ABSTRACT
Objective:To investigate the prevalence of chronic constipation in maintenance hemodialysis (MHD) patients and analyze the risk factors of chronic constipation.Methods:Using the cross-sectional survey method, patients who received MHD in Huadu District People′s Hospital of Guangzhou from September 1, 2021 to September 30, 2021 were enrolled as the research objects. The patient′s demographic, general data and laboratory results were collected. The anxiety level and quality of life were assessed by questionnaires. The patients were divided into constipation group and non-constipation group according to whether they had chronic constipation. The Rome Ⅳ criteria was used to diagnose chronic constipation, and the differences of clinical data between the constipation group and the non-constipation group were compared. The risk factors of chronic constipation in MHD patients were analyzed by logistic regression analysis method.Results:A total of 321 MHD patients were enrolled in this study, with 168 males, 153 females and age of (59.5±13.4) years old (ranged from 29 to 87 years old). There were 160 patients (49.8%) with chronic constipation. The proportions of males, long dialysis age, taking sevelamer and lanthanum carbonate, diabetic nephropathy, and diabetes in the constipation group were higher than those in the non-constipation group, and the differences between the two groups were statistically significant (all P<0.05). The serum calcium, serum phosphorus, calcium-phosphorus product, anxiety scores, average weekly ultrafiltration volume/dry weight in the constipation group were significantly higher than those in the non-constipation group (all P<0.05), and the serum albumin, serum magnesium, urea clearance index (Kt/V) and geriatric nutritional risk index were significantly lower than those in the non-constipation group (all P<0.05). The results of logistic regression analysis showed that moderate to severe anxiety (moderate, OR=3.233, 95% CI 1.339-7.805, P=0.009; severe, OR=5.103, 95% CI 1.906-13.663, P=0.001), existed risk of nutrition (low risk, OR=3.705, 95% CI 1.440-9.533, P=0.007; moderate risk, OR=5.638, 95% CI 2.557-12.430, P<0.001; severe risk, OR=15.097, 95% CI 4.112-55.436, P<0.001), >60 years old (≤40 years old as a reference, OR=4.050, 95% CI 1.366-12.006, P=0.012), diabetes history ( OR=2.224, 95% CI 1.253-3.946, P=0.006), taking sevelamer ( OR=2.290, 95% CI 1.207-4.346, P=0.011), and calcium-phosphorus product ( OR=1.704, 95% CI 1.329-2.186, P<0.001), intact parathyroid hormone ( OR=1.013, 95% CI 1.003-1.022, P=0.007), blood urea nitrogen ( OR=1.092, 95% CI 1.002-1.189, P=0.045) and serum magnesium ( OR=0.042, 95% CI 0.006-0.294, P=0.001) were the independent influencing factors for chronic constipation in MHD patients. Conclusions:The prevalence of chronic constipation in MHD patients is 49.8%. Adequate dialysis, improving calcium and phosphorus metabolism, improving nutritional status, relieving anxiety, and increasing serum magnesium level may help to reduce the risk of chronic constipation in MHD patients.
ABSTRACT
Objective:To analyze the effect of percutaneous transluminal angioplasty (PTA) in the treatment of autogenous arteriovenous fistula (AVF) stenosis and influcing factors of restenosis/loss of function after PTA.Methods:The medical records of 104 patients with AVF stenosis treated by PTA in People′s Hospital of Huadu District from March 2019 to July 2020 and the 1-year follow-up were retrospectively analyzed. Kaplan-meier curves were used to analyze the primary patency rates at 3 months, 6 months and 1 year. COX regression was used to analyze the influencing factors of restenosis/loss of function after PTA.Results:The primary patency rates of AVF at 3, 6 and 12 months after PTA were 86.2%, 83.2% and 64.7%, respectively. Guide wire entry into the distal end of radial artery, the use of two balloons in stepwise mode, postoperative dilatation diameter, and dialysis blood flow after PTA were independent risk factors for restenosis/loss of fuction after PTA for AVF stenosis (all P<0.05). Conclusions:The guide wire into the distal end of the artery and passive use of more than two balloons are important factors affecting AVF restenosis/loss of function after PTA .