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目的检测维持性血液透析患者（MHD）、非透析终末期肾脏疾病患者（ESRD）血清中铁调素（hepcidin）和血清转铁蛋白受体（serum transferring receptor,sTfR）的水平变化,探讨其在肾性贫血铁缺乏中的作用。方法选择维持性血液透析患者80例、非透析终末期肾脏疾病患者80例,健康体检者80例作为对照组。ELISA法检测血清Hepcidin、sTfR、总铁结合力（TIBC）,同时测定血清铁（Fe）、铁蛋白（FER）、血清转铁蛋白（TRF）,比较组间差异。结果 1维持性血液透析患者和非透析终末期肾脏疾病患者血清hepcidin和sTfR水平均明显升高,差异有统计学意义（P〈0.01）。2与非透析ESRD组相比,MHD组的血清hepcidin和sTfR水平显著升高,差异有统计学意义（P〈0.05）。3相关分析显示,血清hepcidin与Scr、hs-CRP、血清铁（Fe）、铁蛋白（FER）呈正相关,r分别为0.515、0.312、0.290、0.286,P均〈0.01;与HGB、eGFR、HCT、TRF、TIBC呈负相关,r分别为-0.466、-0.362、-0.285、-0.248、-0.224,P〈0.05。4血清sTfR水平与铁蛋白、转铁蛋白饱和度（TSAT）有相关性,相关系数分别为-0.764、-0.519,P均〈0.01;与血红蛋白和红细胞压积有相关性,相关系数分别为0.378和0.514,P均〈0.01。5血清hepcidin、sTfR联合铁蛋白或转铁蛋白饱和度诊断缺铁时,绘制受试者工作特征曲线（receiver operating characteristic curve,ROC）,曲线下面积为90.8%,对应的灵敏度为93.3%,特异度为77%。结论血清hepcidin、sTfR联合铁蛋白或转铁蛋白饱和度对于ESRD患者合并肾性贫血铁缺乏的评估及治疗有重要意义。

目的评估针对终末期肾病患者的两种治疗方式——活体亲属肾移植和血液透析的成本费用并进行比较,确定一些直接影响移植费用的医疗因素及其治疗方式的效价比问题。方法回顾性分析了中国西北地区372例常规血液透析的患者和122例活体亲属肾移植患者资料,随访至少满3年。所有的数据囊括了血液透析、肾脏移植、供者摘取手术、免疫抑制剂等的相关费用以及随访期间产生的费用。结果在前3年期间,血液透析患者和肾移植患者每年平均的花费分别为13 713/31 027美元、13 502/11 038美元和13 382/10 285美元。在肾移植患者中,是否服用地尔硫卓、是否发生急性排斥反应及感染并发症同移植费用具有显著相关性。结论从第2年开始,肾移植相比透析治疗具有更优的效价比,意味着更有效率,花费更少;而肾移植术后第1年中,没有服用地尔硫卓、发生急性排斥反应及感染并发症的患者会花费更多。

随着透析技术的进步及医疗保险的贯彻实施，接受血液透析治疗的终末期肾病（End Stage Renal Disease，ESRD）患者越来越多，生存时间越来越长，ESRD患者的心血管系统、血液系统、骨骼疾病等躯体并发症与体征异常已引起人们的广泛关注，而ESRD患者可能出现的如神经衰弱、焦虑症、抑郁症、恐惧感等精神或神经症候群则容易被忽视。

Chronic kidney disease （CKD） is a life-threatening disease that results in end-stage renal disease （ESRD） and consumes substantial health resources. In China, the prevalence of CKD in the general population is 10.8% and increases gradually with age [1]. CKD also causes hypertension.

This study adapted a statistical probabilistic anatomical map of the brain for single photon emission computed tomography images of depressive end-stage renal disease patients. This research aimed to investigate the relationship between symptom clusters, disease severity, and cerebral blood flow. Twenty-seven patients （16 males, 11 females） with stages 4 and 5 end-stage renal disease were enrolled, along with 25 healthy controls. All patients underwent depressive mood assessment and brain single photon emission computed tomography. The statistical probabilistic anatomical map images were used to calculate the brain single photon emission computed tomography counts. Asymmetric index was acquired and Pearson correlation analysis was performed to analyze the correlation between symptom factors, severity, and regional cerebral blood flow. The depression factors of the Hamilton Depression Rating Scale showed a negative correlation with cerebral blood flow in the left amygdale. The insomnia factor showed negative correlations with cerebral blood flow in the left amygdala, right superior frontal gyrus, right middle frontal gyrus, and left middle frontal gyrus. The anxiety factor showed a positive correlation with cerebral glucose metabolism in the cerebellar vermis and a negative correlation with cerebral glucose metabolism in the left globus pailidus, right inferior frontal gyrus, both temporal poles, and left parahippocampus. The overall depression severity （total scores of Hamilton Depression Rating Scale） was negatively correlated with the statistical probabilistic anatomical map results in the left amygdala and right inferior frontal gyrus. In conclusion, our results demonstrated that the disease severity and extent of cerebral blood flow quantified by a probabilistic brain atlas was related to various brain areas in terms of the overall severity and symptom factors in end-stage renal disease patients.