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Darbepoetin alfa injection versus epoetin alfa injection for treating anemia of Chinese hemodialysis patients with chronic kidney failure:A randomized,open-label,parallel-group,non-inferiority Phase III trail

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Chronic Diseases and Translational Medicine 2022年第1期8卷 59-70页

作者： Nan Chen Changying Xing Jianying Niu Bicheng Liu Junzhou Fu Jiuyang Zhao Zhaohui Ni Mei Wang Wenhu Liu Jinghong Zhao Ling Zhong Xiongfei Wu Wenge Li Yuqing Chen Wei Shi Jianghua Chen Aiping Yin Ping Fu Rong Wang Gengru Jiang Fanfan Hou Guohua Ding Jing Chen Gang Xu Yuichiro Kondo Yuliang Su Changlin Mei Department of nephrology Ruijin Hospital Shanghai Jiaotong University School of MedicineShanghai 200025China Department of nephrology Jiangsu Provincial HospitalNanjingJiangsu 210036China Department of nephrology Shanghai Fifth People's HospitalFudan UniversityShanghai 200240China Department of nephrology Zhongda Hospital Southeast UniversityNanjingJiangsu 210009China Department of nephrology Guangzhou First People's HospitalGuangzhouGuangdong 510180China Department of nephrology The Second Hospital of Dalian Medical UniversityDalianLiaoning 116027China Department of nephrology Renji Hospital Shanghai Jiaotong University School of MedicineShanghai 200001China Department of nephrology Peking University People's HospitalBeijing 100044China Department of nephrology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of nephrology Xinqiao Hospital of Army Medical UniversityChongqing 400037China Department of nephrology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China Department of nephrology Southwest Hospital of Army Medical UniversityChongqing 400039China Department of nephrology China-Japan Friendship HospitalBeijing 100029China Department of nephrology Peking University First HospitalBeijing 100034China Department of nephrology Guangdong Provincial People's HospitalGuangzhouGuangdong 510080China Department of nephrology The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310003China Department of nephrology First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxi 710061China Department of nephrology West China HospitalSichuan UniversityChengduSichuan 610041China Department of nephrology Shandong Provincial HospitalJinanShandong 250021China Department of nephrology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of nephrology Nanfang Hospital Southern Medical UniversityGuangzhouGuangdong 5105

Background:Erythropoietin is a glycoprotein that mainly regulates *** patients with chronic renal failure with anemia,darbepoetin alfa can stimulate erythropoiesis,correct anemia,and maintain hemoglobin *** study was designed to demonstrate the efficacy and safety of darbepoetin alfa injections as being not inferior to epoetin alfa injections(Recombinant Human Erythropoietin injection,rHuEPO)when maintaining hemoglobin(Hb)levels within the target range(10.0-12.0 g/dL)for the treatment of renal ***:Ninety-five patients were enrolled in this study from April 15,2013 to April 10,2014 at 25 *** this study,patients(n=95)aged 18-70 years were randomized into a once per week intravenous darbepoetin alfa group(n=56)and a twice or three times per week intravenous epoetin alfa group(n=39)for 28 weeks,who had anemia with hemoglobin levels between 6 g/dL and 10 g/dL due to chronic kidney disease(CKD)and were undergoing hemodialysis or hemofiltration with ESA-naive(erythropoiesis stimulating agent-naive).The primary efficacy profile was the mean Hb level(the non-inferiority margin was-1.0 g/dL,week 21-28);the secondary efficacy profiles were the Hb increase rate(week 0-4),the target Hb achievement cumulative rate and time,the change trends of the Hb levels,and the target Hb maintenance *** events(AEs)were observed and compared,and the efficacy and safety were analyzed between the two treatment ***,the frequencies of dose adjustments between the darbepoetin alfa and epoetin alfa groups were compared during the treatment ***?software version 9.2 was used to perform all statistical *** statistics were used for all efficacy,safety,and demographic variable analyses,including for the primary efficacy ***:The mean Hb level was 11.3 g/dL in the darbepoetin alfa group and 10.7 g/dL in the epoetin alfa group,respectively;the difference of the lower limits of the 95%confidence intervals(C

关键词： anemia chronic renal failure darbepoetin alfa hemodialysis recombinant human erythropoietin

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Gender differences in the relationship between plasma lipids and fasting plasma glucose in non-diabetic urban Chinese popula- tion： a cross-section study

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Frontiers of Medicine 2014年第4期8卷 477-483页

作者： Jie Zheng Yuzhen Gao Yuejuan Jing Xiaoshuang Zhou Yuanyuan Shi Yanhong Li Lihua Wang Ruiying Wang Maolian Li Chuanshi Xiao Yafeng Li Rongshan Li School of Nursing Shanxi Medical University Taiyuan 030001 China Department of Cardiology Second Hospital of Shanxi Medical University Taiyuan 030001 China Department of nephrology and hemodialysis Center Second Hospital of Shanxi Medical University Taiyuan 030001 China Shanxi Renal Disease Research Institution Taiyuan 030001 China Department of Cardiology First Hospital of Shanxi Medical University Taiyuan 030001 China Department of nephrology and hemodialysis Center Shanxi Provincial People's Hospital Taiyuan 030012 China

The association between dyslipidemia and elevated fasting glucose in type 2 diabetes is well known. In non-diabetes, whether this association still exists, and whether dyslipidemia is an independent risk factor for high fasting plasma glucose （FPG） levels are not clear. This cross-sectional study recruited 3460 non-diabetic Chinese subjects （1027 men, and 2433 women, aged 35-75 years old） who participated in a health survey. Men and women were classified into tertiles by levels of plasma lipids respectively. In women, the prevalence of impaired fasting glucose （IFG） was decreased with increased HDL-C. A stepwise increase in HDL-C was associated with decreasing FPG levels （lowest tertiles, FPG： 5.376 ± 0.018; middle tertiles, 5.324± 0.018; highest tertiles, 5.276±0.018mmol/L; P = 0.001）. Reversely, FPG levels increased from lowest tertiles to highest tertiles of LDL-C, TC, and TG. we found that women in the first tertile with lower HDL-C level had a 1.75-fold increase in risk of IFG compared with non-diabetic women in the third tertile with higher HDL-C level （OR： 1.75; 95% CI： 1.20-2.56）. In men, no significant association was found. We took age, BMI, waist/hip ratio, education, smoking, alcohol drinking, and physical exercise as adjusted variables. In Chinese non-diabetic women, dyslipidemia is independently associated with high levels of FPG; TG, HDL-C, and LDL-C are predictors of IFG independent of BMI and waist/hip ratio.

关键词： dyslipidemia plasma lipids plasma fasting glucose impaired fasting glucose non-diabetes

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Factors Associated with Echocardiographic Abnormalities in Patients with Chronic Kidney Disease in a Tertiary Hospital in Ivory Coast

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Open Journal of nephrology 2022年第1期12卷 36-47页

作者： Weu M. Tia Abdoulaye Togo Manzan A. Wognin Reine M. Koffi Jonathan Kpan Bourhaima Ouattara Dame A. Gnionsahe Department of Internal Medicine University Teaching Hospital (CHU) of Bouaké Bouaké C&ocirc te d'Ivoire nephrology-hemodialysis Department University Teaching Hospital (CHU) of Yopougon Abidjan C&ocirc te d'Ivoire

Background: Cardiovascular risk factors (CVRF) are very frequent in pa-tients with chronic kidney disease (CKD) and impose a new environment to which the heart must adapt. Cardiac ultrasound is a non-invasive and easy-to-perform examination that allows quantitative and qualitative assessment of the anatomy and function of the heart. The objectives of this study were to describe abnormalities observed on trans-thoracic Doppler-echocar-diography and to investigate the factors associated with them. Materials and Method: This was a monocentric retrospective cross-sectional study conducted in CKD patients hospitalized in a hospital center in Côte d'Ivoire from January 2017 to December 2018. Results: One hundred and four cases were collected with a mean age of 48.87 ± 14.47 years and a sex ratio of 1.7. Patients with end-stage-renal-disease (ESRD) represented 83.7% with 55.8% of cases of chronic glomerulonephritis. Cardiovascular risk factors were 100% anemia, 84.6% inflammatory profile, 77.9% hypertension, 76.9% hypocalcemia and in 67.3% oedema. Cardiac abnormalities were observed in 78.8% of patients. Left ventricular hypertrophy (LVH), accounting for 20.2% of cases, was associated with male gender (OR 0.127 CI 0.025 - 0.643;p = 0.013) and hypertensive nephropathy (OR 0.189 CI 0.056 - 0.637;p = 0.007). History of hypertension (OR 0.297 CI 0.084 - 1.050;p = 0.060) and diabetes (OR 5.315 CI 1.260 - 22.419;p = 0.023), hypertensive nephropathy (OR 0.174 CI 0.052 - 0.585;p = 0.005) and hypocalcemia (OR 6.094 CI 1.723 - 21.559;p = 0.005) are incriminated in the development of left ventricular dilatation (LVD) which accounted for 38.5% of cases. Conclusion: Left ventricular hypertrophy and dilatation are the main echocardiographic abnormalities observed in our population.

关键词： Chronic Renal Failure Left Ventricular Hypertrophy Ivory Coast

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Management and Evolution of Multiple Myeloma with Renal Failure in Developing Countries: The Case of the Sylvanus Olympio University Hospital in Lome, Togo

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Open Journal of nephrology 2022年第4期12卷 441-450页

作者： Kossi Akomola Sabi Eyram Fianyo Yoan Makafui Amekoudi Viwale Koffi Tessio Laune Odilon Blatome Badomta Dolaama Ayodélé Jonathan Sabi Abdou-Raouf Sibabi Zamarou Tchablinam Naleta Owonayo Oniakitan nephrology Hemodialysis Department of CHU Sylvanus Olympio University of Lomé Lomé Togo Rheumatology Department of The Secondary Hospital of Bè University of Lomé Lomé Togo nephrology Department of CHU Kara University of Kara Kara Togo Rheumatology Department of CHU Sylvanus Olympio University of Lomé Lomé Togo

Background: Renal failure (RF) is a frequent complication during multiple myeloma (MM) and sometimes reveals the disease. The median survival of MM patients with RF is shorter than that of patients with myeloma without renal involvement. Although patient survival has been prolonged with the new therapies, the median survival does not exceed five to seven years. Few data on this subject are available in sub-Saharan Africa. Objectives: To describe the therapeutic management and evolution of MM with RF in a developing country like Togo. Method: This was a retrospective descriptive and analytical study which took place over a period of ten years (2010-2019) and included the records of patients with MM according to the 2009 and/or 2014 IMWG criteria, hospitalized or followed up in the nephrology and rheumatology departments of the CHU-SO with a GFR Results: During the study period, 78 patients with MM had renal failure (55.7%). Therapeutically, hygienic and dietary measures were dictated in 84.6% of cases (68 patients). Rehydration was performed in 38 cases (48.7%);alkalinization of urine in 10 cases (12.8%);use of antibiotics in 36 cases (46.2%), NSAIDs in 51 cases (65.4%);use of biphosphonates in 36 cases (46.6%). Surgical immobilization by screw-plate osteosynthesis was performed in 02 patients. Nephrologically, 8 patients underwent ESRD. The different chemotherapy protocols used were Melphalan-Prednisone in 70% of cases, Melphalan-Cyclophosphamide-Prednisone in 26.7% of cases and Cyclophosphamide-Prednisone in 3.3%. The median overall survival was 8 months. The median survival was 13 months in patients who recovered from renal failure versus 2 months in those who did not recover from renal failure (p = 0.0030). Of the 78 patients in our series, 22 patients had died (28.2%). Conclusion: Despite renal failure, the Alexanian protocol and biphosphonates are still widely used in combination with symptomatic treatment with significant results.

关键词： Renal Failure Multiple Myeloma Management Evolution Togo

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Result of 10 Years of Experience in Echo-Guided Kidney Biopsy Punctures in the nephrology Department of the Martigues Hospital Center, France

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Open Journal of nephrology 2021年第2期11卷 144-155页

作者： Aboubacar Sidiki Fofana Magara Samaké Seydou Sy Sah Dit Baba Coulibaly Christophe Bouaka Ghassan Alchahin Delphine Haussaire Simona Dorina Boncila Hamadoun Yattara Moctar Coulibaly Atabième Kodio Modi Sidibe Saharé Fongoro nephrology unit of the Fousseyni DAOU Hospital Kayes Mali nephrology and hemodialysis Department of the University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology of the University of Sciences Techniques and Technologies of Bamako Bamako Mali nephrology unit of Somino DOLO Hospital Mopti Mali nephrology and hemodialysis Department of the Martigues Hospital Martigues France nephrology unit of Mali Gavardo Hospital Sébénikoro Bamako Mali

Introduction: Percutaneous renal biopsy (PRB) is an essential procedure for the diagnosis and therapeutic management of many primary or secondary nephropathies. Objectives: To identify the indications, to determine the profile of the diagnosed nephropathies and to evaluate the short-term complications related to the practice of echo-guided PRB at the Martigues hospital center. Methodology: This was a retrospective and descriptive study carried out on the records of patients who underwent echo-guided native kidney biopsy from January 1, 2010 to December 31, 2019 in the nephrology department of the Martigues Hospital. Results: The analysis of 123 cases of echo-guided PRB involved 76 men and 47 women with a sex ratio of 1.6. The mean age was 55.92 ± 17.80 with age extremes of 16 and 87 years. Glomerular syndromes were the main indication with 42 cases of nephrotic syndrome (34.1%), 15 cases of nephritic syndrome (12.2%), 11 cases of rapidly progressive glomerulonephritis syndrome (8.9%), and 6 cases of recurrent macroscopic hematuria syndrome (4.9%). The histological findings were 47 cases of primary glomerular lesions (38.3%), 32 cases of nephroangiosclerosis lesions (26%), 24 cases of secondary glomerulopathy (19.5%), 9 cases of interstitial nephritis (7.3%), 2 cases of myelomatous nephropathy (1.6%), and 9 cases (7.3%) of unclassified histological lesions. Twenty-two hypertensive patients (40.7%) had nephroangiosclerosis lesions (p = 0.001). The follow-up was simple in 119 patients (96.7%). Macroscopic hematuria was noted in 4 patients (3.3%). It was associated with a perirenal hematoma in 2 patients including 1 transfused case. Conclusion: Our data provide an important contribution to the understanding of the prevalence and clinical presentation of renal diseases in the nephrology department of the Martigues hospital center.

关键词： Renal Puncture Biopsy nephrology Martigues Hospital Center

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引用

International Journal of Clinical Medicine 2012年第7期3卷 598-602页

作者： Gerhard Lonnemann Eike Wrenger Outpatient Clinic of nephrology Hemodialysis Center Eickenhof Langenhagen Germany Outpatient Clinic of nephrology Hemodialysis Center Eickenhof Langenhagen Germany.

Aim: This observational clinical study tested the effect of injection frequency of the biosimilar epoetin zeta on the weekly dose needed to maintain stable hemoglobin levels in chronic kidney diseases (CKD) patients on intermittent high-flux hemodialysis (HD). Patients and Methods: CKD patients (n = 33) on regular HD therapy 3 times a week were treated for 18 months with epoetin zeta i.v. The hemoglobin levels, the weekly dose as well as the injection frequency of epoetin zeta were monitored at least every two weeks. Patients were followed in three time periods: 1) extended follow-up (months 1 - 18);2) intervention phase (months 19 - 21);and 3) post intervention observation phase (months 28 - 30). During extended follow-up the majority of patients (n = 21) received only one injection of epoetin zeta per week. During the intervention phase, injection frequency was increased to 3 injections per week in all patients accompanied by a reduction in weekly doses of approximately 20% - 30%. Following a 9 month period of dose adjustment all parameters were monitored again in the post-intervention phase. Results: During the first 18 months of epoetin zeta therapy the mean hemoglobin level was stable between 11 and 12 g/dl. The mean weekly dose of epoetin zeta was 7939 IU/week in month 6 and 7909 IU/week in month 18 (p = not significant). The mean frequency (injections/week) was 1.27 in month 6 and 1.29 in month 18 (not significant). Compared to month 18, at the end of the observation at month 30, hemoglobin levels were stable, mean injection frequency increased to 2.25 (p < 0.001) and the mean weekly dose decreased to 5469 IU/week (-31.7%, p < 0.001). Conclusions: Increasing the injection frequency of the short acting biosimilar epoetin zeta to two to three injections per week reduces the weekly dose and thereby the costs of ESA therapy of renal anemia significantly.

关键词： Epoetin Zeta Renal Anemia Drug Efficiency Injection Frequency Chronic hemodialysis

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Response to roxadustat in a patient undergoing long-term dialysis and allergic to erythropoiesis-stimulating agents:A case report

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World Journal of Clinical Cases 2022年第35期10卷 13122-13128页

作者： Cai Xu Deng-Gui Luo Zhe-Yan Liu Dong Yang Dan-Dan Wang Yuan-Zhao Xu Jun Yang Bo Fu Ai-Rong Qi Department of nephrology The Fourth Affiliated Hospital of Guangzhou University of Chinese MedicineShenzhen 518000Guangdong ProvinceChina Department of nephrology Shenzhen Traditional Chinese Medicine HospitalShenzhen 518000Guangdong ProvinceChina

BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal *** is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)*** can effectively increase hemoglobin in patients with dialysis-dependent chronic kidney disease,with an adverse events profile comparable to that of epoetin *** administered roxadustat to a maintenance hemodialysis patient who was allergic to erythropoiesis-stimulating agents(ESAs)and depended on blood transfusion for five *** applying Roxadustat,the patient’s anemia improved *** SUMMARY A 77-year-old Chinese man had type 2 diabetes for 16 years,underwent maintenance hemodialysis for five years,and had fatigue for five *** tests showed severe anemia(hemoglobin concentration of 42 g/L).The patient was administered a subcutaneous injection of ESAs before *** suffered an allergic shock immediately and *** blood pressure dropped to undetectable *** was not administered ESAs *** patient was prescribed iron supplements and received blood transfusions occasionally for five *** hemoglobin concentration ranged from 42-68 g/*** taking six weeks of oral roxadustat three times weekly(100 mg TIW),the patient’s hemoglobin concentration increased significantly,and his symptoms *** adjusted the doses of roxadustat,and the hemoglobin concentration was maintained between 97 and 126 g/*** Oral roxadustat is effective in treating anemia in maintenance hemodialysis patients who cannot be administered ESAs.

关键词： Chronic kidney disease hemodialysis Anemia Roxadustat Erythropoiesis-stimulating agents Allergic shock Case report

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The COVID-19 Vaccine Acceptance in hemodialysis Patients in Togo

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Open Journal of nephrology 2022年第1期12卷 162-168页

作者： Yawovi Mawufemo Tsevi Agbeko Kodjo Djagadou Awèréou Kotosso Lidaw Déassoua Bawe Abdou-Razak Moukaïla Awalou Mohaman Djibril nephrology and hemodialysis Department Sylvanus Olympio University Hospital Lomé Togo Infectious and Tropical Diseases Department Sylvanus Olympio University Hospital Lomé Togo Internal Medicine Department Sylvanus Olympio University Hospital Lomé Togo

Introduction: Wide adoption of vaccination is the key to successfully control the spread of coronavirus 2019 (COVID-19). Objective: To evaluate the acceptability of COVID-19 vaccines and associated factors in hemodialysis patients in Lomé. Patients and Method: Cross-sectional study was conducted from August 1 to 31, 2021 in hemodialysis patients at the Sylvanus Olympio University Hospital to obtain their opinion on the anti-COVID-19 vaccination. Results: One hundred and twenty-three patients on regular hemodialysis were interviewed;their mean age was 45 years [37 - 55.5 years]. The average number of years patients were on dialysis was 3 years [2 - 5 years]. The general opinion on vaccination was mostly unfavorable (59.3%). Reasons given included: doubts about the quality of the vaccine (49.6%), fear of side effects (51.2%), alarming messages on social networks (36.5%) and doubts about the efficacy of the vaccines (33.3%). Only half of the patients in favor of vaccination were already vaccinated at the time of the survey. The main motivations for getting vaccinated were dominated by: fear of developing a severe form of COVID-19 if infected (32.5%), frailty due to age (19.5%) and medical history (15.4%). Social networks (72.3%), television (60.1%), family and friends (55.2%) were the main sources of information for patients about COVID-19 vaccination. Conclusion: hemodialysis patients are mostly septic to anti-COVID-19 vaccination.

关键词： Acceptance Vaccination Covid-19 hemodialysis Togo

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MicroRNA-21 in the pathogenesis of acute kidney injury

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Protein & Cell 2013年第11期4卷 813-819页

作者： Ya-Feng Li Ying Jing Jielu Hao Nathan C Frankfort Xiaoshuang Zhou Bing Shen Xinyan Liu Lihua Wang Rongshan Li Department of nephrology and hemodialysis Center Second Hospital of Shanxi Medical UniversityTaiyuan 030001China Shanxi Renal Disease Research Institution Taiyuan 030001China Department of Blood Purifi cation General Hospital of Jinan Military Command of PLAJinan 250031China nephrology Institute of PLA Changzheng Hospital of Second Military Medical UniversityShanghai 200003China Department of Neuroscience and Neurovirology Temple University School of MedicinePhiladelphiaPA 19140USA Department of Urology Shanghai First People’s HospitalShanghai 200080China Department of nephrology and hemodialysis Center Shanxi Provincial People’s HospitalTaiyuan 030012China

Acute kidney injury(AKI),associated with significant mor-bidity and mortality,is widely known to involve epithelial apoptosis,excessive inflammation,and fibrosis in re-sponse to ischemia or reperfusion injury,which results in either chronic pathological changes or ***,it is imperative that investigations are conducted in order to fi nd effective,early diagnoses,and therapeutic targets needed to help prevent and treat ***,the mech-anisms modulating the pathogenesis of AKI still remain largely ***(miRNAs),small non-coding RNA molecules,play an important role in several fundamental biological and pathological processes by a post transcriptional regulatory function of gene ***-21(miR-21)is a recently identifi ed,typi-cal miRNA that is functional as a regulator known to be involved in apoptosis as well as inflammatory and fi brotic signaling pathways in *** a result,miR-21 is now considered a novel biomarker when diagnosing and treat-ing *** article reviews the correlative literature and research progress regarding the roles of miR-21 in AKI.

关键词： microRNA microRNA-21 gene expression acute kidney injury

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Relationship between platelet morphology indices and uremic pruritus in maintenance hemodialysis patients

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Chinese Medical Journal 2022年第17期135卷 2128-2130页

作者： Zhen Ai Qixia Lei Naya Huang Xiaoqing Ye Raoping Wang Yuanwen Xu Wei Chen Department of nephrology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510080China Key Laboratory of nephrology National Health Commission and Guangdong ProvinceGuangzhouGuangdong 510080China

To the Editor:Uremic pruritus is a common and distressing complication that affects>65% of patients undergoing maintenance hemodialysis(MHD).The intensity of uremic pruritus is associated with depression,impaired sleep,reduced quality of life,and increased mortality in MHD patients;however,the pathogenesis of uremic pruritus is poorly,understood and no effective treatments currently exist.

关键词： patients impaired uremic

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