Etiology of renal failure and peritoneal dialysis complications in Isfahan

Introduction: Worldwide specific diseases are jeopardizing people’s health in the world as well as in Iran. Chronic renal failure as a developed and irreversible failure is usually progressive. End Stage Renal Disease (ESRD) is a situation when renal function is not sufficient to preserve one’s life leading to acute uremia resulting in dialysis and/or kidney transplantation for the patients. Although dialysis methods bring about complications for the patients, peritoneal dialysis is relatively cost-effective and more convenient to survive. The present study aimed to investigate (the) Etiologic factor of renal failure and imposed complications of peritoneal dialysis in the patients of Isfahan Alzahra hospital. Materials and Methods: It was a cross-sectional descriptive study conducted on 67 patients in Isfahan Peritoneal Dialysis Center. The data from the patients were collected through a two-section questionnaire whose first section was allocated to demographic information and the second part was related to the disease and complications of peritoneal dialysis. The collected data were analyzed by SPSS version 18. Results: The findings showed that there were 39 (58%) males and 28 (42%) females. Mean age of the subjects was 48 (18.8) years old. Regarding marital status, 65% were married and 35% were single. Considering complications, 28 subjects (53.5%) had infectious complications while 24 subjects (46.2%) had non-infectious complications. The highest frequency in etiologic factor of renal failure was diabetes mellitus in 29 subjects (43.9%) and the lowest for polycystic kidney in 2 subjects (3%);in addition, hypertension was observed in 51 subjects (77.3%). Discussion: The most frequent and important complication of peritoneal dialysis catheters is infection, which may result in catheter loss and discontinuation of peritoneal dialysis (PD). Diabetes and hypertension were found as the most important etiologic factors for renal failure. They should also be considered as two major risk factors in prevention of renal diseases.

Systemic oncological therapy in breast cancer patients on dialysis

The advancement of renal replacement therapy has significantly enhanced the survival rates of patients with end-stage renal disease(ESRD)over time.How-ever,this prolonged survival has also been associated with a higher likelihood of cancer diagnoses among these patients including breast cancer.Breast cancer treatment typically involves surgery,radiation,and systemic therapies,with ap-proaches tailored to cancer type,stage,and patient preferences.However,renal replacement therapy complicates systemic therapy due to altered drug clearance and the necessity for dialysis sessions.This review emphasizes the need for opti-mized dosing and administration strategies for systemic breast cancer treatments in dialysis patients,aiming to ensure both efficacy and safety.Additionally,ch-allenges in breast cancer screening and diagnosis in this population,including soft-tissue calcifications,are highlighted.

Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia

BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.

Analysis of the Short-Term Curative Effect of Roxadustat in Treating Renal Anemia in Patients with Peritoneal Dialysis

Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.

Analysis of the relationship between postoperative ophthalmic complications and dialysis time of prekidney transplantation

AIM: To determine the influence of the dialysis time before kidney transplantation on postoperative ophthalmic complications. METHODS: One hundred and eighty three patients who were given the follow-up after kidney transplantation were selected, including 124 males and 59 females. The dialysis time before kidney transplantation was (2.9 +/- 2.1) years. Among them, there were 93 cases having cadaveric renal transplantation and 90 cases having living relative renal transplantation. The conditions of ophthalmic complications in all the patients after kidney transplantation were investigated and the incidence rate on ophthalmic complications having different dialysis time before kidney transplantation was given Chi-square test and Chi-square linear trend test. RESULTS: Among 183 patients with kidney transplantation, 95 patients (51.9%) had at least one ophthalmic complication and the rest 88 patients (48.1%) had no significant abnormality at the eye region. The most common ophthalmic complications were pinguecula/conjunctival degeneration (31 cases), the following was caligo lentis (24 cases). The main manifestations were grayish white granule and plaque turbidity occurred in posterior capsule at the posterior pole of crystaline lens. The angulus iridocornealis of 5 patients (5.3%) with cataract and glaucoma were all open-angle through the detection by gonioscope. Through visual field examination, there were 2 patients with paracentral scotoma, 2 patients with arcuate scotoma and one case with nasal step. CONCLUSION: The experiments verify that the incidence of glaucomawas relates to the dialysis time before kidney transplantation, and the incidence rate might be higher if the dialysis time is longer.

Mechanical Complications of Peritoneal Dialysis

Introduction: The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. The mechanical complications of peritoneal dialysis (MCPD) are a major cause of the failure of the technique. The aim of the study was to define the prevalence of peritoneal dialysis (PD) mechanical catheter complications, to determine the time and the factors associated with their occurring. Materials and Methods: A retrospective study was conducted between January 2009 and January 2014 at the nephrology, dialysis and renal transplants department of Ibn Sina university hospital in Rabat. We included all patients who were on peritoneal dialysis and presented mechanical complications. These mechanical catheter complications are represented by catheter migration or obstruction, inguinal or umbilical hernias, early and late peritoneal dialysate leakage, subcutaneous cuff extrusion and hemoperitoneum. Results: MCPD were noted in 23 of the 62 patients (37% of cases). Onset time of complications was 24.8 ± 18.9 months [3 - 60 months]. Among these complications, we noted a catheter migration (65.2%), postoperative hematoma (21.7%), cracking or perforation of catheter (17.4%), epiploic aspiration (17.4%), sleeve externalization (17.4%), catheter obstruction (13%), hemoperitoneum (13%), hernia (22%;13% umbilical and 8.7% inguinal), early dialysate leakage (13%), and pleuroperitoneal leakage (8.7%). The average age of our patients was 54.9 ± 15.5 years [21 - 81 years old], with a male predominance and a sex ratio of 2.28. The average body mass index (BMI) was 25.4 kg/m2. Diabetic patients represent 48.7% of our series. In our study, MCPD represent 13% of causes of transfer to hemodialysis (HD). Conclusion: Prevention of MCPD remains crucial. It is based on good patient education on hygiene and handling errors but also periodic retraining of patients and caregivers.

Non-Infectious Complications of Peritoneal Dialysis in Senegal

Introduction: Senegal has pioneered the implementation of peritoneal dialysis (PD) in West Africa, practicing it since 2004. Non-infectious complications are a significant cause of failure of this technique and the transfer of patients to haemodialysis. The aim of this study was to determine the prevalence and the different types of non-infectious complications in our context. Patients and Methods: This was a 5-year, descriptive, retrospective study of patients on chronic peritoneal dialysis for more than 3 months. Results: During the study period, 75 patients were included. The prevalence of non-infectious complications was 88%, including 45.3% mechanical complications and 76% metabolic complications. Catheter migration was the most common mechanical complication (55.9%), followed by catheter blockage (23.5%). Metabolic complications were dominated by hypoalbuminemia (76.3%). Dyslipidaemia and hypokalaemia affected more than 50% of patients, occurring in 59.3% and 56.9% of cases, respectively. Conclusion: In our study, non-infectious complications related to PD were frequent and varied. They remain a significant cause of technical failure. Mechanical complications are often the cause of permanent transfer to haemodialysis.

Residual renal function in peritoneal dialysis with failed allograft and minimum immunosuppression

Immunosuppression(IS) is often withdrawn in patients with end stage renal disease secondary to a failed renal allograft, and this can lead to an accelerated loss of residual renal function(RRF). As maintenance of RRF appears to provide a survival benefit to peritoneal dialysis(PD) patients, it is not clear whether this benefit of maintaining RRF in failed allograft patients returning to PD outweigh the risks of maintaining IS. A 49 year-old Caucasian male developed progressive allograft failure nine years after living-donor renal transplantation. Hemodialysis was initiated via tunneled dialysis catheter(TDC) and IS was gradually withdrawn. Two weeksafter IS withdrawal he developed a febrile illness, which necessitate removal of the TDC and conversion to PD. He was maintained on small dose of tacrolimus(1 mg/d) and prednisone(5 mg/d). Currently(1 year later) he is doing exceedingly well on cycler-assisted PD. Residual urine output ranges between 600-1200 m L/d. Total weekly Kt/V achieved 1.82. RRF remained well preserved in this patient with failed renal allograft with minimal immunosuppressive therapy. This strategy will need further study in well-defined cohorts of PD patients with failed allografts and residual RRF to determine efficacy and safety.

Efficacy of roxadustat in treatment of peritoneal dialysis patients with renal anaemia

BACKGROUND There are no studies on the use of roxadustat in patients on regular peritoneal dialysis in China.AIM To observe the efficacy and safety of roxadustat in treating renal anaemia in peritoneal dialysis patients.METHODS Patients with renal anaemia who were regularly followed at the Peritoneal Dialysis Center of the First Affiliated Hospital of China Medical University from November 1,2019 to June 30,2020 were selected.A before-and-after self-control design was performed to retrospectively analyse the treatment effects on anaemia in patients treated with recombinant human erythropoietin(EPO)and roxadustat.RESULTS A total of 31 patients with renal anaemia on long-term peritoneal dialysis treated with roxadustat were included.Haemoglobin(Hb)levels were maintained or increased in all patients(100%),and no patients had a decrease in Hb compared with the previous phase.Patients had a mean Hb of 86.2±14.8 g/L with Hb compliance(Hb≥110 g/L)of 16.1%during the EPO phase and a mean Hb of 112.4±18.5 g/L with Hb compliance of 67.7%during the roxadustat phase.No major adverse cardiovascular events occurred in any patient.CONCLUSION The application of roxadustat in peritoneal dialysis patients with renal anaemia can effectively improve the Hb compliance rate.

Impact of Dialysis Coverage on the Provision of Universal Health Insurance in the Republic of the Congo

Introduction: The launch of health insurance in the Republic of the Congo took place against a backdrop of extremely high costs for dialysis, which was not one of the services financed within this framework. The aim of this study is to assess the impact of including dialysis in the health insurance package in Congo. Methodology: This is a descriptive cross-sectional study with an evaluative aim, analyzing the impact of dialysis on the financing capacity of health insurance and health facilities to provide this type of care. Results: The results show that including dialysis in the universal health insurance package will require an additional financial effort of 6.20% of the current total financing capacity of the care basket. Most dialysis sessions are provided by the private health sector (87.5%), whose health facilities are unevenly distributed across the country, and concentrated in the country’s two major cities. This problem is the dual consequence of the very high cost of a dialysis session (average cost 140,234,375 FCFA or 229 US Dollars) and the number of patients under care, which will increase in the absence of effective and ongoing prevention efforts against chronic diseases in general and end-stage renal failure in particular. Conclusion: Dialysis is a high-impact public health intervention. The impact of its inclusion in the universal health insurance care package is difficult to bear financially. For dialysis to be covered by universal health insurance, additional funding and improved technical facilities are needed.

Surgical Complications of Kidney Transplantation in a Resource Limited Country: Retrospective Study of the First Five Years

Background: Kidney transplantation is the most efficient treatment for renal failure but may be ruined by complications. Objective: To report the surgical complications of renal transplantation and the therapeutic means applied. Method: It was a retrospective study including 42 files of kidney transplantation in Côte d’Ivoire. We report 11 cases of surgical complications of the recipient’s intervention during the first five years. Results: The mean age was 42.64 years (±15.04). In 90.9% of the cases, there was a comorbidity factor. Lymphocele and stenosis of the uretero vesical anastomosis were the most frequent complications. One death was observed. Conclusion: Kidney transplantation is an effective way of managing chronic renal failure. Postoperative complications are polymorphic and unpredictable.

When to initiate renal replacement therapy: The trend of dialysis initiation

The timing of renal replacement therapy for patients with end-stage renal disease has been subject to considerable variation. The United States Renal Data System shows an ascending trend of early dialysis initiation until 2010, at which point it decreased slightly for the following 2 years. In the 1990 s, nephrologists believed that early initiation of dialysis could improve patient survival. Based on the Canadian-United States Peritoneal Dialysis study, the National Kidney Foundation Dialysis Outcomes Quality Initiative recommended that dialysis should be initiated early. Since 2001, several observational studies and 1 randomized controlled trial have found no beneficial effect when patients were placed on dialysis early. In contrast, they found that an increase in mortality was associated with early dialysis initiation. The most recent dialysis initiation guidelines recommend that dialysis should be initiated at an estimated glomerular filtration rate(e GFR) of greater than or equal to 6 mL /min per 1.73 m2. Nevertheless, the decision to start dialysis is mainly based on a predefined eG FR value, and no convincing evidence has demonstrated that patients would benefit from early dialysis initiation as indicated by the eG FR. Even today, the optimal dialysis initiation time remains unknown. The decision of when to start dialysis should be based on careful clinical evaluation.

Bilateral Avascular Necrosis of the Femoral Head in Renal Transplant Recipient: A Case Report

Osteoarticular complications are common after renal transplantation. The complications may result from the bone condition prior to transplantation or the iatrogenic effects of the treatments administered. These complications lead to significant morbidity and mortality, in addition to chronic pain and functional impairment. We report the clinical case of bilateral avascular necrosis (AVN) of the femoral head in a kidney transplant recipient. Clinical Case: 53-year-old male with a history of chronic hypertension. He underwent chronic hemodialysis for 12 months and was treated with Entecavir for chronic hepatitis B. The patient received a kidney transplant from a non-related living donor. Induction therapy included Thymoglobulin along with tapered corticosteroids, reaching a dose of 5 mg/day after 3 months, Mycophenolate mofetil (2 g/day), and Tacrolimus adjusted based on residual levels. There was good recovery of renal graft function. After six months, the patient reported bilateral hip pain and functional impairment of both lower limbs. Pelvic X-rays showed signs suggestive of bilateral AVN of the femoral heads. The diagnosis was confirmed by MRI. The patient underwent right hip drilling and total left hip replacement (THR). A right THR was performed a year later. Conclusion: AVN constitutes a frequent cause of morbidity and mortality after RT. The pathophysiology of osteonecrosis remains complex and multifactorial. We emphasize the importance of conducting a thorough assessment of bone health in patients both before and after RT.

The Effect of Glucose Added to the Dialysis Fluid on Blood Pressure, Vasoactive Hormones and Energy Transfer during Hemodialysis in Chronic Renal Failure

Background: Previous studies showed that blood pressure was reduced in patients with chronic renal failure during hemodialysis with glucose added to the dialysis fluid. We wanted to test the hypotheses that blood pressure is reduced in non-diabetic and diabetic dialysis patients, when glucose is added to the dialysis fluid, and that blood pressure changes are caused by changes in plasma concentrations of vasoactive hormones or to vasodilation secondary to an increase in body temperature. Methods: The effect of dialysis with glucose added to the dialysis fluid was measured in three randomized, placebo-controlled, un-blinded and cross-over studies with periods of one week duration. In non-diabetic nephropathy (Study 1, n = 19) and diabetic nephropathy (Study 2, n = 15), we measured blood pressure (BP) and pulse rate (PR), plasma concentrations of glucose (p-Glucose), renin (PRC), angiotensin II (p-AngII), endothelin (p-Endot), insulin (p-Ins), glucagon (p-Glu), and human growth hormone (p-hGH). In non-diabetic nephropathy (Study 3, n = 24), we measured the effect of dialysis with glucose added to the dialysis fluid on energy transport from form the body using body temperature control. Results: Study 1 and 2 showed that BP, PRC, p-AngII, and p-Ins were unchanged, whereas P-Endot increased and P-hGH decreased, in dialysis patients with or without glucose added to the dialysis fluid. In diabetics, a marginal increase in p-Glu was measured during dialysis with glucose, but not without glucose. Study 3 showed that SBP increased significantly using dialysis with temperature control of dialysis fluid compared with no temperature control (145 versus 138 mm Hg). In parallel with the increase in SBP, the energy flux from the patients was significantly higher with temperature control than without. Conclusion: In non-diabetics and diabetics, blood pressure was unchanged during dialysis with glucose added to the dialysis fluid in a short-term study. Vasoactive hormones in plasma were changed in the same way independently of glucose in the dialysis fluid. Systolic blood pressure increased using dialysis with temperature control of dialysis fluid, presumably due to vasoconstriction to prevent or antagonize a fall in body temperature.

Surgical Complications and Evolution of Grafts in Children with Renal Transplantation at Cayetano Heredia National Hospital

Objective: This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH). Materials and Methods: A case study series focused on the incidence of surgical complications and graft outcome in pediatric patients with end stage renal disease (ESRD) who underwent renal transplant (RT) between December 2007 and March 2011. Results: The study described 29 pediatric transplant patients whose average age was 13.69 ± 3.38 (6.2-17.9) years. The etiology of end stage renal disease (ESRD) was renal hypoplasia in 12 patients (41.38%), primary glomerulopathy in 10 patients (34.48%), obstructive uropathy in 4 patients (13.79%), vasculitis in 2 patients (6.9%) and hemolytic uremic syndrome (HUS) in 1 (3.45%) patient. There were 11 surgical complications (34.48%): 2 cases of arterial thrombosis, 3 cases of urinary fistula, 3 of lymphocele, 1 of venous thrombosis, urinoma and perineal collection. The follow-up time was 15.84 ± 12.19 months. Graft survival at 12, 24, and 40 months was 89.29%, 77.16% and 77.16%, respectively. Conclusion: Surgical complications and graft survival in pediatric renal transplantation in our series did not differ from other published series.

Prevalence of Renal Failure in Children and the Need for Dialysis in Paediatric Nephrology in a Developing Country

Background: Renal failure is among the major visceral failures responsible for morbidity and mortality in children. Epidemiological data on renal failure in children are limited in sub-Saharan Africa, including Senegal. We conducted this study to assess the prevalence of renal failure (RF) and the need for dialysis in the paediatric nephrology unit. Patients and methods: This was a retrospective and descriptive study in the pediatric nephrology unit from 1st January 2020 to 30 June 2021, including children with acute or chronic RF. The need for dialysis was judged to be met by its effectiveness in face of an indication. The data collected were analysed on sphinx plus 2017 software. Results: The prevalence of RF was 60% (n/N = 132/220). RF was acute in 59% (n/N = 78/132) of cases. The mean age was 6.53 ± 4.77 years with a sex ratio of 1.8. The mean serum creatinine level was 27.22 mg/L (240.9 μmol/L) and BUN at 0.85 g/L. The aetiologies were dominated by prerenal AKI (Acute Kidney Injury) complicating nephrotic syndrome (NS) in 37.2% (n/N = 29/78) and dehydration due to stomach flu in 17.6% (n/N = 9/51). Acute post-infectious glomerulonephritis including group A streptococcus and plasmodium falciparum accounted for 16.7% (n = 13/78) of intrinsic AKI. The need for dialysis was unmet in 50% (n/N = 7/14) with a mortality of 14.1% (n/N = 11/78). The mean age of the patients with chronic RF was 8.68 ± 4.74 years with a sex ratio of 2.6. The mean serum creatinine level was 36.56 mg/L (323.5 μmol/L) and the BUN level was 0.99 g/L. Half of the children were classified as having CKD stage II (early stage). The aetiologies were dominated by primary focal and segmental glomerulosclerosis (FSGS), 53.7% (n/N = 29/54), renal hypoplasia, 22.2% (n/N = 12/54) and reflux nephropathy, 29.4% (n/N = 5/17). The need for dialysis was unmet in 46.1% (n/N = 6/13). The overall mortality of chronic kidney disease (CKD) with RF was 29.6% (n/N = 8/27). Conclusion: The prevalence of RF was high in the unit. Most aetiologies of AKI were accessible to prevention. Only half of the children had access to free dialysis, hence the need for a dedicated pilot dialysis centre.

Pain during Arteriovenous Fistula Cannulation in Chronic Renal Patients on Hemodialysis

This study aimed to evaluate pain intensity in chronic renal patients under hemodialysis during the arteriovenous fistula cannulation. It was a cross-sectional study conducted in a hemodialysis clinic in the second semester of 2014. 70 individuals participated in the research and were assessed by the visual analogue scale. The project was approved with opinion number 453.508-2013. During cannulation, the pain reported was moderate in 58.5% of patients, intense in 30% and mild in 11.5%. There was no association between the occurrence of pain in relation to gender, shift and time of hemodialysis. The study points out to the need for pre-cannulation analgesia to improve comfort during the procedure.

Effects of endogenous L-cystathionine on enzymatic assays of serum homocysteine in samples from renal dialysis patients

Homocysteine (Hcy) is a thiol-containing amino acid produced by the intracellular demethylation of methionine.Approximately 80% of circulating Hcy in the blood is protein bound by disulfide linkage.The remaining unbound Hcy combines by oxidation either with itself to form the dimer homocystine or with cysteine to form the mixed disulfide cysteine-Hcy.

Effects of Shenkang Injection Combined with Hemodialysis on Dialysis Rate and Nutriture in Patients with Chronic Renal Failure

OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospital from January 2016 to January 2018 were randomly divided into 2 groups.The control group was treated with hemodialysis while the observation group was additionally treated with Shenkang Injection on the treatment basis of the control group.They were treated for 4 weeks and reexamined 1 d after the treatment.Renal function,nutriture,dialysis adequacy,oxidative stress level and inflammatory factor level in the 2 groups were determined before and after the treatment,and traditional Chinese medicine (TCM) syndrome score,dialysis rate within 1 week and incidence of adverse reactions during the treatment were counted before and after the treatment.RESULTS: After the treatment,the levels of serum creatinine (Scr) and urea nitrogen (BUN) in the observation group were lower than those in the control group,and the endogenous creatinine clearance rate (Ccr) was higher than that in the control group (P < 0.05).After the treatment,the nutriture in the observation group was better than that in the control group (P < 0.05).After the treatment,the dialysis rate and time average concentration of urea (TACurea) in the observation group were lower than those in the control group,while the overall urea clearance rate (Kt/V) and protein catabolic rate (PCR) were higher than those in the control group (P < 0.05).After the treatment,the TCM syndrome scores in the observation group was lower than that in the control group (P < 0.05) and the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control,while the level of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the observation group were higher than those in the control group (P < 0.05).After the treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P < 0.05).No serious adverse reactions occurred in the 2 groups.CONCLUSION: Shenkang Injection combined with hemodialysis for the treatment of CRF can effectively improve clinical symptoms and nutriture,and reduce the dialysis rate.