ABSTRACT
OBJECTIVE: To explore changes of biochemical indicators in maintenance hemodialysis patients in the last year of their survival.METHODS: Maintenance hemodialysis patients died from January 1, 2008 to December 31, 2017 were screened for enrollment. They were divided into two groups according to the cause of death: CCVD group and non-CCVD group. For the enrolled patients, biochemical indexes were performed every 3 months within one year before the end of life. RESULTS: A total of 145 cases(80 males, 65 females, median age of death at age 71) were included. Patients were divided into two groups according to the causes of death: 74 cases died of cardio-cerebrovascular diseases(CCVD group) and 71 cases died of non-cardio-cerebrovascular diseases(non-CCVD group). Serum albumin and creatinine concentration were maintained at high levels in the CCVD group and serum phosphorus increased one month before death. The serum calcium compliance rate in the CCVD group was significantly lower than that in the non-CCVD group at 9 months and 6 months before death. The proportion of patients with serum calcium >2.5 mmol/L at 12 th-6 th month before death and with serum phosphorus >1.78 mmol/L at 6 th-1 st months before death was higher than that of non-CCVD group. Serum albumin and creatinine concentration remained lower level and the later decreased early and significantly in the non-CCVD group. The proportion of patients with serum phosphorus <1.13 mmol/L was higher than that of the CCVD group at 3 months and one month before death. Serum albumin in patients who died from infective diseases began to decline significantly at the time of 6 months before death and decreased by 8.57% during 6 months. Serum albumin was consistently lower than 38 g/L and 36 g/L in patients who died from cachexia syndrome and tumor respectively in the last year before death. CONCLUSION: Serum creatinine concentration, serum calcium, serum phosphorus,serum albumin and other indicators of MHD patients with different death causes within the last year of survival presented characteristic changes.
ABSTRACT
<p><b>OBJECTIVE</b>To probe into the application value of the height shortening value as the self-examination index of the middle-aged and aged group's osteoporosis or reduced bone mineral density in communities.</p><p><b>METHODS</b>Four communities were selected by cluster sampling at random in Changsha city to be the objects of study, among which women were 45 years old or older and men were 60 years old. Difference and the percentage proportion of the height shortening between the height of the research objects which was measured at their youth and the height measured at this study, were calculated. Mineral density of the anteroposterior lumber spine L2-L4, the left femur neck of each object of study with the DPX-IQ dual energy X-ray (DEXA) were both examined. Results examined by DEXA were recognized as "Golden Standards" and different absolute and relative height shortening values were taken as positive cutoff points. Sensitivity, specificity and Youden's index were calculated to draw the receiver operator characteristic curve in order to get the positive cutoff which was most suitable to both sensitivity and specificity, and to calculate the predicative values of that self-examination method among different groups.</p><p><b>RESULTS</b>3 cm of height shortened seemed to be the positive cutoff of the self-examination of osteoporosis, and its sensitivity, specificity and Youden's index were 75.4%, 76.7% and 0.521 respectively. 2 cm of height shortened was suggested as the positive cutoff of the self-examination method of reduced bone mineral density, while its sensitivity, specificity and Youden's index were 81.7%, 75.6% and 0.573 respectively. In this self-examination method, positive predicative value was the highest (76.4%; 88.7%) among the women group aged over 65.</p><p><b>CONCLUSION</b>Certain height-shortening value could be used as the rough index of screening osteoporosis of reduced bone mineral density, which set a simple and easy way of self-examination for the middle-aged and elderly population.</p>