Comparison of the effects of different blood purification methods on removal of macromolecules in uremia

Abstract

Objective To compare the effects of different blood purification methods on the removal of large and medium molecular toxins in patients with maintenance hemodialysis(MHD), and to provide the clinical basis for selecting suitable dialysis modalities to prevent or delay the long term complications of uremic patients. Methods 60 MHD patients with long term and stable hemodialysis were enrolled in this study. All of them were selected from the patients with insufficient hemodialysis.According to the digital table, 60 patients were randomly divided into high flux hemodialysis (HFHD)group and hemodiafiltration (HDF) group, 30 cases in each group. And before, 3 months and 6 months after dialysis, the serum β2-MG, PTH and Cys C after dialysis were tested. Results The clearance of PTH in the HFHD group[(286.34±127.33)pg/mL] was significantly higher than that in the HDF group[(376.04±141.74)pg/mL], the difference was statistically significant(t=2.45, P<0.05). The clearance of β2 -MG in the HDF group[(11.34±1.96)mg/L]was significantly higher than that in the HFHD group[(15.41±3.02)mg/L], the difference was significant(t=5.88, P<0.05). The clearance of Cys C in the HFHD group[(263.67±98.72)μg/dL]was significantly higher than that in the HDF group[(345.63±105.00)μg/dL], the difference was statistically significant(t=2.96, P<0.05). Conclusion Both two dialysis methods are very effective in the removal of large and medium molecular uremic toxins in patients. In the removal of patients with increased PTH, HFHD is more effective. In the removal of patients with increased β2-MG, HDF is more effective. In the removal of Cys C, HFHD is better. Key words: Hemodiafiltration; Uremia