1.The effectiveness of comprehensive rehabilitation treatment in patients with chronic renal failure
Chinese Journal of Physical Medicine and Rehabilitation 2003;0(04):-
Objective To observe the therapeutic effects of comprehensive rehabilitation treatment in patients with chronic renal failure (CRF). Methods Fifty patients with CRF were randomly and equally divided into a rehabilitation group and a control group. Those in the rehabilitation group were intervened with comprehensive rehabilitation protocol including regular counseling, health education and adequate aerobic exercise in addition to routine medications, while those in the control group with the routine medications only. The therapeutic effects were evaluated by means of Symptom Check List- 90(SCL- 90) and the questionnaire about quality of life (QOL) for patients with CRF, as well as such biochemical parameters as SCr, BUN, Ccr, DBP and SBP before and after treatment. Results Compared with those in the control group, the physiological capability and other relevant parameters of QOL in the rehabilitation group were significantly improved after one year of comprehensive rehabilitation, while SBP and DBP significantly decreased. There was no statistically significant changes of the concentrations of Scr, Bun, and Ccr. Conclusion Comprehensive rehabilitation intervention is superior to routine drug therapy in terms of improving the physiological capability, decreasing the BP and improving the QOL of the CRF patients.
2.Shear wave elastography in the evaluation of fibrosis degree in renal allograft
Daopeng YANG ; Yan WANG ; Bowen ZHUANG ; Xiaoer ZHANG ; Guangliang HUANG ; Wenfang CHEN ; Gang HUANG ; Xiaohua XIE
Chinese Journal of Ultrasonography 2020;29(10):875-880
Objective:To explore the value of shear wave elastography imaging(SWE) in the diagnosis of renal allograft fibrosis and analyze its advantages and limitations.Methods:The renal allograft of 61 patients who underwent renal allograft biopsy from June 2019 to April 2020 in the First Affiliated Hospital of Sun Yat-sen University were included in this study. According to the Banff classification, there were 51 patients with mild-degree fibration(interstitial fibrosis/tubular atrophy, IFTA 0-Ⅰ), and 29 patients with moderate or severe-degree fibration(IFTA Ⅱ-Ⅲ). Two-dimensional ultrasound, color Doppler flow imaging, SWE and kidney function test performed. All the results were compared between the two groups. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve using pathology as gold standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for the diagnosis of moderate or severe-degree fibration.Results:Compared to mild-degree fibration group, creatinine( P<0.001), glomerular filtration rate( P<0.001), RI of arcuate arteries( P=0.022) and SWE value( P<0.001) significantly increased in the moderate or severe-degree fibration group. There were significant correlations between IFTA and creatinine ( r s=0.488, P<0.001), glomerular filtration rate ( r s=-0.452, P<0.001), RI of arcuate arteries( r s=0.228, P=0.042), SWE value( r s=0.584, P<0.001). Taking the cutoff value of SWE value deduced by ROC curve as 21.7 kPa, the area under ROC curve was 0.827. The sensitivity, specificity, positive predictive value and negative predictive value were 86.2%, 74.5%, 61.0% and 89.7%, respectively. Conclusions:There is a good correlation between the SWE value and the degree of fibrosis in the transplanted kidney. SWE can be used to distinguish mild from moderate or severe fibrosis of renal allograft, providing a potential noninvasive method for the assessment of kidney allograft fibration.