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Prospective study of the short-term effect of 1.75 mmol/L calcium concentration dialysate on hemodialysis patients

Family Medicine and Community Health 2014年第2期2卷 15-21页

作者： Dongliang Zhang Fang Sun Yilun Zhou Xiaofeng Duan Yi Sun Taigen Cui Wenhu Liu Department of Nephrology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Nephrology Beijing Chao-yang HospitalCapital Medical UniversityBeijing 100020China Department of Nephrology Fu Xing HospitalCapital Medical UniversityBeijing 100045China Department of Nephrology Capital Medical UniversityBeijing 100069China

Objective:The purpose of the current study was to determine the influence of a 1.75 mmol/L calcium(Ca)concentration dialysate(DCa 1.75)during maintenance hemodialysis(MHD)therapy for patients with chronic kidney disease,mineral,and bone disorders(CKD-MBD)on biochemical indices and clinical ***:Four hundred eighty-three MHD patients from three hemodialysis centers were *** 24 months of follow-up(January 2011 to December 2012),289 patients from Center 1 who used 1.50 mmol/L Ca concentration dialysate(Dca 1.50)between January and December 2011 and DCa 1.75 between January and December 2012 were included in the high Ca *** remaining 194 patients from the other centers who used DCa 1.50 for hemodialysis between January 2011 and December 2012 were included in the ordinary Ca *** following CKD-MBD biochemical indices were monitored:blood Ca;blood phosphorus(P);intact parathyroid hormone(iPTH);and bone-specific alkaline phosphatase(BAP).The metastatic calcification index included calcification of aortic arch scoring(AoACS),abdominal aorta calcification(AAC),and cardiac valve calcification(CVC).The study end points included all-cause mortality(ACM),car-diovascular and cerebrovascular diseases(CCVDs),fractures,and new metastatic *** changes between the two groups in the observed indices were ***:Two hundred eighty-four patients in the high Ca group(98.3%)and 194 patients in the ordinary Ca group(100.0%)completed an average follow-up of 21.3±5.6 *** DCa 1.75 was used,the blood Ca in the high Ca group increased[(2.39±0.22)mmol/L vs.(2.34±0.21)mmol/L,t=-2.910,P=0.004]compared to the previous year,and increased[(2.39±0.22)mmol/L vs.(2.30±0.16)mmol/L,t=5.187,P<0.001]compared to the ordinary Ca group in the same *** blood P and iPTH decreased[(1.78±0.39)mmol/L vs.(1.89±0.42)mmol/L,t=2.909,P=0.004 and(306.5±298.6)pg/ml vs.(425.7±365.1)pg/ml,t=8.377,P<0.001,respectively]compared with the previous year,an

关键词： Hemodialysis dialysate dialysate Calcium Phosphorus Parathyroid hormone

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A study of effects of using low dialysate calcium concentration (1.50 mmol/L) on blood pressure,serum concentrations of calcium,parathyroid hormone and aldosterone in chronic hemodialysis patients

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外科研究与新技术 2011年第3期 229-234页

作者：范凯文许晨朱敏 Dialysis Center Nephrology Department of Tongji Hospital Affiliated to Tongji University

Background: Dialysis centres around the world use different concentrations of calcium in dialysate solution,ranging from 1. 25 to 1. 75 mmol / L. However,a dialysate concentration of 1. 25 mmol / L is recommended. [1] Higher or lower dialysate calcium concentrations are indicated in patients,depending on their co-morbid factors. We explored the effects of using a calcium dialysate solution of 1. 50 mmol / L compared to a 1. 75 mmol / L calcium dialysate solution on the Blood Pressure (BP) ,serum concentrations of Calcium,Parathyroid Hormone (PTH) and Aldosterone in chronic hemodialysis (HD) patients. Method: 42 patients were enrolled in the study. First a 1. 50 mmol / L low calcium dialysate solution (LCDS) was used for 4 hour dialysis,and for the next session of HD,a 1. 75 mmol / L (NCDS) normal calcium dialysate solution was used. Blood pressure was measured at 5 intervals of time: pre HD,at 60,120,180 and 240 minutes into the HD session. Pre and post HD blood samples were taken for serum calcium,PTH and Aldosterone levels. Results: All 42 patients completed the study. With LCDS,the post HD serum calcium levels were (2. 51 ± 0. 14) mmol / L,compared to (2. 85 ± 0. 17) mmol / L for NCDS (P < 0. 01) . A post HD serum PTH level of (80. 6 ± 144. 93) pg / ml was observed when using LCDS,whereas a (52. 25 ± 115. 89) pg / ml serum PTH level was noted with NCDS (P < 0. 01) . As for aldosterone,a post HD value of (161. 77 ± 80. 42) ng / L was obtained with LCDS and (165. 50 ± 78. 84) ng / L with NCDS (P < 0. 01) . The mean post HD systolic blood pressure was (129. 17 ± 25. 42) mmHg with LCDS dialysis compared to (132. 50 ± 20. 32) mmHg for NCDS dialysis (P < 0. 01) and the diastolic BP values observed were (75. 10 ±10. 34) mmHg and (78. 26 ±11. 63) mm Hg(P <0. 01) ,respectively. Conclusion: LCDS can more effectively improve hypercalcemic status in dialysis patients than NCDS. Using LCDS stimulates the secretion of PTH more than when using NCDS. LCDS decreases aldosterone l

关键词： dialysate concentration hemodialysis parathyroid hormone calcium aldosterone

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Exploration of a reasonable dialysate temperature setting in hemodialysis for patients with hypertension

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Chinese Nursing Research 2016年第3期3卷 133-136页

作者： Lin-Fang Xu Chun-Lei Wu Hong-Mei Sun Tong-Qiang Liu Yanghu Branch Changzhou No.2 People's Hospital

Objective：This study aims to investigate the effect of 4 different dialysate temperatures on blood pressure during hemodialysis for patients with ***：Using a self-controlled method,the patients＇ body temperature was set as ***,the dialysate temperature was set as 37 ℃,T＋0.5 ℃,T,and T-0.5 ℃.The changes in blood pressure,heart rate,mean arterial pressure and dialysis-induced adverse reactions at the 4 different dialysate temperatures were consistently ***：Patients who received hemodialysis with 37 ℃ and T＋0.5 ℃ dialysate demonstrated an unstable blood pressure and a higher incidence of adverse reactions,Patients who received hemodialysis with T and T-0.5 ℃ dialysate showed a relatively stable blood pressure,heart rate,and mean arterial pressure during *** particular,dialysate at T-0.5 ℃ resulted in the most stable blood pressure,the fewest adverse reactions and the best self-assessed comfort scores（P 〈 0.01）.Conclusions：The dialysate temperature during hemodialysis for patients with hypertension should be set to a temperature based on patients＇ preoperative body temperate T or 0.5 ℃ below *** practice is suggested to enhance the stability of patients＇ blood pressure and heart rate during hemodialysis,reduce complications and improve patients＇ tolerance of hemodialysis.

关键词： Hemodialysis Hypertension dialysate Temperature Blood pressure

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The effect of dialysate on the release of TNF-α from peritoneal macrophage in vivo

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Chinese Medical Journal 1997年第10期 61-61页

作者：姚强钱家麒季育华

Objective To investigate the consistant inhibitory effect of peritoneal dialysate on the capacity of peritoneal macrophage to release TNF α and the inhibition associated with different glucose concentration in vivo. Methods We compared the peritoneal macrophage activity obtained from the irrigation solution of the uremia patients (n=2) just after inserting the catheter, with those from the long dwell time dialysate (≥10 hrs) of peritoneal dialysis patients (n=7). The capacity of peritoneal macrophage to release TNF α activity was assayed by measuring its cytotoxicity. At the same time, we compared TNF α activity among different glucose concentration (1.5%, 2.5% and 4.25% dextrose) of dialysate. Results The levels of TNF α in CAPD and control group were 170 and 517 pg/10 6, respectively (Pdialysate containing higher glucose concentration have lower TNF α level (Pdialysate on peritoneal macrophages might continue at least 10 hours in vivo. The higher glucose concentration of dialysate may have the worse effect on peritoneal macrophage activity.

关键词：钱家麒 dialysate effect macrophage release the peritoneal TNF

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Solute clearance effect of citrate anticoagulation hemodialysate for hemodialysis in patients with high risk of bleeding

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Journal of Pharmaceutical Analysis 2008年第4期20卷 225-227,245页

作者：赵光本桂保松于长青薛静孙宏艳 Department of Nephrology the Second Hospital Medical School of Xi'an Jiaotong University Department of Nephrology of the first Affiliated Hospital Dalian Medical University Department of General Surgery Chinese PLA 323 Hospital

Objective To study the solute clearance effect of the new concentrated anticoagulation hemodialysate of citrate for hemodialysis in patients with high risk of bleeding. Methods Forty-two kidney failure patients with high risk of bleeding were divided into two groups (Group A and Group B) according to their hemodialysis manners. Patients in Group A were hemodialyzed with bicarbonate hemodialysate with low-molecular-weight heparin (dalteparin) anticoagulation and those in Group B with the new citrate anticoagulation hemodialysate prepared in our hospital without any other anticoagulant. Blood urea nitrogen (BUN) and creatinine (Cr) concentrations were measured before and after dialysis, and Kt/V and urea reduction rate (URR) were calculated. In addition, activated clotting time (ACT) and ionized calcium (iCa2+) concentration were also measured at the arterial and venous ends. Results ACT was extended and iCa2+ concentration decreased significantly at the venous end compared with those at the arterial end in Group B (P0.05). Conclusion The solute clearance effect of the new concentrated anticoagulation hemodialysate of citrate is excellent during hemodialysis in kidney failure patients with high risk of bleeding.

关键词： citrate dialysate anticoagulation hemodialysis

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Adsorption of urea,creatinine,and uric acid from three solution types using spherical activated carbon and its recyclability

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Chinese Journal of Chemical Engineering 2020年第12期28卷 2993-3001页

作者： Tomohito Kameda Kazuya Horikoshi Shogo Kumagai Yuko Saito Toshiaki Yoshioka Graduate School of Environmental Studies Tohoku University6-6-07 AobaAramakiAoba-kuSendai 980-8579Japan

In this paper,we propose that the urinary toxins from the wastewater be adsorbed on an adsorbent such as spherical activated carbon and the latter be regenerated by subjecting it to high temperatures to recycle activated carbon and also to recycle the water used in *** studied the adsorption of artificial waste dialysate,which is a mixed solution of urea,creatinine,and uric acid,and the separate solutions for each of these and found that their extents of adsorption onto the spherical activated carbon material were nearly *** amount of adsorption was approximately 1.4 mg·g^−1 for urea,18 mg·g^−1 for creatinine,and 20 mg·g^−1 for uric *** urea,creatinine,and uric acid adsorbed onto the spherical activated carbon decomposed on heat treatment at 500℃,and the adsorption capacity of the spherical activated carbon was *** study successfully demonstrated that the spherical activated carbon can be recycled in the waste dialysate treatment process.

关键词： Adsorption dialysate Spherical activated carbon Recycling

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