Clinical study on effects of different blood purification treatment to cardiovascular stability

Abstract

Objective To compare different blood purification techniques on cardiovascular stability in patients with chronic renal failure (CRF) and its inherent possible mechanism. Methods 90patients with CRF were randomly divided into 3 groups. Group A (HD Group) was applied 3 times per week hemodialysis (HD) treatment; Group B (HDF group) 2 times a week routine standard hemodialysis (HD)treatment and 1 time a week hemodiafiltration (HDF) treatment; Group C (HP group) 2 times a week routine standard blood dialysis (HD) treatment and 1 time a week hemoperfusion (HP) combined with hemodialysis (HD) treatment. The treatment time in every group is 10 weeks, after that there was an interval of 2 weeks with a Fresenius F6 or F8 routine HD treatment , the total time was 6 months. The incidence of cardiovascular complications in the three groups during dialysis, and parathyroid hormone (iPTH), plasma renin (RA),angiotensin Ⅱ (Ang Ⅱ ) changes after 6 months of treatment were compared. Results During dialysis,patients of groups B and C compared with group A significantly reduced cardiovascular complications( group B is 11.3%, group C is 10.9%, but group A is 20.4% ), after treatment plasma iPTH, renin (RA),angiotensin Ⅱ (Ang Ⅱ ) were also decreased significantly compared with group A, but the groups B and C had no significant difference. Conclusion Patients with Hemodialysis or hemoperfusion treatment have better cardiovascular stability, This may be associated with the effective removal of plasma RA, Ang Ⅱ , parathyroid hormone (iPTH) and other middle molecule toxins, both treatments have an equal effect due to simple operation and low equipment requirements, hemoperfusion is much easier to be carried out universally. Key words: Cardiovascular complications; Hemodiafiltration HDF; Hemoperfusion; Parathyroid hormone; Renin; Angiotensin Ⅱ (Ang Ⅱ )