Effects of high-flux hemodialysis on FGF-23 and micro-inflammatory state in end-stage renal diseases patients

Abstract

To explore the effects of high-flux hemodialysis (HFHD) on fibroblast growth factor 23 (FGF-23) and micro-inflammatory state in end-stage renal diseases (ESRD) patients to understand the advantages of HFHD in reducing complications in ESRD patients. A total of 60 subjects sheduled for hemodialysis at our hospital in 2012 were randomly divided into two groups of 3-month HFHD and 3-month low-flux hemodialysis (LFHD) (n = 30 each). The levels of serum factors, such as FGF-23, were observed before and after 3-month hemodialysis to evaluate the hemodialysis sufficiency of two groups and analyze the effects of FGF-23 related factors as well as different kinds of hemodialysis on microinflammatory state, biochemical indices and dialysis sufficiency. Before hemodialysis, no intergroup statistical difference (P > 0. 05) existed in age, gender, basic disease, nutrition and levels of hemoglobin (Hb), albumin (ALB), estimated glomerular filtration rate (eGFR), Ca2+,P3- parathyroid hormone (PTIH) and FGF-23 before treatment. After 3-month hemodialysis in two groups, there were a negative correlation between FGF-23, Ca2 + or 1, 25-(OH)2VitD3, a positive correlation between FGF-23 and ALB, P3-, PTH, C-reactive protein (CHRP) or interleukin-6 (IL-6l) and a negative correlation between FGF 23 and HFHD group (P <0. 05) and no significant correlation between FGF-23 and Hb or KT/V (P < 0. 05). Variance analyses were conducted for each factor before and after hemodialysis, indicating that Hb, ALB and Ca2+ significantly increased in both groups after 3-month hemodialysis (P <0. 05) and 1, 25-(OH)2VitD3 significantly elevated in HFHD group (P < 0. 05) but not in LFHD (> 0. 05 . Serum phosphate significantly decreased after 3-month hemodialysis in both groups (P <0. 05) and CHIP, IL-6l, PTH and FGF-23 significantly decreased in HFHD group (P <0. 05), but not in LFHD group (P >0. 05). The levels of P3-, CRP, IL-6, PTH and FGF-23 after 3-month hemodialysis were significantly lower in HFHD group than those in LFHD group (P <0. 05) while the levels of Hb and 1, 25-(OH)2VitD3 after 3-month hemodialysis were significantly elevated in HFHD group compared with those in LFHD group (P < 0. 05). And no significant inter-group difference existed in the levels of Ca2 ALB and KT/V. Compared with LFHD, HFHD is superior in treating anemia and improving nutrition. And HFHD can better decrease FGF-23, correct calcium and phosphorous metabolic disorder and improve micro-inflammatory state.