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Combination of Hemodialysis and Hemoperfusion for the Treatment of End-Stage Chronic Kidney Disease Patients and Its Impact on Microinflammatory Response and Renal Function |
JIAO Lijuan, WANG Ting, LI Yuanyuan, et al |
The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830054, China |
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Abstract Objective: To observe the effects of the combination of hemodialysis and hemoperfusion on micro inflammatory response and renal function in end-stage patients with chronic kidney disease (CKD). Methods: Ninety end-stage CKD patients admitted to our hospital from May 2020 to May 2022 were randomly assigned into an observation group and a control group (45 patients in each group).The control group received only hemodialysis treatment,while the observation group received combined hemoperfusion therapy in addition to hemodialysis.After the treatment,calcium and phosphorus metabolism indicators,renal function,microinflammatory response,and oxidative stress response were compared between the two groups. Results: After 6 months of treatment, the blood phosphorus and calcium phosphorus product levels in the observation group were lower than those in the control group [(1.24±0.29) mmoL/L ratio (1.85 ± 0.20) mmoL/L, (2.49±0.53) mmoL2/L2 ratio (3.75±0.59) mmoL2/L2], with a significant difference (P<0.05), while there was no significant difference (P>0.05) in blood calcium levels between the two groups [(2.01±0.41) mmoL/L ratio (2.03±0.47) mmoL/L]. The levels of UA, Scr, and BUN in the observation group were lower than those in the control group [(319.74±23.73)] μmoL/L ratio (376.25±25.86) μmoL/L, (244.06±16.35) μmoL/L ratio (286.59±20.82) μmoL/L and (15.87±4.26) mmoL/L was statistically significant (P<0.05) compared to (21.74±5.74) mmoL/L. Observation group micro inflammatory index TNF- α, The levels of IL-6 and hs CRP in the control group were lower than those in the control group [(75.15±6.02) ng/L ratio (80.82±6.51) ng/L, (25.48±4.65) ng/L ratio (31.29±5.28) ng/L, (6.24±2.05) mg/L ratio (9.87±2.24) mg/L], with statistically significant differences (P<0.05). The SOD level in the observation group was higher than that in the control group ](73.54±7.28) U/mL vs (66.29±6.87) U/mL], with a significant difference (P<0.05); The levels of MDA and MPO in the observation group were lower than those in the control group [(8.36±2.46) nmoL/mL vs (10.84±2.73) nmoL/mL, (56.29±5.29) U/L vs (61.74±6.73) U/L], with significant differences (P<0.05). Conclusion: The combination of hemodialysis and hemoperfusion for end-stage CKD patients is beneficial for regulating calcium and phosphorus metabolism,protecting renal function,and has a relatively small impact on microinflammatory status and oxidative stress response.This approach has significant clinical value.
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