ObjectiveTo preliminarily explore the effect of Osteoporosis Self-assessment Tool for Asians (OSTA) and Fracture Risk Assessment Tool (FRAX) on predicting osteoporosis and osteoporosis fracture in postmenopausal patients with maintenance hemodialysis (MHD).MethodsThirty-six postmenopausal patients undergoing MHD from August 2017 to October 2018 in Hemodialysis Center of Nephrology Department, West China Hospital of Sichuan University were selected. Relevant data such as age, height, and weight were collected. OSTA index and the 10-year probability of major osteoporotic fractures and 10-year probability of hip fractures of FRAX score were calculated. Bone mineral densities (BMD) of the hip and lumbar spine were measured by dual energy X-ray absorptiometry (DXA) at the same time. The value of OSTA index and FRAX scale in evaluating the risk of osteoporosis predicated on T value ≤?2.5 determined by DXA BMD and fracture in postmenopausal patients with MHD were analyzed.ResultsThe DXA BMD of the 36 patients showed that 50.0% (18/36) had a T value≤?2.5, and 30.6% (11/36) had a fracture history. BMD in postmenopausal patients with MHD was negatively correlated with FRAX score (model without BMD values), and positively correlated with OSTA index. The sensitivity and specificity of OSTA in the prediction of osteoporosis were 94.4% and 61.1%, respectively; and the sensitivity and specificity of FRAX (the model without BMD values) in the prediction of osteoporosis were 88.9% and 50.0%, respectively. The FRAX score with or without BMD had the same clinical value in predicting osteoporosis.ConclusionsPostmenopausal MHD patients have a higher risk of osteoporosis and fracture. Both OSTA index and FRAX scale can predict osteoporosis risk among postmenopausal MHD patients, and the FRAX scale with or without BMD has the same clinical value in predicting osteoporosis risk. In clinical work, for primary hospitals and dialysis centers lacking DXA, preliminary screening of osteoporosis in MHD patients can be performed with OSTA and FRAX scales.
ObjectiveTo investigate the effect of 24-week intradialytic progressive resistance exercise on hemoglobin and iron metabolism in maintenance hemodialysis (MHD) patients.MethodsFrom April to May 2019, 62 MHD patients were enrolled and randomly assigned into exercise group (n=31) and control group (n=31). Both groups of patients received regular routine hemodialysis, on that basis, patients in the exercise group completed intradialytic resistance exercise three times per week for 24 weeks. Each exercise included 8-10 muscle groups (grasping the grip ring with both hands, flexion and extension of the elbows and shoulders on the non-vascular side and lower limbs with sandbag), 3 sets of 15 repetitions with a rest of 1-2 min between 2 sets. Exercise began with a low load, the sandbag weight was gradually increased, and the Borg score was aimed to be 11-13 points after exercise. Hemoglobin, serum ferritin, transferrin saturation, serum creatinine, high-sensitivity C-reactive protein, urea clearance index, recombinant human erythropoietin (rHuEPO) dosage at baseline and after 24 weeks, as well as the cumulative iron supplement dose and hemoglobin variation of the two groups during the study period were evaluated.ResultsThere were 20 patients in the exercise group and 30 ones in the control group who completed the study. After 24 weeks of progressive resistance exercise, the medium (lower quartile, upper quartile) of the amount of rHuEPO in the exercise group decreased from 6 000 (6 000, 9 000) U/week to 6 000 (4 500, 7 125) U/week (Z=?2.599, P=0.009), while that in the control group had no statistically significant difference (Z=?1.340, P=0.180); there was no statistically difference in hemoglobin, hemoglobin coefficient of variation, serum ferritin, transferrin saturation, or 24-week cumulative iron supplementation between the two groups.ConclusionIntradialytic progressive resistance exercise can reduce the amount of rHuEPO in MHD patients, which is benefitial to optimizing the management of hemoglobin.
The coexistence of cognitive impairment and physical frailty in maintenance hemodialysis (MHD) patients is known as cognitive frailty. It has emerged as a novel complication in MHD patients and increases the risk of adverse outcomes such as falls, fractures, functional impairment and death. Timely intervention can delay or even reverse the development of cognitive frailty to dementia, thereby reducing the risk of adverse outcomes and improving the quality of life of patients. Based on this literature review method, this article summarizes the domestic and foreign research progress on the epidemiology, assessment tools, influencing factors and intervention measures of cognitive frailty in MHD patients, aiming to provide reference for clinical staff to carry out early screening and intervention of cognitive frailty in MHD patients.
Objective To investigate the awareness and clinical needs of wearable artificial kidney among maintenance hemodialysis (MHD) patients, and to analyze the related influencing factors. Methods MHD patients were recruited from 2 tertiary hospitals in Sichuan province between April and June 2021. The convenient sampling method was used to select patients. The factors influencing the awareness and demand of MHD patients for wearable artificial kidney were analyzed. Results A total of 119 MHD patients were included. The awareness of wearable artificial kidney among the patients was mainly “never heard” (61 cases) and “heard” (58 cases). Most MHD patients (60 cases) were willing to use and participate in clinical trials in the future. The results of logistic regression indicated that the cost on household economy and treatment effect on life quality were the influencing factors for MHD patients’ awareness of wearable artificial kidney (P＜0.05). The average duration of single dialysis and the impact of treatment on working or studying were the influencing factors for MHD patients’ needs of wearable artificial kidney (P＜0.05). Conclusions The awareness of wearable artificial kidney is low among MHD patients. However, most MHD patients showed great interest in the wearable artificial kidney after preliminary understanding, suggesting that the future clinical application of wearable artificial kidney has great demand.
Objective To explore the current status of electronic health (eHealth) literacy and online health information seeking behavior of maintenance hemodialysis (MHD) patients, and to explore the relationship between them. Methods MHD patients in the Hemodialysis Center of West China Hospital of Sichuan University between January and April 2022 were selected by convenient sampling method. The patients were investigated with general condition questionnaire, eHealth Literacy Scale and internet health information retrieval behavior questionnaire. According to the score of eHealth literacy, patients were divided into high eHealth literacy group and low eHealth literacy group, to compare the differences between the two groups, and analyze the factors that affected the internet health information retrieval behavior. Results A total of 194 MHD patients were included. Among them, 112 were male and 82 were female. The average score of eHealth literacy was 24.84±9.24. There were 136 cases in low eHealth literacy group, and the average score of eHealth literacy was 20.76±7.91. There were 58 cases in high eHealth literacy group, and the average score of eHealth literacy was 34.36±3.01. Multivariate analysis showed that eHealth literacy and education level were the influencing factors of health information search behavior (P<0.05). Conclusions The overall eHealth literacy of MHD patients is low, and the online health information search means is single and behaviorally inconsistent. It is necessary to improve the eHealth literacy of hemodialysis patients, and at the same time, provide various health information publicity and education for patients with different levels of eHealth literacy, which will help them better carry out disease management.
Protein-energy wasting is one of the common complications of maintenance hemodialysis patients. It often causes decreased immune function, increased anemia, and decreased heart, brain, lung and other organ functions, resulting in decreased quality of life, decreased long-term survival rate, and increased mortality. This article discusses the causes, diagnosis, evaluation methods, intervention and prevention of protein-energy wasting in maintenance hemodialysis patients, and aims to provide a theoretical basis for evaluating the nutritional status, early intervention for protein-energy wasting, and improving prognosis and quality of life of maintenance hemodialysis patients.
Objective To investigate the correlation between grip strength and subjective cognitive decline (SCD) in maintenance hemodialysis (MHD) patients of different genders. Methods Patients who underwent outpatient MHD in the Wenjiang Hemodialysis Unit, Department of Nephrology, West China Hospital, Sichuan University between March and June 2024 were selected as the research subjects. Multiple linear regression analysis was used to explore the relationship between grip strength and SCD in MHD patients of different genders. Results A total of 171 patients were investigated, with 76 in the non-SCD group and 95 in the SCD group. The results of multiple linear regression analysis showed that educational level (P=0.039), nutritional status (P=0.026), and grip strength (P=0.042) were the influencing factors of SCD in male MHD patients. Work status (P=0.001) and nutritional status (P=0.011) were the influencing factors of SCD in female MHD patients. Conclusions Educational level, nutritional status, and grip strength are influencing factors of SCD in male MHD patients. Work status and nutritional status are influencing factors of SCD in female MHD patients. Grip strength may serve as an indicator for evaluating SCD in male MHD patients.
Objective To explore the current situation and influencing factors of self-regulatory fatigue in maintenance hemodialysis (MHD) patients, so as to provide good dialysis treatment for MHD patients, reduce their level of self-regulated fatigue and improve their quality of life. Methods The convenient sampling method was used to select the MHD patients in the Wenjiang Hemodialysis Center of West China Hospital of Sichuan University between April 12 and April 30, 2022. The patients were investigated by self-made basic information scale and self-regulatory fatigue scale. Results A total of 131 patients were included. The average score of self-regulatory fatigue was 53.47±6.45, cognitive dimension was 20.21±2.39, emotional dimension was 20.85±2.85, behavioral dimension was 12.40±3.63. The results of multiple linear stepwise regression analysis showed that age, duration of dialysis and educational background could inversely predict the score of self-regulatory fatigue (P<0.05). Conclusions MHD patients have a high level of self-regulatory fatigue. Clinical nurses can make individual dialysis programs according to the actual situation of MHD patients, improve their self-regulated level and physical and mental health, and improve the quality of life of MHD patients.
ObjectiveTo investigate the level and influencing factors of self-management behaviors among maintenance hemodialysis patients.MethodsPatients undergoing maintenance hemodialysis were recruited from 4 tertiary hospitals in Chengdu from October 2016 to October 2017. Convenient sampling method was used to select patients. The instruments used in the study included General Information Questionnaire, Hemodialysis Self-management Instrument, Hemodialysis-related Knowledge Questionnaire, Herth Hope Index, Multidimensional Health Locus of Control Scale, and Chronic Illness Resources Survey.ResultsA total of 360 patients were investigated, and 343 patients were finally included. The mean score of self-management behavior was 54.87±9.65. The results of multiple linear stepwise regression showed that gender, age, ethnic, monthly family income, chronic illness resources, knowledge and internal health locus of control were the significant influencing factors of self-management behaviors (P<0.05).ConclusionThe self-management behavior among patients undergoing maintenance hemodialysis can be promoted by improving the level of knowledge and internal health locus of control, and making effective use of chronic illness resources.
Objective To understand the incidence of frailty in maintenance hemodialysis (MHD) patients, and to explore the correlation and influencing factors of frailty in MHD patients, so as to provide some basis for the intervention of frailty in MHD patients. Methods Patients who underwent MHD in the Department of Nephrology of West China Hospital of Sichuan University from January to March 2021 were selected. Frail scale and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation, and the influencing factors of frail in patients with MHD and its correlation with frail were analyzed. Results A total of 141 patients with MHD were included, including 57 cases without frailty (40.43%), 71 cases in early frailty (50.35%), and 13 cases in frailty (9.22%). 54 cases (38.30%) had very good sleep quality, 56 cases (39.72%) had good sleep quality, 24 cases (17.02%) had average sleep quality, and 7 cases (4.96%) had very poor sleep quality. The frailty of MHD patients was positively correlated with age (rs=0.265, P=0.002), PSQI (rs=0.235, P=0.005) and magnesium (rs=0.280, P=0.001). Logistic regression analysis showed that the influencing factors of MHD patients’ frailty were gender [odds ratio (OR) =4.321, 95%confidence interval (CI) (1.525, 12.243), P=0.006], PSQI [OR=1.110, 95%CI (1.009, 1.222), P=0.032], magnesium [OR=122.072, 95%CI (4.752, 3 135.528), P=0.004], hypertension [OR=0.112, 95%CI (0.023, 0.545), P=0.007] and other diseases [OR=0.102, 95%CI (0.019, 0.552), P=0.008]. Conclusions The incidence of frailty in MHD patients is high. Gender, PSQI, magnesium, hypertension and other diseases are the influencing factors of frailty in MHD patients, and there is a correlation between frailty and sleep. It is suggested that renal medical staff should pay more attention to the assessment of MHD frailty and sleep, and carry out multi-disciplinary personalized intervention to improve the quality of life of MHD patients.
