| Objectives:The maintenance hemodialysis(MHD)patients with different dialysis period in the Hemodialysis Center of Second Hospital of Jilin University were recruited.By analyzing the gender,age distribution,primary disease,main clinical index differences,and further understanding the status quo of hemodialysis in dialysis center of our hospital,we will provide data support for dialysis quality in dialysis center of our hospital,and further guide individualized treatment.Methods:We retrospectively analyzed the clinical data of patients who underwent maintenance hemodialysis longer than 6 months–(3 times/week,4 hours/time)in the hemodialysis center of the second hospital of Jilin university during January 1,2018 and November 30,2018.Patients were divided into three groups according to dialysis age: group A(dialysis age at 6-60 months),group B(dialysis age at 61-120 months),and group C(dialysis age at> 120 months).The patients’ general information,such as gender,age,primary disease,age of dialysis(month),Body Mass Index(BMI),systolic pressure,diastolic blood pressure before dialysis,ejection fraction and Left Ventricular Mass Index(LVMI),Brain Natriuretic Peptide(BNP),creatine kinase isoenzyme,albumin,blood albumin,total cholesterol,triglyceride,low-density lipoprotein cholesterol(ldl-c),serum creatinine,hypersensitive c-reactive protein(hs-CRP),Hemoglobin(Hb)Hemoglobin,Serum Ferritin(SF),Transferrin Saturation(TSAT),blood,blood calcium,phosphorus and the calcium phosphorus product,blood Parathyroid hormone(PTH)were collected.All laboratory test data above are averages.SPSS21.0 software was used for statistical analysis.Results: 1.General informationsIn this study,423 maintenance hemodialysis patients were enrolled in the hemodialysis center of the second hospital of jilin university for maintenance hemodialysis(3 times/week,4 hours/time)and the duration of hemodialysis was 6 months,including 54 young patients(12.8%),254 middle-aged patients(60%),and the elderly(27.2%).The average age was 56.98J±13.6 years.There were 228 males(53.9%)and 195 females(46.1%),with a male to female ratio of 1.17:1.2.Primary disease and proportionsPrimary glomerulonephritis is the main primary disease in patients with maintenance hemodialysis of our hospital,174 cases of all(41.2%),followed by 125 cases(29.6%)of diabetic nephropathy,69 cases(16.3%)of hypertensive renal damage,22 cases(5.2%)of polycystic kidney disease,16 cases(3.8%)of nephrotic syndrome,10 cases(2.4%)of interstitial nephropathy,9 cases(2.1%)of unknown primary disease,and 14 cases(3.3%)of other diseases.3.Curative effect(1)The compliance rates of hemoglobin,parathyroid hormone,albumin,predialysis systolic blood pressure,predialysis diastolic blood pressure,LVMI and EF% of the 423 MHD patients included in the study were 47.3%,22.9%,46.9%,6.9%,63.9%,54.4%,and 85.2%,respectively.(2)Patients were divided into three groups(group A,group B,and group C)according to different age of dialysis.The hemoglobin compliance rates of the three groups were 41.9%,56.3%,and 48.1%,respectively.The difference of hemoglobin compliance rate among three groups was statistically significant and group Awere remarkable lower than group B(P < 0.05).The serum albumin compliance rates of the three groups were 50.9%,39.7% and 46.9%,respectively.There were significant differences in the serum albumin compliance rate among the three groups and group A was significantly higher than that in group B(P < 0.05).The compliance rate of parathyroid hormone was 26.1%,20.0% and 16.7%,respectively.There was no significant difference in parathyroid hormone compliance rate among the three groups(P > 0.05).The compliance rates of LMVI in the three groups were 40.1%,52.1% and 61.3%,respectively.The compliance rate of LMVI among the three groups was significantly different and group A was significantly lower than that of group B and C(P < 0.05).The compliance rate of systolic blood pressure before dialysis was 2.6%,10.4% and 16.7%,respectively.Systolic blood pressure before dialysis was significantly different among the three groups and the group A was significantly lower than that of group B and C(P < 0.05).Diastolic blood pressure compliance rate before dialysis was 60.3%,63.7% and 79.6%,respectively.Diastolic blood pressure before dialysis was significantly different,and group C was significantly higher than that of group A and group B(P < 0.05).(3)The hemoglobin and the serum albumin levels of the three groups were statistically different,and group B were remarkable higher than group A(P < 0.05).The serum albumin levels of the three groups were different,and the differences were statistically significant(P < 0.05).With regard to the left ventricular mass index levels,the group A was obviously higher compared with group B and C(P < 0.05),and it was no difference between group B and group C.There was A significant difference in the number and proportion of patients with primary diabetes among the three groups,and the difference was statistically significant(P < 0.05).Group A is the most,followed by group B,and group C is the last.The number of MHD patients with diabetes gradually decreased with the increase of dialysis age.4.Correlation analysis of dialysis age and indicatorsIn this study,we found that dialysis age was positively correlated with hemoglobin,serum albumin,transferrin saturation,serum ferritin,calcium,ejection fraction,serum creatinine and alkaline phosphatase.But dialysis age was negatively correlated with predialysis systolic blood pressure,predialysis diastolic blood pressure,low density lipoprotein and left ventricular mass index.That is,with the increase of dialysis age,hemoglobin,serum albumin transferrin saturation,serum ferritin,calcium,ejection fraction,blood creatinine,alkaline phosphatase level gradually increased,systolic blood pressure before dialysis,diastolic blood pressure before dialysis,low density lipoprotein,left ventricular muscle mass index level gradually decreased.5.Correlation between hemoglobin,serum albumin,PTH,LVMI and other clinical indicators and risk factors(1)Hemoglobin: It was shown that hemoglobin was negatively correlated with ferritin,CRP and LVMI,whereas it was positively correlated with the hematocrit,proalbumin,albumin,serum creatinine,calcium,phosphorus and calcium phosphorus.For MHD patients with substandard hemoglobin,male is an independent risk factors,while dialysis age,calcium phosphorus product and high-density lipoprotein were protective factors.(2)Serum albumin: There was a negative correlation between serum albumin and age,low-density lipoprotein,CRP,2 microglobulin.While serum albumin was positively correlated with dialysis age,hemoglobin,proalbumin,serum creatinine and calcium.Serum creatinine and triglyceride were independent risk factors for hypoproteinemia.(3)PTH: PTH was negatively correlated with age and LVMI.But as of serum phosphorus,calcium and alkaline phosphatase,PTH was a positive factor.Female and diabetes mellitus were independent risk factors for MHD patients with substandard parathyroid gland.(4)LVMI: There were significantly negative correlationship between LVMI and dialysis age,hemoglobin,parathyroid hormone,transferrin saturation,ejection fraction.Whereas the relationship of LVMI with predialysis systolic blood pressure,creatine kinase isozyme and BNP were significantly positive.Male is an independent risk factor for cardiac hypertrophy,and ejection fraction and hemoglobin are protective factors for LVMI.Conclusions:1.The primary glomerular disease and diabetic nephropathy are still predominant primary morbidity of maintenance hemodialysis patients in our dialysis center.Maintenance hemodialysis patients aged more than 6 months were mainly middle-aged men,and the number of patients aged 6-60 months was the largest.2.With the increase of dialysis age,the incidence of cardiac hypertrophy decreased gradually.In patients with dialysis age of 6-120 months,hemoglobin level and compliance rate increased with dialysis age.The serum albumin level increased gradually and the compliance rate decreased gradually.3.The dialysis age,calcium phosphorus product,serum albumin and high-density lipoprotein are protective factors for the standard hemoglobin.Serum creatinine and triglyceride are risk factors of hypoproteinemia.Diabetes mellitus are the risk factors of MHD patients with substandard parathyroid gland.Increased systolic blood pressure before dialysis is a risk factor for cardiac hypertrophy,while ejection fraction and serum albumin are protective factors for LVMI compliance. |
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