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Publications in Renal Failure in Science Citation Index Expanded (SCI-EXPANDED) between 1992 and 2021 were analyzed. Six publication indicators: total, independent, collaborative, first author, corresponding author, and single author publications as well as their related citation indicators, were used to compare performances of countries, institutes, and authors. Comparison of the highly cited papers and journal's impact factor (IF) contributors was discussed. In addition, the main research topics in the journal were presented. Results show that China published the most total articles and reviews, as well as the first-author papers and corresponding-author papers in the journal. The Chang Gung Memorial Hospital in Taiwan ranked the top in five publication indicators: total, single-institution, inter-institutionally collaborative, first author, and corresponding-author papers. A low percentage of productive authors emerged as a journal IF contributor. Similarly, only a limited relationship between highly cited papers and IF contributing papers was found. Publications related to hemodialysis, chronic kidney disease, and acute kidney injury were the most popular topic, while meta-analysis was new focus in the last decade in the journal. [ABSTRACT FROM AUTHOR]

Background: To study the trend of clinical and basic research output in the field of nephrology in China during the past 20 years. Methods: The journals listed in the 'Urology and Nephrology' category of Science Citation Index Expanded (SCIE) subject categories were selected. The papers were retrieved by searching the PubMed database. Mainland China (ML), Hong Kong (HK), and Taiwan (TW) were chosen as investigative regions compared with other developed countries. Geographical difference in publications in ML was analyzed. The change between clinical and basic research papers was compared. The accumulated or average impact factor (IF) and the number of papers published in the 10 most impacted journals were calculated to determine the quality of papers. Results: The research output in the field of nephrology in ML developed markedly in the last 7 years (an average annual increase of 54%% from 2004); ML exceeded TW and HK since 2008. The research output born in ML was mainly from five cities, for example, Beijing, Shanghai, Nanjing, Guangzhou, and Hangzhou, which accounted for 72%% of the total. Since 2001, clinical research papers increased yearly by 11.55, and the basic research papers increased by 4.55. However, clinical trials were still limited. In 2010, ML had the highest accumulated IF and the lowest average IF. ML had the second highest number of publications in the 10 top-ranking nephrology journals among the three regions. Conclusions: China has made a remarkable progress in the field of nephrology. Clinical researches have promoted the development of nephrology. The quality of research papers in China needs further improvement. [ABSTRACT FROM AUTHOR]

Shenkang injection (SKI) has been widely used in China for many years for the treatment of kidney disease. The objective of this systematic review was to assess the efficacy of Shenkang injection for the treatment of acute kidney injury (AKI). A search was conducted across seven databases, encompassing data from the inception of each database through October 8th, 2023. Randomized controlled trials comparing SKI-treated AKI patients with control subjects were extracted. The main outcome measure was serum creatinine (SCr) levels. Secondary outcomes included blood urea nitrogen (BUN), serum cystatin C (CysC), 24-h urine protein (24 h-Upro) levels, APACHE II score and adverse reactions. This meta-analysis included eleven studies, and the analysis indicated that, compared with the control group, SKI significantly decreased SCr [WMD = −23.31, 95% CI (-28.06, −18.57); p < 0.001]; BUN [WMD = −2.07, 95% CI (-2.56, −1.57); p < 0.001]; CysC [WMD = −0.55, 95% CI (-0.78, −0.32), p < 0.001]; 24-h urine protein [WMD = −0.43, 95% CI (-0.53, −0.34), p < 0.001]; and the APACHE II score [WMD = −3.07, 95% CI (-3.67, −2.48), p < 0.001]. There was no difference in adverse reactions between the SKI group and the control group [RR = 1.32, 95% CI (0.66, 2.63), p = 0.431]. The use of SKI in AKI patients may reduce SCr, BUN, CysC, 24-h Upro levels, and APACHE II scores in AKI patients. The incidence of adverse reactions did not differ from that in the control group. Additional rigorous clinical trials will be necessary in the future to thoroughly evaluate and establish the effectiveness of SKI in the treatment of AKI. [ABSTRACT FROM AUTHOR]

Hypertensive nephropathy continues to be a major cause of end-stage renal disease and poses a significant global health burden. Despite the staggering development of research in hypertensive nephropathy, scientists and clinicians can only seek out useful information through articles and reviews, it remains a hurdle for them to quickly track the trend in this field. This study uses the bibliometric method to identify the evolutionary development and recent hotspots of hypertensive nephropathy. The Web of Science Core Collection database was used to extract publications on hypertensive nephropathy from January 2000 to November 2023. CiteSpace was used to capture the patterns and trends from multi-perspectives, including countries/regions, institutions, keywords, and references. In total, 557 publications on hypertensive nephropathy were eligible for inclusion. China (n = 208, 37.34%) was the most influential contributor among all the countries. Veterans Health Administration (n = 19, 3.41%) was found to be the most productive institution. Keyword bursting till now are renal fibrosis, outcomes, and mechanisms which are predicted to be the potential frontiers and hotspots in the future. The top seven references were listed, and their burst strength was shown. A comprehensive overview of the current status and research frontiers of hypertensive nephropathy has been provided through the bibliometric perspective. Recent advancements and challenges in hypertensive nephropathy have been discussed. These findings can offer informative instructions for researchers and scholars. [ABSTRACT FROM AUTHOR]

Objective: Shenkang injection (SKI) has been widely used in China for many years for the treatment of kidney disease. The objective of this systematic review was to assess the efficacy of Shenkang injection for the treatment of acute kidney injury (AKI). Methods: A search was conducted across seven databases, encompassing data from the inception of each database through October 8th, 2023. Randomized controlled trials comparing SKI-treated AKI patients with control subjects were extracted. The main outcome measure was serum creatinine (SCr) levels. Secondary outcomes included blood urea nitrogen (BUN), serum cystatin C (CysC), 24-h urine protein (24h-Upro) levels, APACHE II score and adverse reactions. Results: This meta-analysis included eleven studies, and the analysis indicated that, compared with the control group, SKI significantly decreased SCr [WMD=−23.31, 95% CI (-28.06, −18.57); p<0.001]; BUN [WMD=−2.07, 95% CI (-2.56, −1.57); p<0.001]; CysC [WMD=−0.55, 95% CI (-0.78, −0.32), p<0.001]; 24-h urine protein [WMD=−0.43, 95% CI (-0.53, −0.34), p<0.001]; and the APACHE II score [WMD=−3.07, 95% CI (-3.67, −2.48), p<0.001]. There was no difference in adverse reactions between the SKI group and the control group [RR = 1.32, 95% CI (0.66, 2.63), p=0.431]. Conclusion: The use of SKI in AKI patients may reduce SCr, BUN, CysC, 24-h Upro levels, and APACHE II scores in AKI patients. The incidence of adverse reactions did not differ from that in the control group. Additional rigorous clinical trials will be necessary in the future to thoroughly evaluate and establish the effectiveness of SKI in the treatment of AKI. [ABSTRACT FROM AUTHOR]

Hypertensive nephropathy continues to be a major cause of end-stage renal disease and poses a significant global health burden. Despite the staggering development of research in hypertensive nephropathy, scientists and clinicians can only seek out useful information through articles and reviews, it remains a hurdle for them to quickly track the trend in this field. This study uses the bibliometric method to identify the evolutionary development and recent hotspots of hypertensive nephropathy. The Web of Science Core Collection database was used to extract publications on hypertensive nephropathy from January 2000 to November 2023. CiteSpace was used to capture the patterns and trends from multi-perspectives, including countries/regions, institutions, keywords, and references. In total, 557 publications on hypertensive nephropathy were eligible for inclusion. China (n=208, 37.34%) was the most influential contributor among all the countries. Veterans Health Administration (n=19, 3.41%) was found to be the most productive institution. Keyword bursting till now are renal fibrosis, outcomes, and mechanisms which are predicted to be the potential frontiers and hotspots in the future. The top seven references were listed, and their burst strength was shown. A comprehensive overview of the current status and research frontiers of hypertensive nephropathy has been provided through the bibliometric perspective. Recent advancements and challenges in hypertensive nephropathy have been discussed. These findings can offer informative instructions for researchers and scholars. [ABSTRACT FROM AUTHOR]

Introduction: To establish a prediction model to predict immunosuppressive medication (IM) nonadherence in kidney transplant recipients (KTRs) based on a combined theory framework. Methods: This polycentric, cross-sectional study included 1191 KTRs from October 2020 to February 2021 in China, with 1011 KTRs enrolled in the derivation set and 180 in the external validation set. Variables selected based on the combined theory of planned behavior (TPB)/health belief model (HBM) theory were analyzed by the least absolute shrinkage and selection operator (LASSO). Internal 10 cross-validation was conducted to determine the optimal lambda value. The receiver operating characteristic (ROC) curve, specificity, and sensitivity were used to evaluate the prediction model, and further assessment was run by external validation. Results: IM nonadherence rate was 38.48% in the derivation set and 37.22% in the validation set. The LASSO model was developed with eight predictors for IM nonadherence: age, preoperative drinking history, education, marital status, perceived barriers, social support, perceived behavioral control, and perceived susceptibility. The model demonstrated acceptable discrimination with the area under the ROC curve of 0.797 (95% CI: 0.745-0.850) in the internal validation set and 0.757 (95% CI: 0.684-0.829) in the external validation set. The specificity and sensitivity in the internal validation and external validation set were 0.741, 0.748, 0.673, and 0.716, respectively. Conclusions: The LASSO model was developed to guide identifying high-risk nonadherent patients and timely and effective interventions to improve their prognosis and survival. [ABSTRACT FROM AUTHOR]

To investigate the clinical characteristics, pathological features, and outcomes of patients with antineutrophil cytoplasmic antibody (ANCA)-positive systemic lupus erythematosus (SLE) in northwest China. This retrospective study included 491 patients with SLE tested for ANCA antibodies and 171 patients with ANCA-associated vasculitis (AAV) as controls. Subgroup analysis limited to those with renal involvement, and by ANCA antibody subtype (PR3 vs MPO). To compare the proteinuria remission rates between ANCA-positive and ANCA-negative lupus nephritis (LN) groups, a logistic regression model was used for propensity score matching based on age, hemoglobin, and baseline estimated glomerular filtration rate (eGFR). Compared to ANCA-negative SLE (n = 442), ANCA-positive SLE (n = 46) occur in older patients; however, these patients were younger than those with AAV (n = 167). The eGFR of patients with ANCA-positive LN (n = 25) was higher than that of patients having AAV with renal involvement (n = 56) but lower than that of patients with ANCA-negative LN (n = 163). Patients with SLE who had MPO-ANCA (n = 16) had higher levels of serum creatinine compared to those with PR3-ANCA (n = 30) (156.5 µmol/L vs. 45.5 µmol/L, p = 0.005). During the follow-up period, the remission rate of proteinuria in patients with ANCA-positive LN was lower than that of patients with ANCA-negative LN (50% vs. 75%, p = 0.008). Patients with ANCA-positive LN may have worse baseline renal function and lower protein remission rates compared to patients with ANCA-negative LN. ANCA titers should be regularly monitored throughout the follow-up period in patients with SLE, especially in cases of renal involvement. [ABSTRACT FROM AUTHOR]

Chronic kidney disease-associated pruritus (CKD-aP) is very common and sometimes refractory to treatment in hemodialysis patients. In a trial conducted in Japan, nalfurafine, effectively reduced itching of treatment-resistant CKD-aP. Our present bridging study aimed to evaluate the efficacy and safety of nalfurafine in Chinese cohort with refractory CKD-aP. In this phase III, multicenter bridging study conducted at 22 sites in China, 141 Chinese cases with refractory CKD-aP were randomly (2:2:1) assigned to receive 5 μg, 2.5 μg of nalfurafine or a placebo orally for 14 days in a double-blind manner. The primary end point was the mean decrease in the mean visual analogue scale (VAS) from baseline. A total of 141 patients were included. The primary endpoint analysis based on full analysis set (FAS), the difference of mean VAS decrease between 5 μg nalfurafine and placebo group was 11.37 mm (p =.041); the difference of mean VAS decrease between 2.5 μg and placebo group was 8.81 mm (p =.110). Both differences were greater than 4.13 mm, which met its predefined success criterion of at least 50% efficacy of the key Japanese clinical trial. The per protocol set (PPS) analysis got similar results. The incidence of adverse drug reactions (ADRs) was 49.1% in 5μg, 38.6% in 2.5 μg and 33.3% in placebo group. The most common ADR was insomnia, seen in 21 of the 114 nalfurafine patients. Oral nalfurafine effectively reduced itching with few significant ADRs in Chinese hemodialysis patients with refractory pruritus. [ABSTRACT FROM AUTHOR]

The role of probiotics in the management of diabetic kidney disease (DKD) has been shown. Several current trials are investigating the effect of probiotics, which are widely used to modulate biomarkers of renal function, glucose, lipids, inflammation and oxidative stress in patients with DKD. However, their findings are controversial. This study aimed to systematically evaluate the impact of probiotics on patients with DKD via meta-analysis. PubMed, The Cochrane Library, Web of Science, Scopus, Embase, China National Knowledge Infrastructure, Chinese Wanfang Database and Chinese VIP Database were searched for relevant studies from the establishment of these databases to September 2021. The pooled results evaluated the impact of probiotics on renal function, glucose, lipids, inflammation and oxidative stress indicators in patients with DKD. Additionally, subgroup analysis was performed based on intervention duration, probiotic dose and probiotic consumption patterns, respectively. Ten trials that included 552 participants were identified for analysis. Compared with the controls, probiotics significantly decreased serum creatinine (Scr) [WMD = −0.17 mg/dL; 95%CI = −0.29, −0.05; p = 0.004], blood urea nitrogen (BUN) [WMD = −1.36 mg/dL; 95%CI = −2.20, −0.52; p = 0.001], cystatin C (Cys C) [WMD = −29.50 ng/mL; 95%CI = −32.82, −26.18; p < 0.00001], urinary albumin/creatinine ratio (UACR) [WMD = −16.05 mg/g; 95%CI = −27.12, −4.99; p = 0.004] and natrium (Na) [WMD = −0.94 mmol/L; 95%CI = −1.82, −0.05; p = 0.04] in patients with DKD. Enhanced glycemic control was observed in patients with DKD receiving probiotics compared with controls, as demonstrated by reduced levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model of assessment-estimated insulin resistance (HOMA-IR), and increased quantitative insulin sensitivity check index (QUICKI). Probiotics affected lipid metabolism parameters with decreasing triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels in patients with DKD. Probiotics could also could improve inflammation and oxidative stress by decreasing high-sensitivity C-reactive protein (hs-CRP), plasma malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH) and nitric oxide (NO). Additionally, subgroup analysis showed that those who received multiple species probiotics had a statistically significant difference in BUN, FPG, HOMA-IR, high-density lipoprotein cholesterol (HDL-c), MDA, TAC, and NO. Meanwhile, Scr, LDL-c, HDL-c, MDA, and TAC were ameliorated when the intervention duration was more than eight weeks and BUN, FPG, HOMA-IR, and MDA were improved when the probiotic dose was greater than four billion CFU/day. Our analysis revealed that probiotics could delay the progression of renal function injury, improve glucose and lipid metabolism, and reduce inflammation and oxidative stress in patients with DKD. Subgroup analysis showed that intervention duration, probiotic dose and probiotic consumption patterns had an effect of probiotics on outcomes. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of depression and anxiety in patients undergoing maintenance hemodialysis (MHD) in Hohhot, a large city on the northern border of China, and to identify independent risk factors for depression and anxiety in these patients. Patients receiving MHD for >3 months were enrolled in the four largest hemodialysis centers between September 2020 and December 2020. Depression and anxiety were assessed using the Zung self-rated depression scale (SDS) and Zung self-rated anxiety scale (SAS), respectively, with demographic and other data collected for logistic regression analyses. Among 305 MHD patients included in this study, the prevalence of depression was 55.1%, including 27.5%, 21.0%, and 6.6% with mild, moderate and severe cases, respectively. The prevalence of anxiety was 25.9%, with 20.0%, 4.6%, and 1.3% having mild, moderate, and severe cases, respectively. An independent protective factor for depression was family income of ≥1415 US dollars/month relative to <157 US dollars/month (odds ratio [OR] 0.209, 95% confidence interval [CI] 0.065–0.673), and predictors of depression included ≥3 comorbidities (OR 18.527, 95% CI 1.674–205.028) and severe pruritus (OR 15.971, 95% CI 5.173–49.315). Independent predictors of anxiety included infrequent exercise (OR 3.289, 95% CI 1.411–7.664) and severe pruritus (OR 5.912, 95% CI 1.733–20.168). The correlation between depression and anxiety in these patients was significant (rs = 0.775, p < 0.001). MHD patients in Northern China had high prevalence rates of depression (55.1%) and anxiety (25.9%). Lower family income, more comorbidities, and a higher degree of pruritus were predictors of depression, while infrequent exercise and severe pruritus were predictors of anxiety. Depression correlated significantly with anxiety. Attention should be given to family income, comorbidity, exercise, and pruritus severity for improved management of depression and anxiety among MHD patients. [ABSTRACT FROM AUTHOR]

Peritoneal dialysis (PD) was introduced in China more than 60 years ago and has grown continuously since then. Now China leads the first of the world in number of patients on PD. In this manuscript a brief review of the history of peritoneal dialysis in China is presented; this includes a description of pioneers and their important contributions, discussion of peritoneal dialysate, the technique of the use of Tenckhoff catheter, the use of continuous ambulatory peritoneal dialysis (CAPD) and dialysis registration. Current ongoing PD research activities among Chinese PD academicians are also discussed. Finally, we present four areas of future focus: 1) the promotion of PD in rural areas where PD use is still very limited due to the lack of PD awareness and education; 2) PD quality management and continuous quality improvement (CQI) program particularly focusing on PD adequacy and patient rehabilitation; 3) development and enforcement of national standards on PD management; 4) multi-center studies to compare the benefits of PD and hemodialysis (HD) that should include survival, rehabilitation and cost-effectiveness. [ABSTRACT FROM AUTHOR]

The incidence and the risk factors of in-hospitalized acute kidney injury (AKI) in patients hospitalized for atrial fibrillation (AF) were unclear. The Improving Care for Cardiovascular Disease in China-AF (CCC-AF) project is an ongoing registry and quality improvement project, with 240 hospitals recruited across China. We selected 4527 patients hospitalized for AF registered in the CCC-AF from January 2015 to January 2019. Patients were divided into the AKI and non-AKI groups according to the changes in serum creatinine levels during hospitalization. Among the 4527 patients, the incidence of AKI was 8.0% (361/4527). Multivariate logistic analysis results indicated that the incidence of in-hospital AKI in patients with AF on admission was 2.6 times higher than that in patients with sinus rhythm (OR 2.60, 95% CI 1.77–3.81). Age (per 10-year increase, OR 1.22, 95% CI 1.07–1.38), atrial flutter/atrial tachycardia on admission (OR 2.16, 95% CI 1.12–4.15), diuretics therapy before admission (OR 1.48, 95% CI 1.07–2.04) and baseline hemoglobin (per 20 g/L decrease, OR 1.21, 95% CI 1.10–1.32) were independent risk factors for in-hospital AKI. β blockers therapy given before admission (OR 0.67, 95% CI 0.51–0.87) and non-warfarin therapy during hospitalization (OR 0.71, 95% CI 0.53–0.96) were associated with a decreased risk of in-hospital AKI. After adjustment for confounders, in-hospital AKI was associated with a 34% increase in risk of major adverse cardiovascular (OR 1.34, 95% CI 1.02–1.90, p = 0.023). Clinicians should pay attention to the monitoring and prevention of in-hospital AKI to improve the prognosis of patients with AF. [ABSTRACT FROM AUTHOR]

The relationship between sleeping disorders and chronic kidney disease (CKD) has already been reported. Snoring, a common clinical manifestation of obstructive sleep apnea–hypopnea syndrome, is of clinical value in assessing sleeping disorder severity. However, investigations of the connection between snoring and CKD are limited, especially in normal-weight populations. This study assessed the relationship between snoring frequency and CKD in obese and normal-weight people in China. A community-based retrospective cross-sectional study of 3250 participants was performed. Study participants were divided into three groups – the regularly snoring group, occasionally snoring group, and never snoring group – based on their self-reported snoring frequency. CKD was defined as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2. Multiple logistic regression analysis was used to explore the relevance between snoring frequency and CKD prevalence. The CKD prevalence in obese participants was higher than that in normal-weight participants. Frequent snorers had a higher prevalence of CKD than those who were not frequent snorers in the obese group. Snoring frequency was correlated with CKD prevalence in obese participants independent of age, sex, smoking and drinking status, systolic blood pressure, triglyceride level, high-density lipoprotein, and homeostasis model assessment of insulin resistance (odds ratio: 2.66; 95% CI: 1.36–5.19; p=.004), while the same relationships did not exist in normal-weight participants (odds ratio: 0.79; 95% CI: 0.32–1.98; p=.614). Snoring appears to be independently associated with CKD in obese but not in normal-weight Chinese adults. [ABSTRACT FROM AUTHOR]

PurposeThe objective of this study is to examine the incidence, clinical characteristics, and outcome (90-day mortality) of critically ill Chinese patients with septic AKI.MethodsPatients admitted to the ICU of a regional hospital from 1 January 2011 to 31 December 2013 were included, excluding those on chronic renal replacement therapy. AKI was defined using KDIGO criteria. Patients were followed till 90 days from ICU admission or death, whichever occurred earlier. Demographics, diagnosis, clinical characteristics, and outcome were analyzed.ResultsIn total, 3687 patients were included and 54.7% patients developed AKI. Sepsis was the most common cause of AKI (49.2%). Compared to those without AKI, AKI patients had higher disease severity, more physiological and biochemical disturbance, and carried significant co-morbidities. Ninety-day mortality increased with severity of AKI (16.7, 27.5, and 48.3% for KDIGO stage 1, 2, and 3 AKI,p < 0.001). Full renal recovery was achieved in 71.6% of AKI patients. Compared with non-septic AKI, septic AKI was associated with higher disease severity and required more aggressive support. Non-recovery of renal function occurred in 2.5% of patients with septic AKI, compared with 6.4% in non-septic AKI (p < 0.001). Cox regression analysis showed that age, emergency ICU admission, post-operative cases, admission diagnosis, etiology of AKI, disease severity score, mechanical ventilation, vasopressor support, and blood parameters (like albumin, potassium and pH) independently predicted 90-day mortality.ConclusionsAKI, especially septic AKI is common in critically ill Chinese patients and is associated with poor patient outcome. Etiology of AKI has a significant impact on 90-day mortality and may affect renal outcome. [ABSTRACT FROM PUBLISHER]

To explore the possible impact factors on daytime sleepiness among peritoneal patients from a single center in China. A cross-sectional study was conducted in 98 prevalent peritoneal dialysis (PD) patients using both the Pittsburgh Sleep Quality Index (PSQI) questionnaire of sleep quality and the Epworth Sleepiness Scale (ESS) questionnaire of excessive daytime sleepiness (EDS). Biochemical differences between daytime sleepiness and non-daytime sleepiness population were evaluated, following univariate and multivariable analysis to find the risk factors on sleep disturbance. The prevalence of 'poor sleep quality' (PSQI > 5) was 74.49%, while daytime sleepiness (ESS ≥ 9) occurred in 22.45%. Mean PSQI was 9.06 ± 4.60 and EES was 6.31 ± 4.98. Compared to non-EDS cases, patients with ESS ≥ 9 had worse residual renal function (RRF), higher serum creatinine, higher serum magnesium and elevated serum ferritin. In univariate analysis, ESS correlated with serum albumin ( r = 0.346, p = 0.015), phosphate ( r = 0.313, p = 0.029), magnesium ( r = 0.376, p = 0.008) and urinary Kt/V ( r = −0.341, p = 0.029). Finally, multivariable linear regression indicated that urinary Kt/V, PSQI and magnesium were independent predictors of ESS score. EDS does exist in PD patients and is associated both with poor nighttime sleep quality and lower RRF. Hypermagnesemia may be a treatable risk factor to improve daytime tiredness. [ABSTRACT FROM AUTHOR]

Background: 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. Methods: 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. Results: 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 ( p < 0.05). While the scores of physical component summary (PCS) and mental component summary (MCS) showed no differences between the two groups ( p > 0.05). The results of the multiple linear regression analysis indicated that age and cerebrovascular disease had negative correlations with PCS ( p < 0.01), whereas the serum prealbumin level had positive correlation with PCS ( p < 0.05). The married status was negatively associated with MCS ( p < 0.01). But the higher education level was positively associated with MCS ( p < 0.01). Conclusions: 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. [ABSTRACT FROM AUTHOR]

There has never been a home hemodialysis (HHD) program or self-care hemodialysis (SC-HD) program in Mainland China, and it may be plausible starting from an SC-HD program. This study describes the systems for, and the initial results of, starting an SC-HD program. A program for SC-HD was instituted at the Peking University Third Hospital. A working group had designed the patient education program and water quality assurance. The patient's education program was established, which consisted of a handbook and a video for training. In May 2009, two patients were recruited and trained for HD. They were adequately dialyzed with satisfactory Kt/V, both the patients could perform all of the self-care procedures after training for 12 weeks. More difficult procedures, such as the self-cannulation, were successfully handled. Significant improvement was found in six of the eight short form (SF)-36 health scales after 6 months for SC-HD treatment. For the past year, there were no severe complications resulting from SC-HD. In summary, our first SC-HD program in Mainland China is feasible and safe. It promotes rehabilitation, increases self-esteem, and improves health-related quality of life. It is also a first attempt for starting an HHD program. [ABSTRACT FROM AUTHOR]

Background: There is an increasing body of evidence showing that educational interventions aiming at empowering patients are successful in chronic disease management. The aim of this study was to conduct an evaluation of the systematic effectiveness of a multi-dimensional education intervention program in a group of pre-dialysis chronic kidney disease (CKD) patients. In addition, we investigated whether the outcome of the program was related with the amount of education. Methods: We collected data retrospectively from 302 patients with CKD stages 3, 4, and 5, who were followed up from February 2006 to March 2008. The patients were divided into long-time education group and short-time education group depending on the number of provided hours of education. Survival analysis was undertaken to see if the progression of the kidney function differed between these two groups. Results: The percentage of patients receiving long-time education was highest with severe degree of impairment of renal function (45.5%%, 61.3%%, and 66.7%% in CKD stages 3, 4, and 5 groups, respectively). In a multivariate regression analysis, adjusting for age, gender, Charlson comorbidity index, and other traditional risk factors of renal failure, such as smoking, hypertension, and renal function (glomerular filtration rate), the length of time until a decline of renal function by 25%% was noted and was significantly shorter in the short-time education group as compared to the long-time education group ( p == 0.0334). Conclusion: Multi-component structured empowerment intervention is effective in pre-dialysis CKD patients and may lead to a delay in the progression of kidney disease. [ABSTRACT FROM AUTHOR]

Aims: To provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis B virus (HBV) infection in maintenance hemodialysis (HD) patients in China and help to inform prevention programs and guide future research. Methods: A systematic review was constructed based on the computerized literature database. Confidence intervals (95% CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios (OR) and 95% CI were calculated by fixed or random effects models. Hepatitis B surface antigen positivity (HBsAg (+)) was set as the sign of HBV infection. Results: Fifty studies met our inclusion criteria. The pooled prevalence of HBV infection among HD patients in China was 11.9%. Blood transfusion was correlated with an increase in HBV infection ( p = 0.05). HD patients with a long-term history were more likely to be infected than those with a short-term history. The levels of alanine aminotransferase were higher in the HBsAg (+) patients ( p < 0.001). Large doses of HBV vaccine (80 μg/dose) increased the seroconversion rate. The response rate of intradermal injection of HBV vaccine was higher than that of intramuscular injection. Conclusion: Hepatitis B is still one of the main complications in HD patients in China, and the frequency of blood transfusion and duration of HD were the risk factors. Large doses and intradermal injection of HBV vaccine were recommended to prevent HBV infection in HD patients. The findings of this meta-analysis have implications for optimal prevention and treatment of Hepatitis B in HD patients. [ABSTRACT FROM AUTHOR]

Background and Aims. To provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis C virus (HCV) infection in maintenance hemodialysis (HD) patients in China, and to help inform prevention programs and guide future research. Methods. A systematic review was constructed based on the computerized literature database by two reviewers independently. Ninety-five percent confidence intervals (CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios and 95% CI were calculated by fixed or random effects models. Results. Forty-three studies met our inclusion criteria. The pooled prevalence of HCV infection among HD patients in China was 41.1% (95% CI 39.5-42.6%). No significant difference was found in HCV infection rates between male and female HD patients (OR = 0.75, 95% CI 0.52-1.07, p = 0.11). HD patients with blood transfusion were 5.65 times more likely to be infected with HCV than HD patients without blood transfusion. A longer duration of HD was associated with increased HCV prevalence. Co-infection with hepatitis B virus did not increase the probability of HCV infection among HD patients (OR = 1.19, 95% CI 0.34-3.20, p = 0.73). Conclusions. Viral hepatitis is still one of the main complications in HD patients, with hepatitis C being the most common one. The key to reducing the incidence of viral hepatitis in HD patients is to control contagion and reduce the frequency of blood transfusion and cross-infection. [ABSTRACT FROM AUTHOR]

Acute renal failure (ARF) is a common complication in hospitalized patients, but little is known about the epidemiology of ARF in China. In this study, we performed a prospective examination of the cause, prognosis, and risk factors associated with ARF at a hospital in Shanghai, China. We considered all ARF patients who were admitted to our hospital from December 2003 to December 2006. Among the 320 ARF patients, 135 (42.2%) were over the age of 60. Sepsis, heart failure, and nephrotoxic drug use were the leading causes of ARF. The overall mortality rate was 31.9%, and mortality rate was significantly higher among the elderly. Logistic regression indicated that heart failure, respiratory failure, and malignant cancer were risk factors independently associated with poor prognosis. In this Shanghai hospital, there was a high incidence and mortality rate of patients hospitalized with ARF. The prognosis of patients who underwent renal replacement therapy was better than those who were treated more conservatively. [ABSTRACT FROM AUTHOR]

Background. The dialysis population has grown rapidly in recent decades. Despite the high cost and poor outcomes of dialysis treatment for ESRD, there are scant data about the level of renal function and the relationship of renal function and serum albumin at the start of dialysis in Chinese ESRD patients. Method. We report the level of serum creatinine (Scr), glomerular filtration rate (GFR), and serum albumin (Salb) in 514 ESRD in-patients who began their dialysis treatment between January 2001 through December 2007 at two large dialysis centers in Changsha, Hunan, China. Data were obtained through reviewing the case records of all 514 patients. GFR was predicted by an equation developed from the Modification of Diet in Renal Disease Study. In addition, serum albumin was analyzed in relation to levels of predicted GFR. Results. The mean (SD) and median predialysis serum creatinine was 1121.92 ± 458.24 and 1032 μmol/L. The mean (SD) and median predicted GFR was 4.98 ± 2.24 and 4.47mL/min/1.73m2. The proportion of patients with predicted GFR of >10, 5 to 10, and <5 mL/min/1.73m2 was 3.7, 36.2, and 60.1%, respectively. The mean predicted GFR was significantly lower among younger patients, uninsured patients, unemployed or farmer patients, patients who were employed, students, patients who selected hemodialysis, patients with ESRD caused by diseases other than diabetes, patients with BUN above the mean, and patients with hemoglobulin beneath the mean. Compared with patients who started with GFR >5mL/min, the patients who started with GFR ≤5mL/min had significantly higher plasma urea and creatinine levels but significantly lower creatinine clearance (mL/min per 1.73m2) and parameters of nutritional status, such as serum albumin, body weight, and BMI. Conclusion. A wide variation existed in renal function at the initiation of dialysis in partial Chinese ESRD patients. Most patients start dialysis at very low levels of predicted GFR. The nutritional status in patients who start dialysis early was better than those in patients who start dialysis when GFR ≤ 5mL/min. Further studies are needed to analyze the impact of level of renal function and nutritional status at the start of dialysis on the outcomes of ESRD. [ABSTRACT FROM AUTHOR]

Background. Chronic kidney disease (CKD) has emerged as a serious public health problem worldwide. How a CKD program should be organized, though, is still unknown. Therefore, we conducted a study to investigate the burden of CKD in a large university hospital and explore the possible approaches to care CKD appropriately in China. Methods. This is a retrospective cohort study of all new cases of CKD in a large hospital determined by a persistently increased serum creatinine (SCr) level (>1.47 mg/dL, >130 umol/L for more than three months) measured in the hospital laboratory. An abbreviate MDRD equation was used to estimate GFR from initial SCr values. Results. There was a large CKD population in the hospital. In all, 1,006 cases had definite chronic kidney disease. Excepting the nephrology department, CKD patients were distributed in 18 disciplines and departments, with the focus on outpatient department and emergency department. In total, 1,257 cases were suspicious of CKD, who had only one or two tests of serum creatinine without detailed follow-up data. Furthermore, when SCr level is higher than 442 umol/L, there were 129 cases with only one test result. Conclusion. CKD is a great burden in the hospital. Multidiscipline cooperation based on outpatient, emergency department, and good follow-up system establishments are necessary for appropriate CKD care. Future work is needed to explore how to organize a good CKD management program to advance the care of patients with CKD. [ABSTRACT FROM AUTHOR]

In 2007, there was emerging toxic nephropathy due to melamine. Renal failure due to melamine crystal is noted in cases of melamine intoxication. In this article, the author studies the melamine crystal by the molecular docking technique and found that the size of crystal is a possible explanation for why the infantile population is more prone to develop renal failure after intoxication. [ABSTRACT FROM AUTHOR]

Critically ill COVID-19 patients may exhibit various clinical symptoms of renal dysfunction including severe Acute Kidney Injury (AKI). Currently, there is a lack of bibliometric analyses on COVID-19-related AKI. The aim of this study is to provide an overview of the current research status and hot topics regarding COVID-19 AKI. The literature was retrieved from the Web of Science Core Collection (WoSCC) database. Subsequently, we utilized Microsoft Excel, VOSviewer, Citespace, and Pajek software to revealed the current research status, emerging topics, and developmental trends pertaining to COVID-19 AKI. This study encompassed a total of 1507 studies on COVID-19 AKI. The United States, China, and Italy emerged as the leading three countries in terms of publication numbers, contributing 498 (33.05%), 229 (15.20%), and 140 (9.29%) studies, respectively. The three most active and influential institutions include Huazhong University of Science and Technology, Wuhan University and Harvard Medical School. Ronco C from Italy, holds the record for the highest number of publications, with a total of 15 papers authored. Cheng YC's work from China has garnered the highest number of citations, totaling 470 citations. The co-occurrence analysis of author keywords reveals that 'mortality', 'intensive care units', 'chronic kidney disease', 'nephrology', 'renal transplantation', 'acute respiratory distress syndrome', and 'risk factors' emerge as the primary areas of focus within the realm of COVID-19 AKI. In summary, this study analyzes the research trends in the field of COVID-19 AKI, providing a reference for further exploration and research on COVID-19 AKI mechanisms and treatment.

Primary renal hypouricemia (RHUC) is a rare autosomal recessive disorder with a mean duration of end-stage acute kidney injury (EIAKI) of 14 days. The pathogenesis of EIAKI in patients with RHUC remains unclear. Several hypotheses have been proposed, including those related to the renal vasoconvulsive effect and the elevating effect of xanthine oxidase (XO). The effect of xanthine oxidase (XO) is most often observed following strenuous anaerobic exercise, which is frequently accompanied by low back pain, nausea, and acute kidney injury (AKI). Consequently, we postulate that EIAKI could be prevented by avoiding strenuous exercise, thus preventing the onset and recurrence of EIAKI. In this paper, we present a case of recurrent EIAKI in a patient with RHUC and a mutation in the SLC2A9 gene.

Publications in Renal Failure in Science Citation Index Expanded (SCI-EXPANDED) between 1992 and 2021 were analyzed. Six publication indicators: total, independent, collaborative, first author, corresponding author, and single author publications as well as their related citation indicators, were used to compare performances of countries, institutes, and authors. Comparison of the highly cited papers and journal's impact factor ( IF ) contributors was discussed. In addition, the main research topics in the journal were presented. Results show that China published the most total articles and reviews, as well as the first-author papers and corresponding-author papers in the journal. The Chang Gung Memorial Hospital in Taiwan ranked the top in five publication indicators: total, single-institution, inter-institutionally collaborative, first author, and corresponding-author papers. A low percentage of productive authors emerged as a journal IF contributor. Similarly, only a limited relationship between highly cited papers and IF contributing papers was found. Publications related to hemodialysis, chronic kidney disease, and acute kidney injury were the most popular topic, while meta-analysis was new focus in the last decade in the journal.