Comparison of the efficacy of hemodialysis, hemodiafiltration and high-flux hemodialysis in the treatment of end-stage renal disease

Abstract

Objective To observe the clinical efficacy of hemodialysis, hemodiafiltration and high-flux hemodialysis in the treatment of end-stage renal disease (ESRD). Methods A total of 205 patients with ESRD were divided into the hemodialysis (HD) group (n=110), high-flux hemodialysis (HFHD) group (n=30) and hemodiafiltration (HDF) group (n=65). Changes of nutrition indexes, inflammation factors, toxin molecules and electrolyte in blood before and after dialysis were observed and compared among the three groups, and the incidence of complications was recorded. Results After dialysis, PA and Hb were significantly increased in three groups (P<0.05), and the increase of Hb was more significant in HFHD group and HDF group than CHD group (P<0.05). After dialysis, UA, Cr and BUN changed significantly (P<0.05), but there were no significant differences between groups (P<0.05). β2-MG and Cysc were significantly decreased in HFHD group and HDF group (P<0.05). The two indexes were significantly lower in HFHD group and HDF group than HD group, and significantly lower in HDF group than HFHD group (P<0.05). After dialysis, Ca2+ in blood of the three groups were significantly increased (P<0.05), while K+ and P+ was significantly decreased (P<0.05), and there were significant differences among the three groups (P<0.05). After dialysis, levels of serum CRP, IL-6 and PTH in HFHD group and HDF group were significantly lower than those before dialysis and those in HD group (P<0.05), and the improvement of CRP, IL-6 and PTH was more significant in HDF group (P<0.05). There were significant differences among the three groups (P<0.05). Conclusions The medium and large molecule clearance rates in patients with ESRD and undergoing HDF and HFHD are significantly high than those in patients undergoing HD. The middle molecular substance removal by HDF is better than that of HFHD. Key words: Kidney Failure, Chronic; Renal Dialysis; Hemodiafiltration