Hua-Chang Fang
National Yang-Ming University
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Featured researches published by Hua-Chang Fang.
Nephron | 2002
Hua-Chang Fang; Kang-Ju Chou; Chien-Liang Chen; Po-Tsang Lee; Yee-Hsuan Chiou; Shih-Yuan Hung; Hsiao-Min Chung
Background/Aim: Uremic patients are at an increased risk of being affected by tuberculosis (TB). Periodical tuberculin skin tests were suggested to detect TB-infected patients. These were replaced by chest radiographs in endemic areas like Taiwan. However, almost 50% of the TB incidence in dialysis patients was extrapulmonary. In this study, we tried to investigate the value of tuberculin tests in dialysis patients in endemic areas. Methods: The patients were recruited from our dialysis unit. Purified protein derivative (PPD) and control tests with antigens for Candida and toxoid were performed using the Mantoux method. PPD with >10-mm induration will be considered positive. Skin anergy meant that the indurations of all antigens were less than 5 mm. A follow-up was done 12 months after the tests. Results: A total of 177 patients were evaluated. Anergy was found in 40 patients (22.6%). A positive predictor of anergy was age >45 years (p = 0.03), while a negative predictor was prealbumin >20 mg/dl (p = 0.04). Fifty-three patients (30%) had positive PPD tests. Seven of the positive PPD patients (13.2%) developed active TB during the following years. Among the 40 patients with skin anergy, 6 (15%) were found to have active TB. Of the 48 patients (21.1%) with indurations of the PPD tests between 5 and 10 mm, none was found to have active TB. Conclusion: Although anergy will influence the sensitivity of PPD tests, these tests in combination with anergy tests could help to establish the diagnosis of TB in uremic patients, even in TB-endemic areas.
Blood Purification | 2004
Shih-Yuan Hung; Yao-Min Hung; Hua-Chang Fang; Jeng-Hsien Yeh; Gin-Chuan Hung; Cheng-Ju Wu; Kang-Ju Chou; Hsiao-Min Chung
Background: Intradialytic hypotension (IH) has been long recognized as a common complication during hemodialysis (HD) therapy, but few studies have discussed IH-related myocardial injuries and the long-term prognosis of patients prone to IH (HP). Methods: We conducted a prospective study on 70 chronic HD patients who had no recent occurrences of acute coronary artery syndrome. The patients were divided into two groups: HP (n = 29) and IH resistant (n = 41). While they underwent HD therapy, we monitored and evaluated their baseline data and their patterns of cardiac troponin I (cTnI), creatine kinase, and creatine kinase isoenzyme MB. Results: The HP and IH-resistant patients had similar baseline cardiac marker levels that did not seem to be influenced by uneventful HD therapy. However, if during HD therapy the patients experienced an episode of symptomatic IH, they were found to have significant increases in the creatine kinase MB activity at the end of HD therapy and in the cTnI levels 44 h following HD. After 12 months, the HP patients with baseline cTnI levels ≧0.20 ng/ml were more likely to experience cardiovascular events or death (adjusted odds ratio 15.0, p = 0.012). Conclusions: Our study showed that, after symptomatic IH episodes, the HP patients were more likely to suffer occult myocardial injuries. HP patients who have high cTnI levels should be closely monitored for cardiovascular diseases.
Lupus | 2003
Po-Tsang Lee; Hua-Chang Fang; Chien-Liang Chen; Yee-Hsuan Chiou; Kang-Ju Chou; Hsiao-Min Chung
We studied the clinical course of 26 systemic lupus erythematosus(SLE) patients who started regular dialysis at our hospital and whose stay exceeded a three-month duration in order to investigate the long-term prognosis in a Chinese cohort. Clinical and serological activities of lupus before and after dialysis were analysed. To compare the long-term survival rate, controls were set using 78 age-matched end-stage renal disease (ESRD) patients who did not have SLE or diabetes mellitus and entered the chronic dialysis program at a similar period with SLE dialysis patients. There was a significant decrease in clinical lupus activity after starting regular dialysis (P < 0.05); however, the serologicalactivity remained the same. The five-and ten-yearsurvivalrates were significantly lower in the SLE patients (73 and 38% in the SLE group versus 95 and 88% in the non-SLE group, P < 0.05). SLE patients had a 4.3-times higher risk of death than non-SLE patients (P < 0.05, 95% confidence interval,1.2-15.2). Also, the deceased SLE patients had persistent lower serum levels of complement 3. SLE patients with ESRD remain clinically quiescent despite persistent serological abnormalities and have a worse prognosis than other uremia patients in the Chinese population.
Blood Purification | 2011
Hao-Huan Hu; Chih-Yang Hsu; Hua-Chang Fang; Po-Tsang Lee; Chien-Liang Chen; Tsu-Yuan Chang; Wei-Chieh Huang; Hsiao-Min Chung; Kang-Ju Chou
Background: The objective of this study was to assess the impact of heparin concentration retained in temporary double-lumen catheters on bleeding risk. Methods: Activated partial thromboplastin time (aPTT) was measured in patients hemodialyzed via double-lumen catheters. Heparin solutions of 5,000 U/ml (group 1, n = 95) and 1,000 U/ml (group 2, n = 89) were randomly retained in catheters after placement and each hemodialysis (HD) session. Blood transfusion, bleeding episodes, and changes of hematocrit were recorded. Results: The aPTT at the beginning of HD or 10 min after heparin lock was significantly prolonged, which was more prominent in the 5,000 U/ml group, whereas the aPTT declined to baseline values at the end of HD or before the next dialysis session in both groups. Infection and occlusion rates were similar in both groups. More patients suffered from major bleeding and prominent decline of hematocrit in the 5,000 U/ml group. Conclusions: Low-dose heparin (1,000 U/ml) retention in double-lumen catheters for temporary HD maintains comparable catheter patency and might reduce the bleeding risk.
Nephron | 2015
Hsin-Yu Chen; Kang-Ju Chou; Hua-Chang Fang; Chien-Liang Chen; Chih-Yang Hsu; Wei-Chieh Huang; Chien-Wei Huang; Chun Kai Huang; Po-Tsang Lee
Background: Ultrafiltration is an adjunctive treatment for decompensated heart failure patients with cardiorenal syndrome. The efficacy and safety of ultrafiltration in the patient cohort are still unknown. Methods: We systematically reviewed and evaluated randomized controlled trials, comparing diuretics with ultrafiltration in adult patients with decompensated heart failure and cardiorenal syndrome through January 2014. The primary outcomes were body weight loss and total fluid removal. Results: We identified 8 trials including 608 patients. In a random-effects model, the pooled difference of body weight loss was 1.44 kg between patients receiving ultrafiltration and diuretics (95% CI, 0.29-2.59; p = 0.01). The difference of fluid removal was 1.28 l between groups (95% CI, 0.43-2.12; p = 0.003). The RR for mortality was 0.90 for ultrafiltration compared with diuretics (95% CI, 0.61-1.33; p = 0.60) and the RR for renal function deterioration was 1.29 (95% CI, 0.90-1.85; p = 0.17). There is a trend toward reducing readmission rate in ultrafiltration group. Conclusions: Ultrafiltration is a safe and effective strategy in the treatment of cardiorenal syndrome without increasing the risk of renal deterioration.
Kidney International | 2003
Po-Tsang Lee; Hua-Chang Fang; Chien-Liang Chen; Hsiao-Min Chung; Yee-Hsuan Chiou; Kang-Ju Chou
Archive | 2013
Hsin-Yu Chen; Chih-Yang Hsu; Wei-Chieh Huang; Chien-Liang Chen; Po-Tsang Lee; Hua-Chang Fang; Kang-Ju Chou; Hsiao-Min Chung; Li-Fong Wang
Acta Nephrologica | 2008
Wei-Chieh Huang; Chih-Yang Hsu; Hao-Huan Hu; Kang-Ju Chou; Po-Tsang Lee; Chien-Liang Chen; Tsu-Yuan Chang; Hua-Chang Fang; Hsiao-Min Chung
Dialysis & Transplantation | 2004
Gin-Chuan Hung; Shih-Yuan Hung; Kang-Ju Chou; Hua-Chang Fang; Yao-Min Hung; Po-Tsang Lee; Yee-Hsuan Chiou; Hsiao-Min Chung
Dialysis & Transplantation | 2005
Chih-Yang Hsu; Shih-Yuan Hung; Hua-Chang Fang; Kang-Ju Chou; Hsiao-Min Chung