Objective To construct an intradialytic exercise intervention program for maintenance hemodialysis （MHD） patients with sarcopenia,and to evaluate its effects. Methods We constructed an intradialytic exercise intervention program for MHD patients with sarcopenia based on evidence summary and Delphi method. 51 patients with sarcopenia who underwent hemodialysis in a tertiary hospital in Lianyungang from March to July 2021 were randomly divided into an experimental group（25 cases） and a control group（26 cases）. The experimental group was given the intradialytic exercise intervention program on the basis of routine nursing. The intradialytic exercise intervention program in MHD patients with sarcopenia includes 5 parts,including pre-exercise assessment,exercise prescription,exercise monitoring,exercise-related support,and exercise effect evaluation. While the control group was given routine nursing during dialysis. After the intervention,the differences in the prevalence of sarcopenia,skeletal muscle mass index,mid-arm muscle circumference,calf circumference,grip strength,usual gait speed and the short physical performance battery（SPPB） score between the 2 groups were compared to evaluate effects of the intervention. Results The prevalence of sarcopenia in the experimental group was lower than that in the control group（P=0.014）,and the grip strength,usual gait speed,calf circumference and the SPPB score were higher than those in the control group after the intervention（P<0.05）. Conclusion The intradialytic exercise intervention program for MHD patients with sarcopenia is scientific and reliable,and the application of this program can effectively improve the relevant indicators of sarcopenia and decrease the prevalence of sarcopenia,which can provide a reference for clinical nursing practice.

Objective To construct a predictive model of decreased skeletal muscle mass in maintenance hemodialysis patients and to apply it in clinical practice to evaluate the effects of the model. Methods A total of 304 maintenance hemodialysis patients in a tertiary hospital in Lianyungang were selected as the training set by convenience sampling method,and various indicators of the decreased skeletal muscle mass group（n=74） and the non-decreased skeletal muscle mass group（n=230） were analyzed by univariate analysis. Logistic regression analysis was used to construct the prediction model and the model was simplified it. The area under the ROC curve was used to test the model effects,and 309 maintenance hemodialysis patients in a tertiary hospital in Xuzhou were selected to externally verity the effects of the model. Results The study finally included 4 factors,namely gender,BMI,calf circumference and predialysis creatinine,to construct the risk prediction model. The area under the ROC curve of this model was 0.911;the area under the ROC curve of the simplified model was 0.911;the accuracy rate of practical application was 75.40%. Conclusion The risk prediction model constructed in this study can predict the risk of decreased skeletal muscle mass in patients undergoing maintenance hemodialysis,and all the indicators are simple and easy to obtain,thus providing references for medical staff to carry out early indenfication and take preventive care interventions for high-risk patients in the early stage.

Objective To investigate the current situation of adverse dietary reactions in patients during hemodialysis and to analyze the influencing factors. Methods A cross-sectional survey was conducted on 368 hemodialysis patients in 4 tertiary hospitals in Lianyungang City by the general data questionnaire and dietary behavior questionnaire,and the influencing factors of adverse dietary reactions were analyzed. Results Among the 81.8%（301 cases） of patients who ate during dialysis,14.0%（42 cases） had hypotension; 4.7%（14 cases） had cough; 1.7%（5 cases） had nausea. Logistic regression analysis results showed that diabetes mellitus,dialysis duration,mealtime,and pre-dietary systolic blood pressure were the influencing factors of hypotension（P<0.05）. The results of single factor analysis showed that age and diet position were influencing factors of cough（P<0.05）,and pre-dietary systolic blood pressure was influencing factor of nausea（P<0.05）. Conclusion During hemodialysis,most of patients who have dietary behaviors are prone to suffer from adverse dietary reactions. Medical staff should pay more attention to patients with diet in hemodialysis,and guide their dietary behaviors during dialysis,so as to reduce the occurrence of adverse dietary reactions.