Effects of high-flux hemodialysis on nutrition status and prevalence of periodontitis in maintenance hemodialysis patients / 中国组织工程研究

ABSTRACT

BACKGROUND: Studies have shown that the prevalence of periodontitis is significantly higher in maintenance hemodialysis patients than the normal population. Therefore, how to improve the malnutrition and periodontal status of MHD patients has been an issue of concerns. OBJECTIVE: To explore the effects of high-flux hemodialysis on nutritional status, micro-inflammatory state and prevalence of periodontitis in maintenance hemodialysis patients. METHODS: Fifty patients with end-stage renal disease were divided into two groups for maintenance hemodialysis. The experimental group (n=25) was subjected to high-flux hemodialysis (ultrafiltration coefficient 59 mL/(h?mm Hg), effective surface area 1.8 m2). In the control group (n=25), low-flux hemodialysis (ultrafiltration coefficient 12 mL/(h?mm Hg), effective surface area 1.4 m2) was performed. Polysulfone membrane dialyzer was used in both groups. Serological indicators and scores on modified quantitative subjective global assessment (MQSGA) (including changes in body weight, diet, gastrointestinal symptoms, activity capacity, complications, degree of fat consumption and muscle consumption) to assess the nutritional status were tested in each group before dialysis and at 1 year of dialysis. Periodontal status of the two groups was examined at 1 year of dialysis. RESULTS AND CONCLUSION: (1) Nutritional status MQSGA score: compared with pre-dialysis, the activity ability and muscle consumption scores of the experimental group was significantly reduced at 1 year of dialysis (P ＜ 0.05), and the other indicators did not change significantly. In the control group, there were no significant changes in all the indicators at 1 year after dialysis. The scores of body weight, activity capacity and muscle consumption in the experimental group were significantly lower than those in the control group at 1 year of dialysis (P ＜ 0.05). (2) Serological indicators: Compared with the pre-dialysis, the hemoglobin, albumin and prealbumin levels in the experimental group were significantly increased at 1 year of dialysis (P ＜ 0.05), while high-sensitivity C-reactive protein, triglycerides, total cholesterol, intact parathyroid hormone, serum β2-microglobulin, serum creatinine and urea nitrogen levels decreased (P ＜ 0.05). The control group also had insignificant changes in the above indexes at 1 year of dialysis. The hemoglobin, albumin and prealbumin levels in the experimental group were significantly higher than those in the control group at 1 year of dialysis (P ＜ 0.05), and the levels of high-sensitivity C-reactive protein, triglyceride, total cholesterol, intact parathyroid hormone, serum β2-microglobulin was lower than those in the control group (P ＜ 0.05). (3) Periodontal status: The prevalence of periodontitis was lower in the experimental group than in the control group (P ＜ 0.05). These findings reveal that high-flux hemodialysis can improve the nutritional status and micro-inflammation state of maintenance hemodialysis patients, and it also effectively reduces the prevalence of periodontitis.