Effects of different hemodialysis modes on level of growth factor-15 and left heart function in uremia patients undergoing maintenance hemodialysis / 中国中西医结合急救杂志

ABSTRACT

Objective To study the effects of different hemodialysis modes on growth factor-15 (GDF-15) and left ventricular function in uremic patients undergoing maintenance hemodialysis (MHD). Methods One hundred and twenty uremic patients with chronic renal failure whose MHD > 3 months admitted to Guiyang Second People's Hospital from June 2017 to June 2018 were enrolled, and they were divided into a hemodialysis (HD)+ hemofiltration (HDF)+hemoperfusion (HP) group (HD 8 times per month, HDF 4 times per month, HP 1 time per month), a HD+HDF group (HD 8 times per month, HDF 1 time per month) and a HD group (HD 8 times a month) according to different dialysis modes, each group 40 cases. The patients' venous blood was collected before treatment and 6 months and 1 year after treatment, serum was separated, and the GDF-15 levels in the three groups were detected; the left ventricular end-diastolic dimension (LVDD), left ventricular end-systolic dimension (LVDS), left ventricular end-diastolic volume (LVVD), left ventricular end-systolic volume (LVVS), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (LVST), maximum blood flow ratio (E/A) of early to late diastole and left ventricular ejection fraction (LVEF) in three groups were detected by echocardiography. Results After treatment, the GDF-15 levels and LVDD, LVDS, LVVD, LVVS, LVPWT, LVST and E/A in the three groups were significantly lower than those before treatment, while LVEF was significantly higher than that before treatment (all P < 0.05); the changes after treatment in the HD+HDF+HP group were more significant than those in the HD+HDF group and HD group [GDF-15 (ng) 853.78±78.80 vs. 921.73±72.54, 971.07±72.05, LVDD (mm) 48.25±1.25 vs. 50.67±1.26, 51.69±1.33, LVDS (mm) 35.21±1.01 vs. 37.84±0.90, 38.91±0.83, LVVD (mL) 101.44±4.40 vs. 109.27±6.47, 115.11±5.46, LVVS (mL) 35.75±1.52 vs. 37.75±1.70, 39.48±1.48, LVPWT (mm) 8.26±0.77 vs. 10.24±0.98, 11.22±0.91, LVST (mm) 9.07±0.48 vs. 10.47±0.61, 11.60±0.58, E/A 1.03±0.05 vs. 1.07±0.06, 1.15±0.08, LVEF 0.64±0.03 vs. 0.59±0.03, 0.51±0.04, all P <0.05]. Conclusion The combined hemo- dialysis with different hemodialysis modes can effectively reduce the level of GDF-15 in uremic patients with chronic renal failure and MHD and improve their left ventricular function, thus the incidence of cardiovascular events and mortality in such patients can be decreased.