Objective To investigate the correlation between hemoglobin variability with hospitalizations/mortality of maintenance hemodialysis(MHD) patients.Methods In a retrospective study,we analyzed the hemoglobin variability and hospitalization and mortality of MHD patients from June,2012 to June,2014.Data of normal distribution were performed by analysis of variance.The X~2test with Yates correction and Fisher’s exact test were used for no-numerical date.Correlations between hemoglobin variability and age,dialysis age and mean hemoglobin were analyzed with Spearman’s correlation test.To predict the hospitalizations/mortality,logistic regression analysis was performed.Results In a total of 105 MHD patients,mean hemoglobin was(108.39±8.81)g/L,mean hemoglobin SD was(11.43±4.62)g/L.95.24%of patients had a high fluctation of hemoglobin.All the patients were divided into outpatients group(42 patients),in the hospital group(45 patients)and dead group(18 patients).The age of three groups were(64.02±13.02)years,(69.44± 13.47)years and(81.44±10.15)years respectively.The dialysis age of three groups were(9.23±6.42)years,(6.80±4.47)years and(4.98±3.00)years.The mean hemoglobin were(110.46±7.12)g/L,(108.51±8.12)g/L and(103.29±12.00)g/L respectively.Hemoglobin SD were(9.96±3.74)g/L,(11.98 ± 5.29)and(13.47 ± 3.73)g/L.The differences between three groups had statistically significance.Hemoglobin variability was significantly correlatied with the erythropoietin adjustments(r= 0.209,P = 0.032).Logistic regression analysis revealed that the dialysis age and hemoglobin SD were the influencing factors of hospitalizations/mortality.Conclusions Hemoglobin variability is common in MHD patients.High hemoglobin fluctuation is the risk factor predicting hospitalizations and mortality.

Objective To detect the level of serum Klotho in chronic kidney disease (CKD) 3-5 stage patients and explore its relationship with the progress of renal function.Methods Twenty-nine patients with CKD 3-5 stage (CKD group) and 10 cases of age-matched non-CKD patients (control group) were enrolled in the study.The level of serum Klotho and fibroblast growth factor 23 (FGF23) were measured by enzyme-linked immunosorbent assay.Results The level of serum Klotho in CKD group was significantly lower than that in control group [(670.07 ± 146.22) ng/L vs.(1 125.50 ± 126.96) ng/L] (P ＜ 0.01).The level of serum FGF23 in CKD group was significantly higher than that in control group[(48.89 ± 44.28) ng/L vs.(10.48 ± 8.93) ng/L] (P ＜ 0.01).Pearson correlation analysis showed that the level of Klotho in CKD patients was positively correlated with estimated glomerular filtration rate (eGFR) and hemoglobin,and Klotho was negatively correlated with log urea nitrogen,log serum creatinine,log FGF23 and phosphate.Multiple regression analysis showed that log FGF23 and serum phosphorus were independent factors for serum Klotho level in patients with CKD.CKD patients were divided into rapid progression of renal function group (10 cases) and renal stability group (19 cases) according to annual rate of eGFR dechne.The patients in rapid progression of renal function group with lower serum Klotho [(580.27 ± 162.15) ng/L vs.(717.33 ± 115.22) ng/L],higher uric acid and more severe proteinuria [(448.00 ±65.21) mmol/L vs.(368.32 ±78.80) mmol/L,(1.99 ± 1.57) g/d vs.(0.60 ± 1.00) g/d] (P ＜0.05).Conclusions Serum Klotho level of CKD 3-5 stage patients decreases with the decline in renal function.Serum phosphate and FGF23 are the independent factors for serum Klotho.Serum Klotho may become the prediction index of renal function progress for patients with CKD.

Objective To investigate the relations between serum adiponectin and coronary artery calcification score (CACS) and to find the risk factors for coronary artery calcification in maintenance hemodialysis(MHD) patients.Methods Twenty-seven MHD patients(MHD group) and 13 healthy persons (control group) were enrolled in this study.The serum adiponectin was measured by enzyme-linked immunosorbent assay method.CACS was calculated by multi-row spiral CT.The circulating parameters such as hemoglobin (Hb),calcium,phosphate,calcium-phosphate product,intact parathyroid hormone (iPTH),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),albumin (Alb),high sensitive C-reactive protein (hs-CRP),and so on were detected.Results The level of serum adiponectin in MHD group [(15.00 ± 7.47) mg/L] was significantly higher than that in control group [(2.07 ± 0.83) mg/L],and there was significant difference (P＜ 0.01).Coronary artery calcification(CACS ＞ 0 score) was observed in 88.9％ (24/27) in MHD group and 10/13 in control group.The mean CACS in MHD group was significantly higher than that in control group [655 (0-3 570) scores vs.126 (0-731)scores],and there was significant difference (P ＜ 0.05).Eleven MHD patients and 1 healthy person had severe coronary artery calcifications,(CACS ≥ 400 scores).There was significan t difference in dialysis duration,diastolic pressure,phosphate calcium-phosphate product and adiponectin (P ＜ 0.05 or ＜ 0.01).Spearman analysis showed that CACS of MHD patients was positively correlated with dialysis duration,phosphate,calcium-phosphate product,serum creatinine and adiponectin (P ＜ 0.01 or ＜ 0.05).Only calcium-phosphate product remained as independent predictor of CACS in multivariate analysis (P ＜0.01).Conclusion Coronary artery calcification is common in MHD patients and which is correlated with dialysis duration,serum phosphate,calcium-phosphate product,serum creatinine and adiponectin.