Long-term clinical study of effects of hemodialysis combined with hemoperfusion on clearance of protein-bound uremic toxins in maintenance hemodialysis patients / 军事医学

ABSTRACT

Objective To observe the effects of long-term hemodialysis(HD) combined with hemoperfusion(HP) on the levels of protein-bound uremic toxins (PBUTs) in maintenance hemodialysis (MHD) patients.Methods Forty-six patients with MHD were selected and divided into HD +HP group and HD group .HD+HP group ( n=22 ) was treated with low-flux HD twice a week and HD combined with HP once a week ,while HD group(n=24) was treated with low-flux HD three times a week.The follow-up lasted 36 weeks.The pre-dialysis concentration of PBUTs was measured at week 12, 24, 36 and baseline.PBUTs included hippuric acid (HA), indoxyl sulphate (IS)and p-cresyl sulphate (PCS).High performance liquid chromatography-tandem mass spectrometry ( HPLC-MS/MS) was used for determination .Results After 36 weeks of follow-up, the concentration of the three toxins in the HD +HP group was lower than that in the HD group during the study.At the end of the study, the reduction rates of HA, IS and PCS were 33.5%,12.8% and 24.2%, respectively, in HD+HP group.The three toxins in HD group increased by 2.3%,21.8%and 2.8%.The clearance rate of HA, PCS and IS in the HP+HD group was higher than in HD group (P<0.05).Conclusion Long-term HD combined with HP can more effectively remove PBUTs , and keep them at a lower level .