Abstract:Objective: To investigate the effect of hemoperfusion combined with hemodialysis and hemodiafiltration on mineral and bone metabolism in patients with maintenance hemodialysis. Methods: A total of 90 cases of MHD patients were selected from January 2017 to September 2019. Those patients were divided into two groups with 45 cases each according to the random number table method. The observation group was treated with hemoperfusion combined with hemodialysis, while the control group was treated with hemodiafiltration. The treatment lasted for 6 months. The renal function, mineral and bone metabolism of the two groups were compared before and 6 months after treatment, and the clinical symptoms of the two groups were observed. Results: After treatment, the levels of serum creatinine (Scr), blood urea nitrogen (BUN) and β2-MG were significantly reduced in both groups, and the levels of those indexes in the observation group were lower than those in the control group (P<0.05). After treatment, the incidences of skin pruritus, joint pain, muscle weakness and hypertension in the observation group were significantly lower than those in the control group (P<0.05). After treatment, there was no significant change in blood calcium level in the two groups compared with before treatment (P>0.05), while the blood phosphorus level in the observation group was significantly lower than that in the control group (P<0.05). The serum levels of osteoprotegerin (OPG), Bone morphogenetic protein-2 (BMP-2) and bone alkaline phosphatase (BALP) in the two groups were significantly reduced, and the observation group was lower than the control group after treatment (P<0.05). Conclusion: Hemoperfusion combined with hemodialysis can effectively improve the clinical symptoms of MHD patients and correct abnormal mineral and bone metabolism.
宋菊香, 夏薇青, 马辉, 王天智, 刘翠红. 不同血液净化方式对维持性血液透析患者矿物质及骨代谢状况的影响[J]. 河北医学, 2021, 27(1): 105-108.
SONG Juxiang, XIA Weiqing, MA Hui, et al. Effects of Different Blood Purification Methods on Mineral and Bone Metabolism in Patients with Maintenance Hemodialysis. HeBei Med, 2021, 27(1): 105-108.
[1] Butani L, Calogiuri G. Hypersensitivity reactions in patients receiving hemodialysis [J]. Ann Allergy Asthma Immunol, 2017, 118(6): 680~684. [2] Raghavan R, Eknoyan G. Uremia: A historical reappraisal of what happened [J]. Clin Nephrol, 2018, 89(5): 305~313. [3] Lu W, Ren C, Han X, et al. The protective effect of different dialysis types on residual renal function in patients with maintenance hemodialysis: a systematic review and meta-analysis [J]. Medicine (Baltimore), 2018, 97(37): e12325. [4] Pomare Montin D, Ankawi G, Lorenzin A, et al. Biocompatibility and cytotoxic evaluation of new sorbent cartridges for blood hemoperfusion [J]. Blood Purif, 2018, 46(3): 187~195. [5] Stevens PE, Levin A, Kidney Disease.Improving global outcomes chronic kidney disease guideline development work group members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline [J]. Ann Intern Med, 2013,158(11): 825~830. [6] Koc H, Hoser H, Akdag Y, et al. Treatment of secondary hyperparathyroidism with paricalcitol in patients with end-stage renal disease undergoing hemodialysis in Turkey: an observational study [J]. Int Urol Nephrol,2019, 51(7): 1261~1270. [7] Locatelli F, Carfagna F, Del Vecchio L, et al. Haemodialysis or haemodiafiltration: that is the question [J]. Nephrol Dial Transplant, 2018, 33(11): 1896~1904. [8] 宋培.血液灌流联合血液透析对尿毒症患者肾功能及T淋巴细胞水平的影响[J].河北医学,2019,25(8):1253~1257. [9] Shah A. Phosphorus and other aspects of CKD-MBD in the conservative management of chronic kidney disease [J]. Panminerva Med, 2017, 59(2): 124~132. [10] Viecelli AK, O'Lone E, Sautenet B, et al. Vascular access outcomes reported in maintenance hemodialysis trials: A Systematic Review [J]. Am Kidney Dis, 2018, 71(3): 382~391. [11] Lyu B, Banerjee T, Scialla JJ, et al. Vascular calcification markers and hemodialysis vascular access complications [J]. Am Nephrol, 2018, 48(5):330~338. [12] Rochette L, Meloux A, Rigal E, et al. The role of osteoprotegerin in vascular calcification and bone metabolism: the basis for developing new therapeutics [J]. Calcif Tissue Int, 2019, 105(3): 239~251. [13] Nguyen-Yamamoto L, Tanaka KI, St-Arnaud R, et al. Vitamin D-regulated osteocytic sclerostin and BMP2 modulate uremic extraskeletal calcification [J].CI Insight, 2019, 4(13): e126467.