ObjectiveTo investigate the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease (CKD).MethodsA total of 336 patients with CKD were investigated by a general data questionnaire, the CKD Self-care Behavior Scale, Social Support Scale, Generalized Anxiety Self-assessment Scale, and 9-item Patients Health Questionnaire through WeChat platform, and the influencing factors of self-care behavior were explored by binary logistic regression analysis.ResultsThe median score of self-care behavior of CKD patients without dialysis was 60, and the patients with median and high level of self-care behavior accounted for 97.6%. The score of self-care behavior of CKD patients without dialysis was positively correlated with the total score of social support (r=0.210, P<0.001), objective support score (r=0.127, P=0.020), subjective support score (r=0.195, P<0.001), and social support utilization score (r=0.164, P=0.002), and negatively correlated with the anxiety score (r=–0.132, P=0.015), depression score (r=–0.230, P<0.001), body mass index (r=–0.181, P=0.001), and systolic blood pressure (r=–0.168, P<0.001). The results of binary logistic regression analysis showed that the influencing factors of non-dialysis CKD patients’ self-care behavior were gender [(odds ratio, OR)=2.179, 95% confidence interval, CI (1.134, 4.187), P=0.019], systolic blood pressure [OR=0.967, 95%CI (0.947, 0.987), P=0.002], and depression score [OR=0.844, 95%CI (0.765, 0.931), P=0.001].ConclusionsThe self-care behavior of CKD patients without dialysis is at the median and high level. Healthcare workers can improve the self-care behavior of CKD patients by reducing their negative emotions such as depression, and guiding patients to carry out blood pressure management, to delay the progress of the disease.
Objective
To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD).
Methods
Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed.
Results
The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026).
Conclusions
Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
Objective To compare the infection characteristics and pathogen resistance between dialysis and non-dialysis patients with chronic kidney disease (CKD) in West China Hospital of Sichuan University, and provide a reference for clinical diagnosis and treatment. Methods The clinical data of CKD patients with non-repeated etiological evidence admitted to West China Hospital of Sichuan University between January 2010 and December 2021 were retrospectively analyzed. The patients were divided into dialysis group and non-dialysis group according to treatment methods. The infection characteristics and pathogen resistance of the two groups were analyzed by WHONET 5.6 and SPSS 23 softwares. Results A total of 1387 patients with CKD with positive etiology were included, excluding coagulase-negative Staphylococcus, which was common contamination pathogens of bloodstream infections. There were 527 patients in the dialysis group and 860 patients in the non-dialysis group in this study. There was no significant difference in gender between the two groups (P>0.05). There were significant differences in age, disease stage and specimen type between the two groups (P<0.01). The pathogenic bacteria samples of dialysis patients were mainly blood (25.81%) and dialysate (44.02%), and Staphylococcus aureus was the main pathogenic bacteria. In the non-dialysis group, sputum (49.88%) and urine (35.47%) were the main contents. In main Gram-positive pathogens, there were high resistance rates to penicillin and cephalosporin, and high sensitive rates to vancomycin and linezolid. In Gram-negative pathogenic bacteria, there were high resistance rates to penicillins, the first generation cephalosporins and the third generation cephalosporins, and high sensitive rates to β-lactamase inhibitor compound preparation, the fourth generation cephalosporins and other antibiotics. Conclusions CKD patients are easy to be complicated with infections. In clinical practice, it is necessary to pay attention to pathogen culture results, and selectively use antibiotics based on drug sensitivity results. At the same time, medical staff in hemodialysis centers should pay attention to aseptic operation and hand hygiene to reduce the risk of concurrent infection in dialysis patients.
Chronic kidney disease (CKD) has been highlighted as one of the most important public health problems due to sharply climbing incidence and prevalence. To efficiently attenuate the disease burden and improve the disease management, not only active and effective treatment should be administrated, but also comprehensive follow-up nursing management with innovative and evolving spirits should be implemented. Thus dynamic changes of diseases could be acquired in time and patients are under appropriate medical instruction as soon as possible. This editorial is based on quickly developing medical big data resources and advanced internet techniques, from both aspects of patients and health care providers, briefly talking about integrated management strategy of CKD and its future development in China.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
In 2020, chronic kidney disease has become one of the top 10 causes of death in the world. More and more evidence shows that proper exercise rehabilitation is beneficial to the health of patients with chronic kidney disease, which can improve the survival rate and slow down the decline of renal function. However, existing studies have significant differences in form, intensity, duration, and specific implementation methods of sports rehabilitation, which need to be further standardized and unified. This article introduces the impact of exercise rehabilitation on patients with chronic kidney disease and the clinical application of Chinese traditional exercises in patients with chronic kidney disease, and mainly discusses the application experience of exercise rehabilitation characterized by “Three-in-one Taiji” in the Department of Nephrology of West China Hospital of Sichuan University. It aims to provide a basis for the model innovation of integrated management of chronic kidney disease in China.
Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
End-stage renal disease is a late complication of chronic kidney disease (CKD) and one of the leading causes of high mortality worldwide. Over the years, the impacts of gut microbiota and their associated uremic toxins on kidney diseases through the intricate “gut-kidney axis” have been extensively studied. However, translation of microbiome-related omics results into specific mechanisms is still a significant challenge. In this paper, we review the interaction between gut microbiome and blood purification, as well as the current microbiota-based therapies in CKD. Additionally, the current sequencing technologies and progresses in the gut microbiome research are also discussed.
The incidence of chronic kidney disease is on the rise and has become an important factor affecting global public health issues. The intake of sweet beverage remains high worldwide, which has been proved to be related to chronic health problems such as obesity, type 2 diabetes, some cancers and cardiovascular diseases. In recent years, some studies have found that a higher intake of sweet beverage is associated with chronic kidney disease and its risk factors. This article mainly reviews the current research status and potential mechanisms of the correlation between different types of sweet beverages and risk of chronic kidney disease.
