1.Analysis of the influencing factors for pruritus and construction of a nomogram prediction model in peritoneal dialysis patients
Rui YANG ; Shu ZHOU ; Jianxiong LIN ; Chunyan YI ; Xiao YANG ; Wei CHEN ; Haiping MAO
Chinese Journal of Nephrology 2025;41(4):258-265
Objective:To explore the influencing factors for skin pruritus and to construct a nomogram prediction model in peritoneal dialysis (PD) patients.Methods:It was a retrospective cross-sectional investigation study. The PD patients who were regularly followed up between July, 2023 and April, 2024 in PD center of the First Affiliated Hospital of Sun Yat-sen University were enrolled in this study. The pruritus status was evaluated by the 14-Item UP-Dial Scale. The general demographic data and clinical data were collected. The patients were divided into pruritus group and non-pruritus group according to the presence or absence of skin itching. The differences of clinical data and laboratory results were compared between the two groups. Logistic regression was used to analyze the associated factors for pruritus in PD patients. The nomogram model was constructed by R software. The receiver operating characteristic (ROC) curve analysis and the Hosmer-Lemeshow goodness-of-fit test were used to evaluate the performance of the model, and its clinical effectiveness was evaluated using the calibration curve.Results:A total of 315 PD patients were enrolled in this study, with age of (48.0±12.9) years, including 134 females (42.5%). Among them, 161 patients (51.1%) experienced skin pruritus. Of whom, 111 patients (68.9%) had mild pruritus, 34 patients (21.1%) had moderate pruritus, 16 patients (9.9%) had severe pruritus. The age ( t=-2.266, P=0.024), proportion of diabetes mellitus ( χ2=3.910, P=0.048), Charson comorbidity index ( Z=-2.458, P=0.014), blood eosinophil percentage ( Z=-2.385, P=0.017), C-reactive protein ( Z=-2.590, P=0.010), serum phosphorus ( Z=-3.233, P=0.001) and β2 microglobulin ( Z=-2.756, P=0.006) level in the pruritus group were higher than those in the non-pruritus group, and the measured glomerular filtration rate (mGFR) level ( Z=-3.708, P<0.001) of patients in the pruritus group was lower than that in the non-pruritus group. There were 262 patients in the training set and 53 patients in the validation set. The multivariate logistic regression analysis in the training set revealed that advanced age ( OR=1.032, 95% CI 1.010-1.054, P=0.004), lower mGFR ( OR=0.758, 95% CI 0.648-0.886, P<0.001), higher serum phosphorus ( OR=2.761, 95% CI 1.282-6.024, P=0.010), and elevated blood eosinophil percentage ( OR=1.098, 95% CI 1.012-1.191, P=0.025) were independent factors associated with pruritus in PD patients. The nomogram model constructed based on these indicators demonstrated good discrimination and calibration. In the training set, the area under the ROC curve ( AUC) was 0.757 (95% CI 0.699-0.816), with Hosmer-Lemeshow test χ2=4.979, P=0.760. In the validation set, the AUC was 0.779 (95% CI 0.651-0.907), and Hosmer-Lemeshow test χ2=12.938, P=0.114. Conclusions:The prevalence of skin pruritus is 51.1% in PD patient. Advanced age, lower mGFR, higher serum phosphorus and higher blood eosinophil percentage are the independent influencing factors for pruritus in PD patients. The nomogram model constructed based on these indicators shows excellent predictive performance for skin pruritus in PD patients.
2.Relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis
Shan LYU ; Chunyan YI ; Shuchao LU ; Xiao YANG ; Haiping MAO ; Wei CHEN ; Jianxiong LIN
Chinese Journal of Nephrology 2025;41(11):811-816
Objective:To analyze the relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis (PD).Methods:In this cross-sectional study, the patients undergoing maintenance PD therapy for more than 3 months at the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University, from May to October 2023 were recruited retrospectively. The social dysfunction screening scale and family support self-rating scale were used to evaluate the social dysfunction and family support of PD patients, respectively. The social demographic and clinical data of the patients were collected. Logistic regression analysis model was used to identify associated factors of social dysfunction in PD patients.Results:A total of 359 PD patients were recruited with age of (42.6±9.5) years old. Among them, 197 patients (54.9%) were males, and 33 patients (9.2%) were complicated with diabetes. The dialysis age was 28.8 (13.5, 56.3) months. The score of social function was 2 (1, 4), and the score of family support was (10.5±2.2). There were 199 patients (55.4%) having social dysfunction. There were 224 patients (62.4%) employed after PD. Compared with the normal social function group, the social dysfunction group had significantly lower score in family support ( Z=-2.613, P=0.009), serum potassium ( t=-2.725, P=0.007), urea clearance index ( Z=-2.346, P=0.019) and proportions of married status ( χ2=6.847, P=0.009), pre-dialysis employment ( χ2=3.996, P=0.046) and post-dialysis employment ( χ2=8.331, P=0.004), and higher serum creatinine ( Z=2.175, P=0.030), and proportions of annual household income < 100 000 yuan ( χ2=6.270, P=0.012) and diabetes mellitus ( χ2=4.400, P=0.036). Multivariate logistic regression analysis revealed that family support ( OR=0.828, 95% CI 0.733-0.935, P=0.002), diabetes mellitus ( OR=3.551, 95% CI 1.456-8.658, P=0.005) and serum potassium ( OR=0.559, 95% CI 0.374-0.835, P=0.005) were independent correlated factors of social dysfunction in young and middle-aged PD patients. Conclusions:The prevalence of social dysfunction is 55.4%, and the employment rate is 62.4% in young and middle-aged PD patients. Poor family support, diabetes mellitus and decreased serum potassium level are independently associated with social dysfunction in young and middle-aged PD patients.
3.Analysis of the influencing factors for pruritus and construction of a nomogram prediction model in peritoneal dialysis patients
Rui YANG ; Shu ZHOU ; Jianxiong LIN ; Chunyan YI ; Xiao YANG ; Wei CHEN ; Haiping MAO
Chinese Journal of Nephrology 2025;41(4):258-265
Objective:To explore the influencing factors for skin pruritus and to construct a nomogram prediction model in peritoneal dialysis (PD) patients.Methods:It was a retrospective cross-sectional investigation study. The PD patients who were regularly followed up between July, 2023 and April, 2024 in PD center of the First Affiliated Hospital of Sun Yat-sen University were enrolled in this study. The pruritus status was evaluated by the 14-Item UP-Dial Scale. The general demographic data and clinical data were collected. The patients were divided into pruritus group and non-pruritus group according to the presence or absence of skin itching. The differences of clinical data and laboratory results were compared between the two groups. Logistic regression was used to analyze the associated factors for pruritus in PD patients. The nomogram model was constructed by R software. The receiver operating characteristic (ROC) curve analysis and the Hosmer-Lemeshow goodness-of-fit test were used to evaluate the performance of the model, and its clinical effectiveness was evaluated using the calibration curve.Results:A total of 315 PD patients were enrolled in this study, with age of (48.0±12.9) years, including 134 females (42.5%). Among them, 161 patients (51.1%) experienced skin pruritus. Of whom, 111 patients (68.9%) had mild pruritus, 34 patients (21.1%) had moderate pruritus, 16 patients (9.9%) had severe pruritus. The age ( t=-2.266, P=0.024), proportion of diabetes mellitus ( χ2=3.910, P=0.048), Charson comorbidity index ( Z=-2.458, P=0.014), blood eosinophil percentage ( Z=-2.385, P=0.017), C-reactive protein ( Z=-2.590, P=0.010), serum phosphorus ( Z=-3.233, P=0.001) and β2 microglobulin ( Z=-2.756, P=0.006) level in the pruritus group were higher than those in the non-pruritus group, and the measured glomerular filtration rate (mGFR) level ( Z=-3.708, P<0.001) of patients in the pruritus group was lower than that in the non-pruritus group. There were 262 patients in the training set and 53 patients in the validation set. The multivariate logistic regression analysis in the training set revealed that advanced age ( OR=1.032, 95% CI 1.010-1.054, P=0.004), lower mGFR ( OR=0.758, 95% CI 0.648-0.886, P<0.001), higher serum phosphorus ( OR=2.761, 95% CI 1.282-6.024, P=0.010), and elevated blood eosinophil percentage ( OR=1.098, 95% CI 1.012-1.191, P=0.025) were independent factors associated with pruritus in PD patients. The nomogram model constructed based on these indicators demonstrated good discrimination and calibration. In the training set, the area under the ROC curve ( AUC) was 0.757 (95% CI 0.699-0.816), with Hosmer-Lemeshow test χ2=4.979, P=0.760. In the validation set, the AUC was 0.779 (95% CI 0.651-0.907), and Hosmer-Lemeshow test χ2=12.938, P=0.114. Conclusions:The prevalence of skin pruritus is 51.1% in PD patient. Advanced age, lower mGFR, higher serum phosphorus and higher blood eosinophil percentage are the independent influencing factors for pruritus in PD patients. The nomogram model constructed based on these indicators shows excellent predictive performance for skin pruritus in PD patients.
4.Relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis
Shan LYU ; Chunyan YI ; Shuchao LU ; Xiao YANG ; Haiping MAO ; Wei CHEN ; Jianxiong LIN
Chinese Journal of Nephrology 2025;41(11):811-816
Objective:To analyze the relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis (PD).Methods:In this cross-sectional study, the patients undergoing maintenance PD therapy for more than 3 months at the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University, from May to October 2023 were recruited retrospectively. The social dysfunction screening scale and family support self-rating scale were used to evaluate the social dysfunction and family support of PD patients, respectively. The social demographic and clinical data of the patients were collected. Logistic regression analysis model was used to identify associated factors of social dysfunction in PD patients.Results:A total of 359 PD patients were recruited with age of (42.6±9.5) years old. Among them, 197 patients (54.9%) were males, and 33 patients (9.2%) were complicated with diabetes. The dialysis age was 28.8 (13.5, 56.3) months. The score of social function was 2 (1, 4), and the score of family support was (10.5±2.2). There were 199 patients (55.4%) having social dysfunction. There were 224 patients (62.4%) employed after PD. Compared with the normal social function group, the social dysfunction group had significantly lower score in family support ( Z=-2.613, P=0.009), serum potassium ( t=-2.725, P=0.007), urea clearance index ( Z=-2.346, P=0.019) and proportions of married status ( χ2=6.847, P=0.009), pre-dialysis employment ( χ2=3.996, P=0.046) and post-dialysis employment ( χ2=8.331, P=0.004), and higher serum creatinine ( Z=2.175, P=0.030), and proportions of annual household income < 100 000 yuan ( χ2=6.270, P=0.012) and diabetes mellitus ( χ2=4.400, P=0.036). Multivariate logistic regression analysis revealed that family support ( OR=0.828, 95% CI 0.733-0.935, P=0.002), diabetes mellitus ( OR=3.551, 95% CI 1.456-8.658, P=0.005) and serum potassium ( OR=0.559, 95% CI 0.374-0.835, P=0.005) were independent correlated factors of social dysfunction in young and middle-aged PD patients. Conclusions:The prevalence of social dysfunction is 55.4%, and the employment rate is 62.4% in young and middle-aged PD patients. Poor family support, diabetes mellitus and decreased serum potassium level are independently associated with social dysfunction in young and middle-aged PD patients.
5.Sexual and reproductive health knowledge and practice among students in six senior high schools in three regions in East China
Ying-hong LU ; Li-ping ZHU ; Biao ZHANG ; Hong-fang MAO ; Peng-fei LIANG ; Bing-ying LI ; Li DU ; Biao XU
Shanghai Journal of Preventive Medicine 2021;33(9):838-844
Objective:To know the status of knowledge, attitude and behavior related to sexual and reproductive health in high school students in three regions of East China, and to provide a reference for adolescent reproductive health education
6.The effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception
Liezhen HU ; Bei XIA ; Tingting LIU ; Tingting DING ; Wei YU ; Jinlong DENG ; Jia LI ; Zhou LIN ; Hongwei TAO ; Shumin FAN ; Xia FENG ; Lei LIU ; Na XU ; Jianxiong MAO ; Chi ZHANG ; Dong XIAO ; Bin WANG ; Xiaopeng MA
Chinese Journal of Ultrasonography 2021;30(9):800-805
Objective:To evaluate the effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception.Methods:One thousand eight hundred and thirty patients with acute intussusception diagnosed by ultrasound in Shenzhen Children′s Hospital from September 2017 to July 2020 were treated with ultrasound-guided hydrostatic reduction method. The therapeutic effects, complications and ultrasonic features were observed.Results:Among 1 830 cases, 1 791 cases were diagnosed as primary intussusception, and 39 cases were secondary intussusception. The overall rate of successful ultrasound enema reduction were 1 780/1 830(93.7%) patients. All 50/1 830(2.7%) patients underwent surgery after unsuccessful enema reduction, including 42 cases of primary intussusception, and 8 cases of secondary intussusception. The complication of intestinal perforation occurred in 3 cases (0.16%), and there were no deaths.Conclusions:Ultrasound-guided enema reduction for pediatric acute intussusception is an effective and safe method without radiation exposure, and can be used as the preferred method for non-operative treatment of intussusception.
7.Prevalence and risk factors of exit-site infection in elderly peritoneal dialysis patients
Jianxiong LIN ; Bining LIANG ; Shuchao LU ; Shan LYU ; Xiaoli YU ; Haiping MAO ; Xueqing YU ; Xiao YANG
Chinese Journal of Nephrology 2020;36(6):417-423
Objective:To explore the prevalence and risk factors of exit-site infection (ESI) in elderly peritoneal dialysis (PD) patients.Methods:The status of exit-site was evaluated in elderly PD patients (≥60 years) who had catheter insertion in our center between January 1, 2009 and December 31, 2013, with follow-up for 1 year or withdrawing from peritoneal dialysis in this period. The patients were divided into ESI and non-ESI group. The data was collected including demographics, clinical features, and nursing care methods of the exit-site.Results:A total of 247 patients were recruited in this study, aged (68.6±6.2) years, among whom there were 132 male (53.4%) and 119 diabetes (48.2%). Median follow-up time was 12.0 months. Thirty-two patients had 34 episodes of ESI with a rate of 82.5 patient-months per episode (0.15 episodes per year). Coagulase-negative Staphylococcus was the main pathogen, accounting for 35.3% of the ESI. No bacterial growth was found in 8.8%. The exit-site nursing care status included that poor compliance of exit-site care 23.5%, poor catheter immobilization 62.3%, history of catheter-pulling injury 9.7%, mechanical stress on exit-site 5.3%, improper frequency of nursing care 29.6%, mupirocin usage 13.8%, patients taking exit-site care 26.7%, exit-site caregiver instability 16.6%. There were no differences in demographic (such as age, gender, primary disease, etc) and laboratory data (hemoglobin, serum albumin, blood potassium, etc) between the ESI and non-ESI groups. Poor compliance with exit-site care ( HR=2.352, 95% CI 1.008-5.488, P=0.048), poor catheter immobilization ( HR=3.074, 95% CI 1.046-9.035, P=0.041) and exit-site caregiver instability ( HR=2.423, 95% CI 1.004-5.845, P=0.049) were significantly correlated with increased risk of ESI. Conclusions:The prevalence of ESI in elderly PD patients was 0.15 episodes per year. Educating PD patients to improve the compliance with exit-site care, maintain catheter immobilization and do exit-site care by a stable and trained caregiver may reduce ESI events in elderly PD patients.
8.Impact of continuous quality improvement on reducing the incidence of peritoneal dialysis-related peritonitis in patients within the first year of peritoneal dialysis initiation
Jianxiong LIN ; Chunyan YI ; Xiaoli YU ; Xiaodan ZHANG ; Xiaofeng WU ; Xiao YANG ; Haiping MAO ; Xueqing YU
Chinese Journal of Nephrology 2020;36(8):588-594
Objective:To explore the effect of continuous quality improvement (CQI) on reducing the incidence of peritoneal dialysis (PD)-related peritonitis in patients within the first year of PD initiation.Methods:The patients who received catheter placement from January 2006 to December 2016 in our hospital were enrolled in this study. All patients were divided into four groups: pre-CQI group patients who initiated PD treatment from 2006 to 2007 (before CQI phase, group A), CQI Ⅰphrase patients who initiated PD treatment from 2008 to 2010 (group B), CQI Ⅱ phrase patients who initiated PD treatment from 2011 to 2013 (group C), and CQI Ⅲ phrase patients who initiated PD treatment from 2014 to 2016 (group D). The method of plan, do, check and act (PDCA) was conducted to decrease the incidence of PDRP. All the patients were followed up for 12 months or until they withdrew from PD in this period. Poisson analysis was used to compare the incidence of PDRP among the groups.Results:There were 2 383 PD patients recruited in this study, including 346 cases in group A, 850 cases in group B, 688 cases in group C and 499 cases in group D, with an age of (47.1±15.8) years, among whom 59.1% of the patients were male, and 21.4% with diabetes. The follow-up time was (10.9±2.8) months. Compared with group A, the incidence of PDRP was lower than that in group C (0.156 episodes/patient year vs 0.234 episodes/patient year, P=0.020); the incidence of gram positive PDRP decreased (0.052, 0.049, 0.054 episodes/patient year vs 0.104 episodes/patient year, all P<0.05) in group B, C, D; the incidence of gram negative PDRP increased in group B, then decreased in group C and group D (all P>0.05). Cox regression analysis indicated that CQI was independently associated with the incidence of gram positive PDRP ( HR=0.526, 95% CI 0.349-0.792, P=0.002). Conclusion:CQI can effectively reduce the incidence of gram positive PDRP in patients within the first year of PD initiation.
9.Prevalence and determinants of masked hypertension defined by home blood pressure monitoring in peritoneal dialysis patients
Tong LIN ; Xi XIA ; Rui YANG ; Jing YU ; Yagui QIU ; Jianxiong LIN ; Chunyan YI ; Haiping MAO ; Xiao YANG ; Fengxian HUANG
Chinese Journal of Nephrology 2020;36(9):666-674
Objective:To evaluate the prevalence of masked hypertension defined by home blood pressure monitoring in patients on peritoneal dialysis (PD) and examine its determinants.Methods:The patients who performed PD in the First Affiliated Hospital of Sun Yat-sen University from January 1, 2006 to December 31, 2013 were recruited. Baseline demographic, clinical and biochemical examination data were collected to analyze the prevalence and clinical characteristics in patients with masked hypertension defined by home blood pressure monitoring. Multivariate logistic regression model was used to analyze the related risk factors of masked hypertension in PD patients with clinic normotension.Results:There were 1 425 patients (866 males) enrolled in this study, with age of (46.9±14.9) years and body mass index of (21.6±3.1) kg/m 2. The prevalence of masked hypertension in PD patients was 31.9%, and the prevalence of masked hypertension in patients with clinic normotension was 57.5%. Multivariate logistic regression analysis showed that higher body mass index ( OR=1.057, 95% CI 1.001-1.116, P=0.047), incorporating diabetes mellitus ( OR=1.996, 95% CI 1.160-3.433, P=0.013), use of multiple antihypertensive drugs ( OR=1.336, 95% CI 1.122-1.590, P=0.001) and elevated office blood pressure ( OR=1.785, 95% CI 1.546-2.060, P<0.001) were independent risk factors of masked hypertension in PD patients with clinic normotension. Conclusions:The prevalence of masked hypertension is high in PD patients. Higher body mass index, incorporating diabetes mellitus, use of multiple antihypertensive drugs and elevated office blood pressure are independent risk factors for masked hypertension in PD patients with clinic normotension.
10.Prevalence and risk factors of restless legs syndrome in maintenance peritoneal dialysis patients
Xiaoli YU ; Jianxiong LIN ; Chunyan YI ; Haiping MAO ; Xueqing YU ; Xiao YANG
Chinese Journal of Nephrology 2018;34(10):721-726
Objectives To investigate the prevalence and its risk factors of restless legs syndrome (RLS) in maintenance peritoneal dialysis (PD) patients.Methods Patients who performed PD in the First Affiliated Hospital of Sun Yat-sen University were recruited by convenience sampling.International Restless Legs Syndrome Study Group diagnostic criteria and International Restless Leg Syndrome rating scale were used to diagnose and evaluate the RLS and its severity.Co-morbidities level,baseline demographic,clinical and biochemical data were collected to analyze the clinical characteristics of patients with RLS.Multivariate logistic regression analysis was used to assess the risk factors for RLS.Results A total of 421 PD patients were enrolled in this study.Their age was (46.3±12.8) years old,44.2% were female and 17.3% with diabetes.The median vintage of PD was 46.8(28.0,73.5) months.The prevalence of RLS was 14.0%,most of whom were affected with moderate or severe RLS.Logistic regression analysis showed that younger age,long-term dialysis duration,higher serum calcium and phosphorus were the risk factors associated with RLS in PD patients after adjustment for confounders (all P < 0.05).Conclusions Prevalence of RLS in PD patients is 14.0%.Younger age,long-term dialysis duration,higher serum calcium and phosphorus were the risk factors associated with

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