO2 comes to patients’ bloodstream every hemodialysis treatment and “acidosis by dialysate” may occur if lungs do not properly clear away this burden of CO2. Moreover, vascular access recirculation may be easy diagnosed by detecting CO2 in the arterial line of extracorporeal circuit if CO2-enriched blood from the flter reenters arterial needle.
文摘Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We investigated whether the dialysis adequacy （Kt/v） and serum hemoglobin level had any correlation with depression severity. Psychiatric interview was performed on 30 HD and 30 CAPD patients. Hamilton depression rating scale （HAMD） was used to evaluate depression symptoms. Kt/v and serum hemoglobin level were detected. Half of HD patients were depressive, while depression wasn＇t found in any CAPD patient. Hemoglobin was in positive correlation with the HAMD, while Kt/v was in negative correlation with the HAMD. Patients on CAPD had less depressive symptoms. Good dialysis adequacy diminish depressive symptoms.
基金Supported by the grant from the National Natural Science Foundation of China (30700373)
文摘Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis. Results The average age of the six patients was 52.3±19.3 years old. Four were males. Vascular accesses at the onset of infective endocarditis were as follows： permanent catheters in three, temporary catheters in two, and arteriovenous fistula in one. Three were fbund with mitral valve involvement, two with aor tic valve involvement, and one with both. Five vegetations were found by transthoracic echocardiography, and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment, in which two were still on hemodialy sis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery, but died of heart failure alter further hemodialysis for three months. One was well on maintenance hemodi alvsis for three months after surgery. Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever, for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiography produces negative findings. With catheters removed, lull course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective cndocarditis.
文摘Objective:The aim of this study was to investigate renal insufficiency in patients with chemotherapy.Methods:Prescribing chemotherapy in a regular hemodialysis patient with renal failure,and monitoring of serum drug concentrations to determine its safety and effectiveness.Results:Chemotherapy assessment efficiency:SD(better),hemodialysis did not affect THP treatment,their safety was guaranteed.Conclusion:The chemotherapy of renal dysfunction is not an absolute contraindication to fully assess the patient's adverse effects and tolerability,the reasonable arrangements for hemodialysis and the timing of administration can be safe and effective chemotherapy.
