Professor Dong Jie’s mentor was professor Wang Haiyan, China’s “mother of the nephrology”. She completed a strict training in medical education and research in the Peking University Health Science Center. During her doctoral period, due to the needs of the project, Dong Jie once ran across the families of many dialysis patients in Beijing and saw that uremia patients were poor due to illness, they lost their jobs or were even forgotten by their families and the society. Her heart was touched and she was determined to use simple and effective cure methods without affecting normal social functions to save the patients. Peritoneal dialysis is a maintenance dialysis method that is consistent with this concept. It uses the semipermeable membrane properties of the patient's own peritoneum to effectively remove toxins and water, greatly saving health and human resources, and is very suitable for vigorous promotion in China.
It’s beautiful because it’s simple
"It’s beautiful because it’s simple" is exactly the true portrayal of Dong Jie's exploration to peritoneal dialysis. Abdominal wall pressure complications is a unique complication of peritoneal dialysis, due to the patient's congenital abdominal wall defects or acquired malnutrition, weak tissue, peritoneal diarrhea infusion of hernia, hernia, scrotal edema and other complications. Although the incidence is lower than 5%, the patient often discontinues peritoneal dialysis treatment. The traditional concept is that these patients have a high surgical risk and poor results. They are generally reluctant to try, and Dong Jie believed that she can overcome the difficulties. She actively communicated with the Beijing Medical College Medical Imaging Department, general surgery, thoracic surgery, etc. to form a multidisciplinary team, not easily let go of any one case. Nowadays, the interdisciplinary team of Peking University Hospital has accumulated rich clinical experience and brought good news for many similar cases in North China. Continued dialysis treatment is no longer a distant dream.
Professor Dong Jie
Make peritoneal dialysis easier
How to make peritoneal dialysis simpler and give full play to its technical superiority is what Dong Jie is thinking about. She is convinced that simplicity is an art and that when it comes to dealing with complex issues, it is better to make it as simple as possible.
The peritoneal dialysis operation requires the patient to use aseptic technique to connect his or her own peritoneal dialysis tubing and peritoneal dialysis tubing system and if inadvertently, may cause peritonitis. However, ultraviolet irradiation, wearing masks and hats, and the "six-step method" of washing hands, etc., this series of cumbersome procedures not only waste the patient's time but also hampers the scope of their activities and is not conducive to the return to society. The clean operation compartment designed by Dong Jie team creates a mini-sterile space that is compact and portable and provides a mobile exchange room for patients to go out to play, learn and work. This technology obtained 5 utility model patents, 1 invention patent, and successfully implemented the patent transformation, which created favorable conditions for the registration and promotion of enterprise products.
Peritonitis is one of the risks that affect the survival rate of patients, and it is crucial to effectively prevent peritonitis. However, according to the classic protocol for peritonitis treatment recommended by the international guidelines, it is necessary to continue the intraperitoneal or intravenous injection of antibiotics for 14 to 21 days. This not only costs manpower and time, increases medical expenses, but also does not help maintain patient compliance. Dong Jie’s team conducted a randomized controlled study and figured out that intraperitoneal plus vancomycin plus daily oral fluocinolone every 5 days can achieve a high cure rate and low recurrence rate comparable to traditional treatment levels. This simpler and more economical treatment plan is particularly suitable for patients with peritoneal dialysis who have poor sight and mobility.
Malnutrition of dialysis patients is another independent risk factor for poor prognosis. Routine assessment, early diagnosis and treatment are very important in clinical practice. Traditional methods for assessing muscle protein storage are expensive, invasive, and inconvenient to grasp. After continuous trials and efforts, they finally developed a new lean body mass prediction formula for both peritoneal dialysis and chronic kidney patients. The accuracy and precision are superior to the aforementioned traditional methods, providing a rapid measurement of muscle protein in clinics for clinicians.
Together for a better future
Dong Jie is not satisfied with what has already achieved. She is leading the team to make even more efforts to further promote peritoneal dialysis technology. In the surveys of provinces and cities across the country, she profoundly realized that the current medical and health policy is a key factor that restricts the development of peritoneal dialysis technology, including restrictions on the use of peritoneal dialysis fluids and the lack of peritoneal dialysis-related medical fees. She understood that we must vigorously assist the health policy department in formulating and improving relevant policies in the new round of medical reforms in China.
Since 2016, Dong Jie has, on the one hand, appealed to the nephrology medical practitioners at national, provincial and municipal academic events to encourage everyone to join hands and actively communicate with policy departments, in order to shake up this layer of frozen ground; on the other hand, she relied on experts from the Blood Purification Branch under the leadership of the Beijing Medical Association to communicate with the leaders of the Beijing Municipal Health and Family Planning Commission, the Medical Insurance Center and the National Development and Reform Commission, and achieved remarkable results. In the past few years, the experts have submitted 9 surgical projects and 7 medical fee-paying projects that have attracted the attention of Beijing Municipality and related government departments. The favorable policy for Beijing's peritoneal dialysis is just around the corner.
It’s beautiful because it’s simple. She feels at ease with no regrets. "We will not let outside turmoil be our embarrassment. We do a little bit each day and we will be closer to our goal," said Dong Jie, who won the John Maher Award. She will continue to pursue the ideal peritoneal dialysis treatment, allowing uremia patients to live in an infinitely close to normal life.
Written by: Lu Linlin
Edited by: Wang Chengsiou
