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Objective To cxplore the optimal levels of serum calcium,phosphorus and intact parathyroid hormone (iPTH) in peritoneal dialysis (PD) patients.Methods This study is a single center,retrospective cohort study.The associations between serum calcium,phosphorus and iPTH and all-cause mortality in 217 PD patients were analyzed.All patients started PD between January 1,2008 and April 30,2016 were enrolled and followed up to December 31,2016.At baseline and every 3 months,biochemical and therapeutic information was collected.Cox proportional hazard regression models and cubic splines analysis were employed to assess the lowest mortality risk ranges in serum markers of bone metabolism.Results There was no significantly difference between patients within target ranges based on KDOQI or KDIGO guideline and those outside the target ranges by Kaplan-Meier survival analysis.The lowest mortality risk ranges were 2.17-2.40 mmol/L for serum calcium,1.20-1.67 mmol/L for serum phosphorus and 180-350 ng/L for serum iPTH by using Cox models and cubic splines analysis.Moreover,cumulate survival had significant difference between patients within the descriptive ranges and those out of the descriptive ranges at time-averaged values but not at baseline values.Conclusions The optimal time-averaged ranges of PD patients are 2.17-2.40mmol/L for serum calcium,1.20-1.67 mmol/L for serum phosphorus and 180-350 ng/L for serum iPTH.These ranges need further validation by large population studies to further conform.
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Objective To analyze the related factors of micro-albuminuria and macroalbuminuria in type 1 diabetes mellitus (DM) in the classification tree model,and to screen the high risk population of diabetic kidney disease.Methods 394 patients with type 1 diabetes were enrolled in the hospital from 2008 to 2015.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 1 diabetes group (299 cases),micro-albuminuria group (73 cases) and macro-albuminuria group (22 cases).The classification tree model was utilized to analyze related factors of the different stages of proteinuria,and the high-risk population was screened by node gain analysis.Results Four important explanatory variables were screened out by the classification tree model from the 27 candidate variables related to primary renal damage,including retinopathy,fibrinogen,waist-hip ratio (WHR),red blood cell distribution width (RDW).Retinopathy was an major factor of DKD.The probability of macro-albuminuria in retinopathy and WHR ＞ 0.82 group was 43.8％,and if at the same time RDW ＞ 0.14,the probability of macro-albuminuria was 88.9％.Conclusions The classification tree model can analyze factors of the separate stages of proteinuria in type 1 diabetic patients effectively.Retinopathy is the major influential factors of type 1 diabetic patients with proteinuria.
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Objective To explore the relationship between sense of coherence and coping styles among patients at the stabile phase after peritoneal dialysis. Methods About 86 patients at stable phase after peritoneal dialysis were recruited in the investigation. The sense of coherence (SOC-13) and medical coping modes questionnaire (MCMQ) were used to evaluate the sense of coherence and coping styles. Results The average score of sense of coherence was (60.93±13.77), which was at a lower level. The scores of coping styles were confrontation, avoidance and resignation, ranked from high to low. Avoidance and resignation dimensions were higher than the norm in coping styles (all P<0.001) and there was no statistically significant difference between confrontation dimension and the norm (P>0.05). There was positive relationship between confrontation and the average score of sense of coherence, comprehensibility, manageability, meaningfulness (all P<0.05). There was negative relationship between resignation and the average score of sense of coherence, comprehensibility, manageability, meaningfulness (all P<0.001). Conclusions Patients at the stable phase after peritoneal dialysis have a lower sense of coherence and are inclined to confrontation and avoidance coping styles. The higher sense of coherence, the more positive coping styles PD patients use. Medical workers should provide personal interventions according to the results of the sense of coherence so that the patients take positive coping styles.
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Objective To analyze the related factors of micro-albuminuria and macroalbuminuria in type 1 diabetes mellitus (DM) in the classification tree model,and to screen the high risk population of diabetic kidney disease.Methods 394 patients with type 1 diabetes were enrolled in the hospital from 2008 to 2015.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 1 diabetes group (299 cases),micro-albuminuria group (73 cases) and macro-albuminuria group (22 cases).The classification tree model was utilized to analyze related factors of the different stages of proteinuria,and the high-risk population was screened by node gain analysis.Results Four important explanatory variables were screened out by the classification tree model from the 27 candidate variables related to primary renal damage,including retinopathy,fibrinogen,waist-hip ratio (WHR),red blood cell distribution width (RDW).Retinopathy was an major factor of DKD.The probability of macro-albuminuria in retinopathy and WHR ＞ 0.82 group was 43.8％,and if at the same time RDW ＞ 0.14,the probability of macro-albuminuria was 88.9％.Conclusions The classification tree model can analyze factors of the separate stages of proteinuria in type 1 diabetic patients effectively.Retinopathy is the major influential factors of type 1 diabetic patients with proteinuria.
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Complications in CRF-CAPD were treated by TCM during the past 17 years. Loss of appetite and hypoproteinemia were treated with modified Renshen Yangrong Decoction, for abdominal pain and distention, modified Xiangsha Liujunzi Decoction; for peritonitis, modified Dacaihu Decoction; for diarrhea due to hypofunction of spleen with exuberant dampness, modified Shenling Baizhu Powder; for Yang-deficiency of the Spleen and Kidney, modified Lizhong Decoction plus Sishen Pill; for skin pruritus, Siwu Decoction with additives; for renal -ortheopathy, treated by principles of tonifying the liver - kidney, strengthening the bones and tendons and blood - activating and stasis - relieving; for hyperlipidemia, by principles of tonifying the liver -kidney, phlegm and turbidity - eliminating and blood - activating stasis - relieving; for renalanemia, Guishao Sijunzi Decoction with additives. To improve patient'sliving quality and nutrition, self- formulated Shentekang capsule was given to improve renal function, decrease the frequencies and duration of dialysis, self - formulated Shenshuai Recipe was administered.