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Kidney International Supplements (2019) 9, e1-e81 e53 Chapter 6. Prevalence, incidence, and characteristics of dialysis patients e57 Chapter 7. Clinical measurement and treatment among dialysis patients e60 Chapter 8. Vascular access e62 Chapter 9. Cardiovascular diseases and diabetes among dialysis patients e63 Chapter 10. Hospitalization e66 Chapter 11. Medical expenditures for dialysis patients e68 Chapter 12. Kidney transplant waiting list e74 Chapter 13. Discussion e75 References e76 Appendices: Definitions of ICD coding e76 Appendix 1 | Coding of various CKD etiologies e77 Appendix 2 | Coding of CKD stages e78 Appendix 3 | Coding of diabetes mellitus e78 Appendix 4 | Coding of hypertension e78 Appendix 5 | Coding of CVD e80 Appendix 6 | Coding of CVD operations e81 Appendix 7 | Coding of AKI www.kisupplements.org d e t a i l e d c o n t e n t s

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Kidney International Supplements (2019) 9, e1-e81 e53 Chapter 6. Prevalence, incidence, and characteristics of dialysis patients e57 Chapter 7. Clinical measurement and treatment among dialysis patients e60 Chapter 8. Vascular access e62 Chapter 9. Cardiovascular diseases and diabetes among dialysis patients e63 Chapter 10. Hospitalization e66 Chapter 11. Medical expenditures for dialysis patients e68 Chapter 12. Kidney transplant waiting list e74 Chapter 13. Discussion e75 References e76 Appendices: Definitions of ICD coding e76 Appendix 1 | Coding of various CKD etiologies e77 Appendix 2 | Coding of CKD stages e78 Appendix 3 | Coding of diabetes mellitus e78 Appendix 4 | Coding of hypertension e78 Appendix 5 | Coding of CVD e80 Appendix 6 | Coding of CVD operations e81 Appendix 7 | Coding of AKI www.kisupplements.org d e t a i l e d c o n t e n t s

No abstract

The number of patients on hemodialysis (HD) is rapidly increasing in China. As an Asian country with a large number of HD patients, understanding the status of Chinese HD patients has a special significance. We reported here the baseline data for China Dialysis Outcomes and Practice Pattern Study Phase 5 (DOPPS5). The DOPPS is an international prospective, observational cohort study. Patients were restricted to the initial sample of patients who participated in China DOPPS5. We summarized the baseline demographic and clinical data of patients. Results were weighted by facility sampling fraction. 1186 patients were initial patients in China DOPPS5. The mean age was 58.7 ± 3.5 years, with 54.6% males. The median dialysis vintage was 3.4 (1.5, 6.3) years. The main assigned primary end-stage kidney disease (ESKD) causes was chronic glomerulonephritis (45.9%), followed by diabetes (19.9%). 17.6% patients had hepatitis B infection, and 10.0% patients had hepatitis C infection. 25.9% patients had a single-pooled Kt/V < 1.2. 86.6% patients had albumin > 3.5 g/dl. 18.8% patients had hemoglobin < 9 g/dl. 66.5% patients had serum calcium in target range (8.4–10.2 mg/dl), 41.5% patients had serum phosphate in target range (3.5–5.5 mg/dl) and 51.2% patients maintained PTH in 150–600 pg/dl. 88.2% patients used fistula as their vascular access. Meanwhile, there were differences in the demographic, clinical, laboratory, and treatment characteristics among the three cities participated in China DOPPS. We observed a relatively higher albumin level and a higher rate of fistula usage in our patients. But it remains a major challenge to us on the management of CKD-MBD and anemia. This study did not include patients in small cities and remote areas, where the situation of HD patients might be worse than reported.

Introduction: Although intradialytic exercise is considered a form of "nonpharmacological medicine" for patients receiving maintenance hemodialysis (MHD), this practice has not been widely implemented in most dialysis centers because of clinical limitations. We, therefore, aimed to design an intradialytic exercise training program to improve the implementation of this practice and determine its impact on physical performance and cardiovascular risk factors in patients receiving MHD. Methods: A total of 132 MHD patients at 4 outpatient dialysis units were enrolled and assigned randomly into exercise (n = 67) and control groups (n = 65). During a 2-year period, patients in the exercise group participated in 20-min exercise training sessions within dialysis sessions on 3 days per week. All patients underwent assessments of physical function (6-min walk test) and cardiovascular risk factors (blood pressure [BP], total cholesterol [TC], low-density lipoprotein [LDL], high-sensitivity C-reactive protein [hsCRP], albumin [Alb], hemoglobin [Hb], and erythropoietin [EPO] dose) at the baseline and annually thereafter. Results: Of the participants, 50.8% had completed the study after 2 years. No statistically significant intragroup or intergroup differences were observed in the measures of 6MD, BP, TC, hsCRP, Alb, Hb, and EPO dose. Conclusion: The results suggest that although this low-intensity, nonprogressive intradialytic exercise program may be practical, it was not sufficient to improve physiological function and reduce cardiovascular disease risk factors in patients receiving MHD.

Background: Early mortality risk of maintenance hemodialysis (MHD) patients varies by country and ethnicity. Here, early mortality in incident Chinese HD patients were studied.Methods: Data from 1 January 2007 to 31 December 2013 were pulled from Beijing dialysis registry system. All included patients were followed to the end of 2013. This time period of dialysis was divided into six intervals (≤120, 121–365 days; 1–2, 2–3, 3–4, ≥5 years). Patients’ demographics, primary cause of end-stage renal disease (ESRD), date of first HD, date of death, cause for death, date and cause of censoring were extracted from the registry database. All-cause mortality (per 100 patient-years) was calculated for each period stratified by sex, age and cause of ESRD. Monthly mortality rates were also calculated.Results: A total of 11,955 patients were included, 6738 were males and 5217 were females. The mean age at dialysis initiation was 57.7 ± 16.1 years. The median follow-up time was 19.8 months. There were total 2555 deaths. The overall mortality rate was 8.2 per 100 patient-years. Mortality rates were 18.7, 7.5, 6.9, 6.9, 6.5 and 6.2 in each period. The first 2 months mortality rates were 41.9 and 16.6 per 100 patient-years. Higher mortality was observed in patients who were older, female, diabetic and hypertensive.Conclusions: The most critical period was the first 2 months of dialysis initiation. Patients who were older, female, diabetic and hypertensive had higher risk of early mortality. Our analysis highlighted that the transitional period from sever CKD stages to dialysis initiation, when optimal supportive care should be adopted, was crucial for patients’ survival.