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Objective To explore the efficacy and short-term complications of a modified technique to percutaneously insert a peritoneal dialysis catheter. Methods We reviewed the outcomes of 94 patients who underwent peritoneal dialysis catheterization between October 2017 and April 2020. Of these, 47 cases were placed by a conventional Seldinger technique, whereas 47 cases were placed by a modified technique based on the Seldinger method. The success rates of the catheter insertion and three-month postoperative complications were compared between these two groups. Results The catheter insertion success rates were comparable between the two groups: 93.6% in the conventional technique group and 97.9% in the modified technique group (p = 0.307). The incidence of postoperative catheter migration was lower using the modified technique (4.3%) than the conventional technique (18.3%) (p = 0.037). None of the patients in the modified technique group had postoperative dialysate leakage, whereas this occurred in 9.0% of patients in the conventional technique group (p = 0.036). There were no statistically significant differences in the incidence of postoperative bleeding, infection, or visceral damage between the two groups. Conclusions The modified Seldinger technique for percutaneous peritoneal dialysis catheter insertion reduced the short-term postoperative complications of catheter migration and dialysate leakage, with a comparable successful catheter insertion rate compared with the conventional Seldinger technique.

Secondary hyperparathyroidism (SHPT) is a common complication in patients with end-stage renal disease (ESRD) and parathyroidectomy (PTX) is an effective treatment for SHPT. To examine the differen...

Introduction Sclerostin has been reported to be a novel biomarker associated with the bone-vascular axis. In this study, we determined the relationships between serum sclerostin and all-cause mortality, the prevalence of cardiovascular events (CVEs), and coronary artery calcifications (CACs) in dialysis patients. Methods A total of 165 dialysis patients (84 hemodialysis [HD] and 81 peritoneal dialysis [PD]) were enrolled in this study. We performed multivariable linear regression analysis to test the relationships between serum sclerostin levels and demographics and clinical parameters. We also performed Cox proportional hazard regression analysis to determine independent predictors of overall survival and CVEs. Results The median serum sclerostin level was 250.9 pg/mL in dialysis patients. Kaplan–Meier analysis showed that both overall and CVE-free survival rates were significantly lower in the high serum sclerostin group (serum sclerostin level >250.9 pg/mL) compared to the low serum sclerostin group (serum sclerostin level ≤250.9 pg/mL) in patients with PD (p 0.05). Conclusions A low serum sclerostin was associated with better overall survival and lower prevalence of CVEs in patients with PD, but had no relationships in patients with HD. We found that serum sclerostin level was not correlated with CACs in either patients with HD or PD.

Much attention has been paid to the quality of life (QOL) in dialysis patients worldwide. However, differences in QOL between peritoneal dialysis (PD) and hemodialysis (HD) patients have not been clearly identified. The objectives of this study were to compare the differences of QOL between PD and HD patients, and to investigate factors contributing to QOL in the Chinese population.All patients who received PD or HD more than 3 months were enrolled in the study. The demographic and clinical data were also obtained. SF-36 was used to assess QOL.A total of 190 (91.8%) of 207 dialysis patients were enrolled in the study. PD patients had markedly lower scores on role-physical (RP) and bodily pain (BP) domains than HD patients, but had remarkably higher scores on role-emotional (RE) domain (p0.05). While the scores of physical component summary (PCS) and mental component summary (MCS) showed no differences between the two groups (p0.05). The results of the multiple linear regression analysis indicated that age and cerebrovascular disease had negative correlations with PCS (p0.01), whereas the serum prealbumin level had positive correlation with PCS (p0.05). The married status was negatively associated with MCS (p0.01). But the higher education level was positively associated with MCS (p0.01).There were no significant differences on QOL between the two dialysis modalities. The possible factors related to QOL were age, cerebrovascular disease, marital status, education, and serum prealbumin levels.

To study the risk factors for acute kidney injury (AKI) in-patients with acute myocardial infarction (AMI).A total of 1371 cases of adult in-patients with AMI in the First People's Hospital of Changzhou from January 2008 to December 2012 were retrospectively analyzed. Based on the occurrence of AKI diagnosed according to the 2012 KDIGO AKI criteria, they were divided into AKI group and non-AKI group and further into conservative treatment groups, coronary angiography (CAG) groups, and coronary artery bypass grafting (CABG) groups based on the timing of AKI occurrence, respectively. Related risk factors of AKI were analyzed by univariate and multivariate logistic regressions.410 (29.9%) developed AKI. Patients with AKI had significantly increased in-hospital mortality than patients without AKI. Multivariate logistic regression analysis showed that decreased baseline eGFR, increased fasting plasma glucose (FPG), use of diuretics and Killip grade IV were independent risk factors of AKI, while increased DBP on admission was a protective factor for patients in conservative treatment group. Decreased baseline eGFR, increased FPG, use of diuretics, intraoperative hypotension and acute infection were independent risk factors of AKI for patients in the CAG group. Decreased baseline eGFR, increased FPG, use of diuretics and low cardiac output syndrome after operation were independent risk factors of AKI for patients in the CABG group.AKI is a common complication and associated with increased mortality after AMI. Decreased baseline renal function, increased FPG and use of diuretics were common independent risk factors of AKI after AMI.

A high body mass index (BMI) is a positive predictor of outcome in hemodialysis. But reports for peritoneal dialysis (PD) have been less numerous. The aim of the present investigation was to study the association between BMI and survival among PD patients and to discuss the main risk factors affecting survival.A total of 159 patients who received PD from 1 January 2006 to 31 December 2010 at the Department of Nephrology in the Third Affiliated Hospital of Soochow University were enrolled in the study. Blood samples and baseline characteristics of the study cohort were obtained at the start of PD. Patient survival status was recorded through 31 December 2010.Patients were stratified into two groups as normal weight (BMI, 18.5-24.9) and overweight (BMI, 25.0-29.9). Kaplan-Meier survival curve revealed that the normal weight patients had survival advantage over overweight patients (p0.01, by log-rank test). Cox proportional hazard models revealed that BMI, age, diabetes mellitus, coronary vascular disease, congestive heart failure and lipoprotein(a) (Lp(a)) were significant risk factors associated with all-cause mortality (p0.05). After adjustment for these covariates, survival was consistently higher for normal weight patients (p0.01). Furthermore, the study demonstrated that normal weight patients had lower serum Lp(a) (p0.05), C-reactive protein (CRP) (p0.05), and peritonitis rate (p0.05) compared with overweight patients.The results indicated that normal BMI at the commencement of PD had significant survival advantage in our study. The mechanisms for this might be related to lower cardiovascular risk, less chronic inflammation, and peritonitis prevalence.