Abstract:Objective: To investigate the effect of high flux dialysis (HFD) combined with hemoperfusion (HP) on nutritional status and calcium-phosphorus metabolism in maintenance hemodialysis (MHD) patients. Methods: A total of 87 patients who underwent MHD in the 363 Hospital from January 2019 to January 2022 were selected, and randomly divided into 2 groups. Patients in the observation group (n=44) were treated with HFD combined with HP, and patients in the control group (n=43) were treated with conventional hemodialysis. Both groups received 3 consecutive months of treatment. The two groups were compared on nutritional status, inflammatory status, calcium-phosphorus metabolism level, and sleep quality before and after treatment, and adverse reactions were recorded. Results: After treatment, the levels of serum albumin (ALB), prealbumin (PA), hemoglobin (HB) and body mass index (BMI) were increased, while the levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF-α), blood calcium, blood phosphorus and intact parathyroid hormone (iPTH), calcium-phosphorus product and Pittsburgh Sleep Quality Index (PSQI) were significantly reduced. The changes of serum ALB, PA, HB, IL-6, hs-CRP, TNF-α, blood calcium, blood phosphorus, iPTH, calcium-phosphorus product and PSQI scores in the observation group before and after treatment were greater than those in the control group (P<0.05). The incidence rates of skin pruritus, myalgia and fatigue in the observation group (9.09%, 11.36% and 9.09%) were lower than those in the control group (30.23%, 32.56% and 25.58%) (P<0.05). Conclusion: HFD combined with HP can effectively improve the nutritional status of MHD patients, correct micro-inflammatory state and calcium-phosphorus metabolism, improve sleep quality, and reduce adverse reactions.
汤月秋, 卢晓梅. 高通量透析联合血液灌流对维持性血液透析患者营养状况及钙磷代谢的影响[J]. 河北医学, 2023, 29(4): 561-566.
TANG Yueqiu, LU Xiaomei. Effect of High Flux Dialysis Combined with Hemoperfusion on Nutritional Status and Calcium-Phosphorus Metabolism in Maintenance Hemodialysis Patients. HeBei Med, 2023, 29(4): 561-566.
[1] Nagy E,Mahmoud M,El-Kannishy G,et al.Impact of malnutrition on health-related quality of life in patients on maintenance hemodialysis[J] Ther Apher Dial,2021,25(4):467-474. [2] 刘玲,李铭新.血液透析联合血液灌流对维持性血液透析患者营养、免疫和内皮功能的影响[J].川北医学院学报,2022,37(5):642-645. [3] Chi XG,Ma Z,Zhang WB,et al.Effects of high-flux hemodialysis combined with levocarnitine on vascular calcification,microinflammation,hepcidin,and malnutrition of elderly patients on maintenance hemodialysis[J] Ann Palliat Med,2021,10(3):3286-3298. [4] 李京,王怡,李霞.血液透析联合血液灌流治疗对慢性肾病患者钙磷和脂质代谢的影响[J].重庆医学,2020,49(9):1409-1412. [5] Han Q,Liu B,Lin S,et al.Pittsburgh sleep quality index score predicts all-cause mortality in Chinese dialysis patients[J].Int Urol Nephrol,2021,53(11):2369-2376. [6] Akhlaghi Z,Sharifipour F,Nematy M,et al.Assessment of nutritional status in maintenance hemodialysis patients:a multicenter cross-sectional study in Iran[J].Semin Dial,2021,34(1):77-82. [7] 李明,李灿明,叶增纯,等.维持性血液透析患者死亡及其危险因素的单中心分析[J].中山大学学报(医学科学版),2020,41(4):620-626. [8] 冉燕,吴琴宁,龙艳君,等.全身免疫炎症指数与维持性血液透析患者蛋白质能量消耗及预后的关系[J].中华医学杂志,2021,101(28):2223-2227. [9] 徐明芝,安娜,陈汝满,等.高通量透析与血液透析滤过对慢性肾衰竭患者IL-17、CD16表达影响[J].中国免疫学杂志,2020,36(13):1641-1646. [10] 姜瑞丰,施妙君,鄢巨振.维持性血液透析患者血清Sfrp5、Klotho水平变化及其与钙磷代谢的关系[J].广东医学,2020,41(2):152-155. [11] 苗鹏伟,默秀婷,田津生,等.不同通量血液透析方式对维持性血液透析患者血中钙磷及全段甲状旁腺激素的影响[J].中国中西医结合急救杂志,2021,38(5):580-583.