Intratumoral microbiota play key roles in cancer but are challenging to profile due to low biomass. We developed CIRCMIP, an enzymatic pipeline that eliminates linear DNA to enrich bacterial genomes, achieving 100-fold higher sensitivity than standard metagenomics. Applied to 312 pan-cancer specimens, CIRCMIP identified Staphylococcus lugdunensis as a signature bacterium enriched in early-stage bladder cancer (BLCA), where its presence predicts poor survival. Integrated modeling and lipidomics revealed that S. lugdunensis colonization drives aberrant lipid metabolism with secretion of LPC14:0. Both S. lugdunensis and LPC14:0 drive BLCA progression by promoting fatty acid uptake and β-oxidation. Mechanistically, chemical proteomics revealed LPC14:0 as a direct PPARδ ligand, binding via hydrogen bonds with Thr292/Thr289. This activation upregulates fatty acid transporters (CD36, FABP4) and metabolic enzymes (ACOX2), fueling malignant proliferation. Furthermore, CIRCMIP-derived biomarkers show robust diagnostic accuracy, establishing a new research paradigm and revealing the S. lugdunensis–LPC14:0–PPARδ axis as a therapeutic target in bladder cancer.
BACKGROUND:Despite a surge in neuropathic pain (NP) biomarker research over the past 2 decades, the translation of discoveries into clinical practice remains slow. To understand this translational gap, we conducted a comprehensive bibliometric analysis to map the field's evolution, intellectual structure, and strategic challenges. METHODS:We conducted a bibliometric analysis of NP biomarker-related publications from 2004 to 2024 using the Web of Science Core Collection (WoSCC) database. Tools including CiteSpace, VOSviewer and Scimago Graphica were employed to evaluate authors, institutions, countries/regions, journals, keywords and co-citations. RESULTS:A total of 2437 articles were included in this study. The United States and European countries play a leading role, while China demonstrates high publication output but comparatively lower citation impact. Keyword analysis identified 5 major research clusters, exposing a clear thematic evolution from foundational "molecular mechanisms" towards technology-driven frontiers, including "neuroimaging" and emerging biomarkers like "neurofilament light chain" (NfL). CONCLUSION:This study provides a strategic map of the NP biomarker field, highlighting a persistent gap between robust basic science discovery and its clinical application. The field's fragmentation into distinct research "silos" (e.g., molecular, neuroimaging) underscores that the primary future challenge is enhancing interdisciplinary integration. Accelerating progress will depend on building bridges between these domains to develop the multi-modal biomarker strategies essential for improving patient care.
OBJECTIVE:With the increase of patients with end-stage renal disease (ESRD), most of are receiving hemodialysis, hypoglycemia is a frequent occurrence in ESRD patients due to alterations in glucose and insulin metabolism. The purpose of our study was to explore the correlation between hypoglycemia and long-term survival in patients with ESRD during hemodialysis. METHODS:Using the database of Hemodialysis Center in Taizhou Second People's Hospital, 268 ESRD patients undergoing maintenance hemodialysis (MHD) for more than 3 months between January 1, 2019 and September 30, 2023 were enrolled. Basic information, laboratory tests and treatment conditions of patients were collected. We analyzed the impact of hypoglycemia during hemodialysis on survival rate, and explored whether hypoglycemia is an independent risk factor for mortality in MHD patients. RESULTS:We found that factors such as BMI, smoking, and alcohol consumption didn't affect survival rate in ESRD patients, while all-cause mortality was higher in ESRD patients with diabetes, cardiovascular diseases, cerebrovascular disease and experienced hypoglycemia during hemodialysis (p < 0.05). We also observed that almost all ESRD patients with diabetes experienced hypoglycemia during dialysis, and 87.5% experienced ≥3 times, while this phenomenon was hardly observed in nondiabetic ESRD patients. Cox proportional hazards model analysis found that, frequent hypoglycemia (≥3 times) was associated with higher mortality risk in ESRD patients (p = 0.041), adjusted hazard ratios (95% confidence intervals) 3.998 (2.462-6.492). CONCLUSIONS:Occurrence of hypoglycemia during dialysis was associated with a higher risk of death, frequent hypoglycemia (≥3 times) was an independent risk factor for death in MHD patients.
Continuous renal replacement therapy (CRRT) used in cardiac surgery-associated acute kidney injury (CSA-AKI) may have different characteristics from other diseases. We reviewed the medical records of patients with CSA-AKI requiring CRRT who underwent cardiac surgery from January 2020 to September 2021. Patients with AKI caused by other reasons who received CRRT during the same period were also evaluated. A total of 28 patients with CSA-AKI and 12 patients with AKI caused by other reasons were enrolled in this study. Compared with AKI patients caused by other reasons, patients with CSA-AKI were found to have lower mean arterial pressure, higher level of bilirubin, higher vasoactive-inotropic score, and larger daily diuretic dosage. The patients with CSA-AKI were prescribed CRRT earlier than the patients with AKI caused by other reasons. There was a significant difference in the CRRT anticoagulation method between patients with CSA-AKI and patients with AKI caused by other reasons. Six patients with CSA-AKI were treated with regional citrate anticoagulation (RCA), and the other 22 patients were treated with low molecular weight heparin or without anticoagulants. The timing of CRRT initiation in patients with CSA-AKI is earlier than that in patients with AKI caused by other reasons. Although RCA is recommended as the preferred anticoagulant for patients without contraindications, patients with CSA-AKI often have circulatory dysfunction and severe liver damage, so the risk of citrate accumulation is greater, whether to use RCA should be determined according to the individual condition of the patient.
Abstract Background Decreased dietary protein intake (DPI) may lead to protein-energy malnutrition and may be associated with increased mortality risk. We hypothesized that longitudinal changes in dietary protein intake have independent associations with survival in peritoneal dialysis (PD) patients. Methods 668 stable PD patients were selected in the study from January 2006 to January 2018 and were followed up until December 2019. Their three-day dietary records were collected at the baseline (the sixth month after PD) and thereafter every 3 months for two and a half years. The latent class mixed models (LCMM) were used to identify subgroups of PD patients with similar longitudinal trajectories of DPI. The relation between DPI (baseline and longitudinal data) and survival was examined using Cox model to estimate death hazard ratios. Meanwhile, different formulae were used to assess nitrogen balance. Results The results showed that baseline DPI ≤ 0.60g/kg/day was associated with the worst outcome in PD patients. Patients with DPI 0.80–0.99g/kg/day and DPI ≥ 1.0g/kg/day both presented positive nitrogen balance; patients with DPI 0.61–0.79g/kg/day presented obviously negative nitrogen balance. Longitudinal association between time-dependent DPI and survival was found in PD patients. The consistently low DPI' (0.61–0.79g/kg/d) group was correlated with increased death risk as compared with the 'consistently median DPI' group (0.80–0.99g/kg/d, HR = 1.59, p = 0.008), whereas there was no difference in survival between 'consistently median DPI' group and 'high-level DPI' group (≥1.0 g/kg/d, p > 0.05). Conclusion Our study revealed that DPI ≥ 0.8 g/kg/day was beneficial to the long-term outcome for the PD population.
Purpose: Benign prostatic hyperplasia (BPH) describes common noncancerous prostate enlargement. BPH is usually associated with lower urinary tract symptoms and an increased risk of cerebrovascular diseases, such as stroke and its recurrence. White matter hyperintensities (WMHs), markers of cerebral injury, increase the risk of stroke, cognitive impairment, dementia, and death. The relationship between BPH and WMHs remains unclear. This study aimed to determine the association between BPH and WMHs. Methods: A total of 788 male patients from the First Affiliated Hospital of Kunming Medical University from July 2019 to September 2021 were enrolled in this cross-sectional study. BPH was assessed by abdominal ultrasound, and three independent neuroradiologists rated the presence or absence of WMHs. Multiple imputations of chained equations were used to handle missing data. Logistic regression was used to assess the relationship between BPH and WMHs. Results: Patients with BPH presented an increased risk of WMHs with a crude odds ratio (OR) of 2.76 (95% CI, 2.02-3.79) and an adjusted OR of 1.75 (95% CI, 1.24-2.48) after controlling for potential confounding factors in the multivariate logistic regression. Conclusion: We found that BPH was closely associated with WMHs in male Chinese individuals.
Background: Chronic kidney disease (CKD) is very common now and associates with high overall and cardio-vascular mortality. Numerous studies have reported that Heart rate variability (HRV) could also be used to detect cardiovascular autonomic dysfunction (CAD). We investigated the association of electrochemical skin conduc-tance (ESC) of EZSCAN results with HRV in non-dialysis CKD patients.Methods: In a cross-sectional study, we enrolled 248 prevalent non-dialysis CKD patients. Patients underwent a 24-h Holter (CB-2302-A, Bio Instrument, China). A time domain analysis of HRV was performed, and the following parameters were obtained: SDNN, SDANN, rMSSD, pNN50. EZSCAN device (Impeto Medical, Paris, France) measures ESC values of each participants. Mean global skin conductance computed as 0.5 * (reflecting (right + left hand)/2 + (right and left foot)/2). Log transforms data into a normal distribution for statistical analysis.Results: There were 142 males and 106 females included in the present study. Patients' age was 56.6 +/- 17.08 years. Logarithm(Log) (global ESC) was independently predicted by age (P<0.01), hypertension history, esti-mated Glomerular filtration rate (eGFR) and log SDNN (P<0.05). While log SDANN, rMSSD and pNN50 were not independent predictors for log (global ESC).Conclusion: Increased global ESC significantly associated with elevated HRV, specifically SDNN in non-dialysis CKD patients. This suggested that global ESC may appear to be an important predictor of CAD, and even could be used as a cardiovascular risk factor in non-dialysis CKD patients.
This retrospective study was designed to compare the cause of hospitalization and influencing factors between patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Baseline data and laboratory parameters of 192 dialysis patients (92 HD patients and 100 PD patients) were compared. Quantitative parameters with normal distribution were assessed using independent t-test or analysis of variance (ANOVA). Quantitative parameters with non-normal distribution were assessed by non-parametric test. Qualitative data were statistically compared using χ2 test. The number of patients with urban employee medical insurance (88 HD patients and 60 PD patients) and rural cooperative medical care (12 HD patients and 40 PD patients) significantly differed (P < .01). The hospitalization rate of PD patients was significantly higher than that of HD counterparts. The average length of hospital stay of PD patients was 10 days, remarkably longer than 8 days of HD patients (P < .01). The primary cause of hospitalization for HD patients was infection-related complications, followed by cardiovascular, cerebrovascular complications and dialysis access disorders. The primary cause of hospitalization for PD patients was infection-related complications, followed by dialysis access disorders, cardiovascular, and gastrointestinal complications. Compared with the HD group, the levels of hemoglobin, serum albumin, alkaline phosphatase, intact parathyroid hormone were significantly decreased, whereas serum urea nitrogen, serum creatinine, phosphorus levels and cardiothoracic ratio were remarkably increased in the PD group (all P < .01). The hospitalization rate of PD patients is relatively higher, and the length of hospital stay is longer. Extensive attention and efforts should be delivered to enhance the understanding of disease and lower the risk of complications for patients.
BACKGROUND:A big concern for continuous ambulatory peritoneal dialysis (CAPD) is dialysis adequacy in anuric patients. Some studies have even suggested that CAPD patients should be transferred to hemodialysis when they become anuric in order to achieve adequate dialysis. In the present study, we tried to find out whether anuric patients can maintain nitrogen balance with standard or even lower dialysis dose.MATERIALS AND METHODS:This was a cross-sectional single-center study. Fifteen anuric CAPD patients were selected. Their 3-day dietary records were reviewed by a dedicated dietitian to calculate their energy, protein, and nitrogen intake (NI). Nitrogen removal (NR) from urine and dialysate was measured by Kjeldahl technique. Fluid status was evaluated by bioimpedance analysis. Subjective global nutritional assessment was used to evaluate nutritional status.RESULTS:Among the 15 patients, 9 males and 6 females, mean age was 63.80 (31 - 77) years, dialysis duration 39.76 (6 - 127) months, body weight 58.70 ± 9.86 kg, and height 160.20 ± 7.93 cm. The mean dietary protein intake was 43.28 ± 7.57 g/day (0.80 ± 0.15 g/kg/d), total Kt/V was 1.59 ± 0.32 with dialysis dose of 7,904.00 ± 1,481.79 mL. However, they achieved neutral nitrogen balance (NI 6.92 ± 1.21 g/d vs. NR 6.83 ± 1.36 g/d, N balance 0.09 ± 1.00 g/d). All of them maintained good nutritional status (SGA "A", serum albumin 39.67 ± 3.58 g/L), and no symptom of nitrogen retention (serum urea 20.49 ± 3.06 mmol/L). Meanwhile, they achieved good volume control with a slightly low total fluid removal (704.00 ± 293.21 mL/d).CONCLUSION:Our study suggested that anuric patients (even with low Kt/V) can achieve nitrogen balance and stay well-nourished with appropriate dietary protein intake.
Background: Diabetic microvascular complications, including diabetic kidney disease (DKD), retinopathy (DR), and neuropathy (DN), were major causes of morbidity and mortality in diabetic patients worldwide. It has been suggested that urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were not the only indicators of renal function impairment in DKD and that they were also associated with diabetic peripheral neuropathy (DPN) which might affect nerve conduction velocity (NCV). As 30-40% of DPN patients had no subjective symptoms, while current perception threshold (CPT) could detect sensory nerve damage at an early stage. As a result, we aimed to investigate correlation between UACR, eGFR and CPT in DKD patients. Methods: A total of 273 DKD patients from the First Affiliated Hospital of Kunming Medical University from January 2018 to June 2020 were enrolled to complete the CPT test. CPT values of the bilateral median nerve and superficial and deep peroneal nerves at 2000 Hz, 250 Hz, and 5 Hz were collected. Results: In normoesthesia and hypaesthesia patients with DKD, MDRD-eGFR correlated negatively with TC (r =-0.135, P = 0.037), left superficial peroneal and deep peroneal nerve 2000 Hz CPT (r =-0.205, P = 0.001) and right superficial peroneal and deep peroneal nerve 2000 Hz CPT (r =-0.154, P = 0.017). Besides, left and right superficial peroneal and deep peroneal nerve 2000 Hz CPT correlated with CKD-EPI-eGFR and UACR. Multivariate logistic regression analysis found left superficial peroneal and deep peroneal nerve 2000 Hz CPT was independently associated with both MDRD-eGFR and CKD-EPI-eGFR. Conclusion: Decreased MDRD-eGFR and CKD-EPI-eGFR were expected to be a predictor of peripheral nerve injury in normoesthesia and hypaesthesia patients with DKD.
Background: As kidney disease progresses, patients often experience a variety of symptoms. There are very few studies reporting spectrum of predialysis patients' symptoms in peritoneal dialysis (PD) patients. Furthermore, the clinical significance of predialysis patients' symptoms for PD patients' prognosis remains unknown. Methods: In this retrospective cohort study, patients who started PD during 1 January 2006 to 31 January 2018 were included. Patients' predialysis symptoms and clinical parameters were obtained. Both the short- and long-term patients' outcome were investigated by Cox regression and Kaplan-Meier's survival analysis to identify the relationship between clinical symptoms and patients' mortality on PD. Results: A total of 898 incident PD patients were included. The anorexia (58%) was the most common predialysis symptom in the present cohort, followed by insomnia (32.7%), fatigue (27.6%), syndromes of heart failure (27.6%), and nausea (20.5%). The only symptom significantly associated with both six-months and 12-months mortality on PD was nausea (HR 2.359, 95% CI 1.377-4.040, p=.002 and HR 1.791, 95% CI 1.176-2.729, p=.007, respectively). But in the long-term, anorexia (HR 1.392, 95% CI 1.070-1.811, p=.014) was the only symptom significantly associated with patient's all-cause mortality after adjusting for other confounding factors. Conclusions: Our study demonstrated that nausea and anorexia were the most important predialysis symptoms, which was associated with patients' short- and long-term mortality on PD treatment, respectively. The results indicated that predialysis evaluation and management of symptoms of nausea and anorexia may be a possible way to improve patients' outcome on PD.
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.
Blood pressure (BP) is a known prognostic marker for mortality in patients on maintenance hemodialysis (MHD). However, definition of the BP and its optimal values vary essentially among different MHD populations. Our purpose was to clarify these important clinical parameters in a Chinese MHD cohort. Accordingly, we reviewed the available records of patients on regular MHD during the past 10 years and made a comparison between the deceased (n=81) and survival ones (n=131). Multiple logistic regression and Kaplan-Meier survival analysis were used to examine the effect of BP on mortality and long-term survival, respectively. The all-cause mortality in our patients was 38.2%, in which 49.4% was from cardio-cerebrovascular deaths. Using the multiple logistic regression, we found that the sitting (the same definition hereafter) pre-dialysis systolic BP (SBP) was significantly associated with both the all-cause mortality and cardio-cerebrovascular deaths exclusively in patients of 60-80 years. Moreover, a pre-dialysis SBP of 140-160 mmHg in these patients had the minimum all-cause mortality (23.5%) against that conferred by either a lower (42.1%) or higher SBP value (61.5%). This observation was further confirmed by the Kaplan-Meier survival analysis. As fresh gain to the practice of hemodialysis, our report revealed that BP worked in a time-dependent way among a Chinese MHD cohort and highlighted a U-shaped association between the pre-dialysis SBP and all-cause mortality. These findings may hence help to obtain optimal BP control for better survival and lend some prognostic insight into mortality in these MHD patients.
OBJECTIVE:To investigate trends in hospitalization expenditures in adults with kidney disease, to analyze the time pattern of outpatient and inpatient medical expenditures for patients with kidney diseases, and to support the health care reform by exploring the causes.METHODS:Medical expenditure data for kidney disease patients aged ≥18 years from the outpatient and in-patient data of the information center in the Grade?A tertiary hospital in Beijing, China from January 1, 2012, to December 31, 2017, were retrospectively analyzed. It provided descriptive evidence on the time patterns of expenditures per visit and capita, and potential influencing factors of the time changes were further explored.RESULTS:It was found that medical expenditures had increased rapidly from 2012 to 2017. The result showed that the average outpatient expenditure per capita for kidney disease patients was 4 598 yuan in 2012, with an increasing tendency to 11 536 yuan in 2017. There was an obvious increase in the average number of visits (per year) from 3.94 in 2012 to 9.11 in 2017. Meanwhile, the mean inpatient expenditures per capita had an increasing tendency from 323 753 yuan in 2012 to 45 904 yuan in 2017. There was also an increase of mean inpatient expenditures per admission from 27 184 yuan in 2012 to 34 933 yuan in 2017, with a similar number of admissions over the 6 years. The increases in outpatient and inpatient expenditures per capita were driven by different reasons. The increase in outpatient expenditures per capita was driven by the increase of patient visits, while the increase in inpatient expenditures per capita was driven by the increase of the expenditures per admission. Also, drug and medical materials were the two categories that had the largest contribution to the inpatient expenditures. Drug expenses were the highest one, with an average of 12 524 yuan per visit in 2017, accounting for 32.4% of the average total expenditure in that year, while the average cost of consumables was 9 215 yuan, accounting for 23.9%.CONCLUSION:The increase of outpatient expenditures per capita was related to the increase of patient visits. Meanwhile, the growth of drug and consumable costs contributed to the total increase in the total inpatient healthcare costs. It is necessary to increase the proportion of treatment costs and medical service fees in the total expenditure.
Studies on nondialysis populations have linked visit-to-visit blood pressure (BP) variability (BPV) to cerebrovascular events and mortality. In view of the high prevalence of hypertension in hemodialysis patients, the predictive values of numerous factors for stroke, especially visit-to-visit BPV, were evaluated in this prospective cohort study.A total of 151 patients were enrolled in this study. The demographic features and various laboratory parameters were analyzed. At each routine hemodialysis visit, the predialysis, intradialysis, and post-dialysis BP measurements were systematically performed. We defined BPV using 4 metrics: standard deviation of the BP, coefficient of variation, average real variability (ARV), and variability independent of mean (VIM). Differences in the predialysis BPs from one treatment to the next (ie, interdialytic variability) and differences in the BPs from predialysis to post-dialysis (ie, intradialytic variability) were both studied in this work.Twenty-one patients developed stroke and 25 patients died. The multivariate Cox proportional hazards regression model revealed a significant relationship between stroke and the interdialytic BPV (both predialysis systolic BP variability and predialysis diastolic BP variability) and low-density lipoprotein-cholesterol (LDL-C).Our results indicate that a high interdialytic BPV is associated with an increased risk for stroke that is independent of several factors, including age, sex, antihypertensive medication use, and mean BP over time. There is potential that the optimal treatment goal for hemodialysis patients may be to reduce the interdialytic BPV rather than either the mean BP or the intradialytic BPV.
Background Given the important role of Sphingosine-1-phosphate (S1P) in maintaining the hemostasis in intestinal barrier function and regulation of inflammation and immune, we hypothesize that S1P might be a biomarker to predict peritonitis in peritoneal dialysis (PD) patients. Methods In this case-control study, 78 stable, continuous ambulatory peritoneal dialysis patients were enrolled and followed for the episode of PD associated peritonitis. Patients were divided into two groups by whether or not they had peritonitis during follow-up: non-peritonitis (n = 65) and peritonitis (n = 13) group. S1P was analyzed by enzyme-linked immunosorbent assay. Logistic regression analysis was used to assess factors associated with peritonitis. The variables identified by univariable regression models (p < 0.1) were further selected into the multivariable logistic regression model to determine whether they could independently affect peritonitis. Results Patients with peritonitis had a lower level of S1P than that of patients without peritonitis (1.3 ng/mL IQ 0.8, 3.6 ng/mL vs. 2.8 ng/mL IQ 1.5, 5.4 ng/mL, p = 0.018). The peritonitis group had lower serum albumin, lower blood leukocyte, lower hemoglobin and lower platelet count as compared to the non-peritonitis group. Logistic regression analysis showed that S1P (OR = 0.381, 95% CI = 0.171–0.848, p = 0.018), blood leukocyte count (OR = 0.438, 95% CI = 0.207–0.925, p = 0.030), and serum albumin (OR = 0.732, 95% CI = 0.556–0.962, p = 0.025) were independent factors associated with peritonitis in the present PD population. Conclusion Our study showed that S1P was an independent determinant of subsequent peritonitis in PD patients. S1P might serve as a biomarker to predict peritonitis in PD patients.
Introduction It is unclear whether patients with end-stage renal disease (ESRD) and nephrotic syndrome (NS) can be treated with peritoneal dialysis (PD). Objectives To investigate the outcomes of PD treatment in ESRD patients with or without NS. Methods In this retrospective cohort study, all incident patients with ESRD and NS who started PD from 1 February 2006 to 31 December 2017, were matched with patients without NS using propensity scores based on age, sex, diabetes mellitus status, and serum albumin. Results Fifty-three patients in the NS PD group and 53 matched controls were included. The median survival of the NS PD group was comparable to that of the non-NS PD group. An interaction effect was observed between survival time and baseline NS status. Thus, patients' outcomes within and after 1.5 years were analyzed separately. Both mortality (log-rank test,p= .235) and technique failure (log-rank test,p= .543) rates within 1.5 years in patients with NS were comparable to those of the non-NS group. After 1.5 years, however, the NS status at baseline was associated with lower all-cause mortality (p= .020) and lower technique failure (p= .008) rates in PD patients compared with the non-NS group. The multivariable Cox regression analysis showed that compared with the patients in the non-NS PD group, PD patients with NS had both significantly lower all-cause mortality and lower technique failure rate after adjusting for other factors. Conclusions Our study indicates that PD may be considered as a long-term renal replacement therapy for patients with ESRD and baseline NS.
INTRODUCTION This study aimed to investigate the influence of peritoneal transport characteristics on clinical outcome in nondiabetic and diabetic nephropathy peritoneal dialysis (PD) patients. MATERIALS AND METHODS All 112 patients were from the PD Center. Peritoneal transport characteristic was assessed by peritoneal equilibration test. The patients were divided into 2 groups of high-transport group (HT) and non-high-transport group (non-HT) and followed-up till December 31st, 2010. The primary outcomes were all-cause death and technique failure. RESULTS The patients were followed-up for 65.9 ± 23.9 months. Diabetic nephropathy patients with HT had a higher all-cause mortality (P = .04) and technique failure (P = .04) than those with non-HT. There were no differences in outcomes between HT and non-HT subgroups without diabetic nephropathy. Cox regression demonrtrated that high peritoneal transport (HR, 2.369; 95% CI, 1.056 to 5.311), diabetic nephropathy (HR, 2.499; 95% CI, 1.134 to 5.508), age (HR, 1.081; 95% CI, 1.032 to 1.133), and peritoneal creatinine clearance (HR, 0.962; 95% CI, 0.929 to 0.997) independently predicted all-cause mortality in continuous ambulatory PD patients. Moreover, high peritoneal transport (HR, 2.299; 95% CI, 1.079 to 4.899) and age (HR, 1.070; 95% CI, 1.026 to 1.116) predicted technique failure in continuous ambulatory PD patients. CONCLUSIONS Diabetic nephropathy PD patients with HT had a higher all-cause mortality and technique failure than those with non-HT, but we did not find the correlation between peritoneal transport and outcome in nondiabetic patients. The peritoneal transport was an independent predictor for outcomes in continuous ambulatory PD patients.
The technique of hemodialysis was introduced into China more than 50 years ago; and both research and use of clinical hemodialysis began in mid-1960s to late-1960s. A brief review of the history of hemodialysis in China is presented here, including a brief description of pioneers and their contributions, local development and use of dialyzers, hemodialysis machines, and vascular access, and dialysis management and logistics.