The effects of different modes of blood purification on related physiological and biochemical indexes in patients with maintenance of hemodialysis / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effects of 3 different blood purification methods with single treatment or continuous treatment for 2 months on the physiological and biochemical indexes of patients with maintenance of hemodialysis (MHD). Methods The clinical data of 90 patients who underwent MHD in Department of the Blood Purification of Wuhan General Hospital of PLA from March 2016 to April 2017 were retrospectively analyzed, and they were divided into three groups hemodialysis (HD) group, hemodiafiltration (HDF) group and HD + hemoperfusion (HP) group, 30 cases in each group. All the patients were treated routinely with erythropoietin and iron, and original oral antihypertensive drugs were continuously taken. The patients in HD group underwent 3 times of HD each week, 4 hours each time; the patients in HDF group applied once HDF and twice of HD each week, once 4 hours, and post dilution method was adopted with the replacement volume 50 - 70 mL/min; the patients in HD+HP group performed once HD+HP and twice HD each week, 4 hours each time. The levels of blood creatinine (SCr), urea nitrogen (BUN), plasma leptin (LP), serum parathyroid hormone (PTH), serum hypersensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), etc. were collected before single dialysis, 4 hours and 2 months after continuous treatment, and the differences in above indexes were compared among the three groups. Results With the prolongation of dialysis time, renal function related indexes (SCr, BUN), macromolecular toxin related indexes (LP, PTH) and micro inflammation related indexes (hs-CRP, IL-6) in the three groups were significantly lower than those before dialysis, the degrees of decrease of the indexes after continuous treatment for 2 months were more obvious than those after single treatment for 4 hours, but there were no statistical significant differences in inter-group comparisons of SCr and BUN among the three groups (both P ＞ 0.05). After 2 months of continuous treatment, the degrees of decrease of LP, PTH and hs-CRP and IL-6 levels in group HD+HP were more significant than those in either HD group or HDF group [LP (ng/L) 7.56±2.67 vs. 9.55±3.67, 8.82±2.47, PTH (ng/L) 356.88±189.46 vs. 520.55±330.16, 487.43±234.26, hs-CRP (mg/L)10.30±3.21 vs. 21.43±4.46, 12.31±3.92, IL-6 (ng/L) 18.56±4.62 vs. 34.21±6.77, 19.84±6.41, all P ＜ 0.05]. Conclusion HD+HP can effectively improve the physiological and biochemical indexes of MHD patients, and is an ideal way to treat MHD patients.