RESUMO
Objective:To investigate the characteristics of cardiac structure and function changes in maintenance hemodialysis (MHD) patients.Methods:The information of 363 MHD patients with dialysis age ≥3 months who were registered in Huadu District People′s Hospital of Guangzhou City before January 2020 was collected, and the echocardiographic screening was performed to analyze the changes in cardiac structure and function.Results:The most common abnormal changes of heart structure and function in MHD patients were valve regentation (69.7%), left ventricular hypertrophy (LVH) (51.8%), left ventricular diastolic dysfunction (29.8%), valve calcification (11.6%), and left ventricular systolic dysfunction (10.2%). With the increase of age, the left ventricular ejection fraction of MHD patients decreased, and the proportion of left ventricular diastolic dysfunction, left atrial enlargement and pulmonary hypertension increased (all P<0.05). Among 363 MHD patients, 188(51.8%) had LVH. It was found that LVH patients had higher average single ultrafiltration volume, higher brain natriuretic peptide (BNP) level, more type 2 diabetes, lower left ventricular ejection fraction (all P<0.05), and were more prone to chest tightness, chest pain, post activity shortness of breath, heart failure and other symptoms compared with the non-LVH patients (all P<0.05). Conclusions:Most MHD patients have different degrees of cardiac structural changes. Early intervention, reduction of single ultrafiltration volume and control of blood glucose are beneficial to improve the dialysis quality of MHD patients and reduce the occurrence of cardiovascular events.
RESUMO
Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.