Objective To compare the one?year survival rates of maintenance hemodialysis (HD) patients with different quality of life, and analyze related factors affecting the prognosis of patients. Methods Patients on hemodialysis for at least 3 months were enrolled. A short form 36 health survey questionnaire (SF?36) and Pittsburgh sleep quality index (PSQI) were used to evaluate the quality of life and quality of sleep. To observe one?year all?cause mortality and Cox regression model was used to analyze the factors associated with survival outcomes. Results A total of 159 patients undergoing hemodialysis were included, in which 136 patients completed the follow?up after one?year observation. The one?year survival rate in patients with both high physical component summary (PCS) and mental component summary (MCS) scores was significantly better than the patients with low PCS and MCS scores (P﹤0.05). PCS, hemoglobin and serum albumin were the protection factors for HD patients. Conclusions Quality of life is strongly associated with prognosis in HD patients. Enhancing quality of life is of clinical significance in the improvement of HD patients' survival rate.

(0.05)).Conclusions Losartan can only effectively hypertension following renal transplantation,but also obviously lessen slight hyperuricemia.

OBJECTIVE: To study the effect of continuous renal replacement therapy on acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. METHODS: A patient was complicated with acute renal failure, severe acute pancreatitis, lung infection, bleeding in anastomosisbetween duodenum and jejunum, and peritonitis following simultaneous pancreas-kidney transplantation. He was treated with immunosuppressor, antibiotics, amylopsin inhibitor, haemostatic and alimentation; at the same time, he was treated with continuous renal replacement therapy for 22 days. The Baxter system was used for continuous venovenous hemofiltration. RESULTS: The vital signs and hemodynamic indicators were stable during continuous renal replacement therapy. Pulmonary edema was well controlled, and acid-base equilibrium of water electrolyte was maintained. The function of vital organs was stableand graft function was normal following continuous renal replacement therapy for 22 days. He was completely cured and out of hospital on day 40. CONCLUSION: Continuous renal replacement therapy plays an important role in treating acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. Thus, it is a well kidney support for ultaneous pancreas-kidney transplantation.

Objective To observe the influence of highflux hemodialysis(HFD)on homocysteine(Hcy) level and major cardiovascular events of maintenance hemodialysis (MHD) patients. Methods Patients eligible for inclusion were randomly divided into HFD group and low flux hemodialysis(HD)group with 30 cases in each group. Patient′s serum homocysteine (Hcy),major cardiovascular events and various clinical indicators were observed for 12 months then the data were analyzed. Results Hcy baseline levels in 2 groups(21.02 ± 11.79 mmol/L vs. 19.86 ± 6.97 mmol/L)indicated no significant difference(P = 0.162)before hemodialysis but Hcy levels had significant difference(20.29 ± 11.45 mmol/L vs. 24.57 ± 13.23 mmol/L),(P=0.045)after 12-month observation. There was lower incidence of major cardiovascular events in HFD when compared to that in HD group (10.0% vs. 33.3%) which showed significantly statistical difference (P=0.034),and there was no mortality in HFD group but 1 case of death in HD group. All-cause mortality in 2 groups showed no significant difference (P > 0.05). Conclusion Long-term HFD treatment significantly reduces Hcy levels and the incidence of major cardiovascular events of MHD patients

Objective To investigate renal histopathological changes and cli ni cal characteristics in 20 women with preeclamptic nephropathy or gestational pro teinuria.Methods Between 1999 and 2002, 20 women who suffered from preeclampsia or proteinuria during pregnancy underwent postpartum renal biopsies from fifth d ay to third month after delivery. One woman repeated her renal biopsy half year later. Each biopsy specimen was divided into three parts,and processed and stain ed for conventional light microscopy(LM), immunohistology (IH) and electron micr oscopy (EM) examination. The clinicopathological data were studied and women wer e followed up after discharge for a long time. Results Sixteen of 20 women were diagnosed as preeclampsia, whose altered glomeruli demonstrated a typical endoth elial lesion (endotheliosis), and mild to moderate proliferation of mesangial ce lls. IH revealed either negative or mild IgG、IgM and C3 deposits. Focal glomeru losclerosis (FGS) was observed in one of 16 cases, whose microproteinuria (0 49 g/24 h) lasted for more than one year, meanwhile the proteinuria of other 15 wo men disappeared completely within 3～6 months after delivery. Besides, one was I gA nephropathy (IgAN) complicated preeclamptic nephropathy, whose proteinuria de creased obviously after delivery, but remained microhematuria, and endothelial l esion disappeared in repeat biopsy after half year. One was IgAN and received a treatment of adrenocorticosteroid and immunosupressive agents because of macropr oteinuria. One was mild mesangial proliferative glomerulonephritis presenting co nstant microhematuria and microproteinuria. One was typeⅠmembranous nephropathy , whose proteinuria decreased remarkably after delivery as well. Conclusions Ren al histopathological changes of preeclampsis are typical endothelial lesion, and often recover completely within 6 months after delivery. Recovery may be delaye d in the case of FGS accompanied. Pregnancy may aggravate primary renal damage w hich will be improved after delivery. Postpartum renal biopsy is safe and benefi cial to early diagnosis, treatment and prognosis.

This paper retrospectively analyzed the clinical manifestation,diagnostic method,as well as the clinical treatment of 8 cases,who suffered complicated tuberculosis infection following renal transplantation.Of the 8 cases,2 cases showed blood Tb-Ab positive,1 case was positive to antiacid bacillus of sputum,the rest cases with negative TBAb.3 patients with 2 showed organs infection,6 patients passed the tissue biopsy diagnose,body temperature of 6 cases fall to normal after 3-7 days of antituberculotic treatment,mild liver dysfunction appeared in 2 patients,hyperuricemia occurred in 7 patients,in addition,1 patient developed reject reaction.Among all the cases,7 cases healed,1 died of pulmonary fungal infection.The result showed that minimal invasive tissue biopsy offers reliable basis for early diagnosis and treatment of disease.

OBJECTIVE: To investigate the effect of Losartan and Amlodipine on serum and urine transforming growth factor -β_1 in patients undergoing kidney transplantation. METHODS: A total of 40 patients with mild or moderate hypertension (systolic pressure 140-170 mm Hg, and diastolic pressure 85-100 mm Hg, 1 mm Hg=0.133 kPa) following primary kidney transplantation were selected from First People's Hospital of Foshan, including 23 males and 17 females aged (38.6±19.2) years. They were randomly divided into two groups (n=20): Losartan group (oral administration 50 mg per day) and Amlodipine group (oral administration 5 mg per day). The blood pressure of patients should be controlled below 130/80 mm Hg. The blood pressure, renal function, 24 h-proteinuria, serum and urine transforming growth factor-β_1 6 months after medication were observed. RESULTS: A total of 40 patients were included in the final analysis. The systolic pressure and diastolic pressure of patients were decreased after administration (P < 0.05) and decreased to normal levels 6 months after administration (P < 0.01). During treatment, there were significant differences in blood pressure decrease and mean arterial pressure between two groups (P > 0.05). No difference was found in total efficacy between two groups (P > 0.05). In addition, blood urea nitrogen, creatinine, and blood uric acid did not significantly alter after treatment in two groups (P > 0.05). After 6 months of treatment, 24 h-proteinuria, serum and urine transforming growth factor -β_1 in Losartan group were significantly decreased compared with before treatment (P < 0.05), while no obvious changes were found in Amlodipine group (P > 0.05). The 24 h-proteinuria, serum and urine transforming growth factor-β_1 in Iosartan group were significantly less than Amlodipine group (P < 0.05).CONCLUSION: Both Losartan and Amlodipine effectively controlled hypertension of patients following kidney transplantation, but Losartan significantly decreased 24 h-proteinuria, serum and urine transforming growth factor-β_1 compared with Amlodipine.

OBJECTIVE: To report the current situation of dialysis and transplantation in Foshan City. METHODS: A total of 18 hospitals performed dialysis filled the registration forms, which comprised situations of hospital, staff establishment, blood purification developing, blood purification equipments, hemodialysis patients, peritoneal dialysis patients, and acute renal failure patients. The registration time was form the beginning to ending of 2007, and the information was statistical analyzed.RESULTS: Totally 18 hospitals in Foshan district performed hemodialysis and 6 of them offered peritoneal dialysis simultaneously. There were 155 hemodialysis machines, 6 CRRT machines, and 15 dialyser reuse devices. Totally 1 718 patients received dialysis in 2007 year, including 93.60% hemodialysis patients and 6.40% peritoneal dialysis patients. Until the end of 2007, 1011 patients were received dialysis treatment, including 90.60% hemodialysis and 9.40% peritoneal dialysis. Glomerulonephritis (47.1%) was still the first primary disease of dialysis, then diabetic nephropathy (28%), third arteriosclerosis nephropathy (9.7%), fourth obstructive nephropathy (3.2%). Totally 743 hemodialysis patients stopped treating for reasons of death, improvement or recovery, changed to peritoneal dialysis, kidney transplantation, transfer, economics and lost follow-up, accounted for 20.3%, 20.1%, 7.2%, 4.1%, 21.5%, 20.2% and 6.6%, respectively. Cerebrovascular disease, cardiovascular disease, infection, dystrophy, synthetic factors and other were the main reasons for death, which accounted for 16.6%, 28%, 17.2%, 3.2%, 18.4% and 16.6%. A total of 16 patients stopped peritoneal dialysis for death (68.7%), improvement or recovery (18.7%), changed to hemodialysis (7.1%), or lost follow-up (6.3%). The causes of death were cerebrovascular disease (21.4%), cardiovascular disease (7.1%), infection (28.6%) and others (42.9%).CONCLUSION: There are 18 hospitals can perform dialysis treatment in Foshan district. Glomerulonephritis, diabetic nephropathy, arteriosclerosis nephropathy and obstructive nephropathy are the first four primary diseases of dialysis. Cerebrovascular disease and infection are the main causes of death.

AIM: To detect the expression of connective tissue growth factor (CTGF), transforming growth factor-?_1 (TGF-?_1) and ?-smooth muscle actin (?-SMA) in rat unilateral ureteral obstructive (UUO) nephropathy animal model, and to observe the kinetic changes at different stages of firosis. METHODS: Male SD rats were subjected to either left ureteral ligation or sham operation, then killed at 3, 7, 14, 21 or 28 days after UUO or sham operation (n=6 at each time point). HE, Masson or PAS staining were applied to the renal tissue sections. The extent of tubulointerstitial injury was determined by Banff classification. RESULTS: The extent of tubulinterstitial fibrosis became serious with the time of obstruction. Tubules were mostly atropic and replaced by proliferative fibrous tissue at day 28. The expression of CTGF and ?-SMA were consistent with the damage of tubulointerstitial. The positive correlation among CTGF or ?-SMA and the tubulointerstitial injury scores were significant. The expression of TGF-?_1 came to peak at day 7 to 14, and gradually decreased at day 21 and 28. CONCLUSION: These results indicate that the expression of CTGF may be upregulated by TGF-? in UUO rats, and CTGF may be involved in tubulointerstitial fibrosis through the development of myofibroblasts.

Objective To discuss the application and significance of homocysteine (Hcy),renal function and serum lipid levels in renal transplantation,by testing those from patients after renal transplantation.Methods Hcy,creatinine (Cr),urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected in transplantation group(n=63) and control group(n=60).Serum Hcy,Cr and BUN of transplantation group were continuously monitored before and 1,3,7,14 days after operation,and the relationship between Hcy and renal function before and after renal transplantation were compared.Results Compared with control group,Hcy,Cr and BUN in transplantation group all increased and the difference between two groups was statistically significant (P<0.05).Hcy,Cr and BUN in transplantation group all decreased after renal transplantation and the differences between two groups had statistical significance (P<0.05).Compared with that before surgery,Hcy,Cr and BUN in transplantation group gradually reduced 1,3,7 and 14 days after surgery,and the differences were statistically significant (P<0.05).Cr and BUN were positively correlated with Hcy (r=0.627,P<0.05).TC and LDL-C in transplantation group were higher than that in control group and the differences had statistical significance (P<0.05) while the difference of TG and HDL-C didn′t have statistical significance (P>0.05).Conclusion Hcy,Cr and BUN can be used as monitoring indicators of efficacy after renal transplantation,also which can be used to observe the incidence and severity of hyperlipidemia.