Efficacy and mechanism of hemoperfusion plus hemodialysis for peripheral neuropathy of uremic patients on maintenance hemodialysis

Abstract

To explore the efficacy and mechanism of hemoperfusion (HP) plus hemodialysis (HD) for peripheral neuropathy of uremic patients on maintenance hemodialysis. A total of 66 uremic patients on hemodialysis during January 2014 and April 2011 were assigned randomly into HP+HD, low-flux HD and high-flux HD groups (n=22 each). The serum levels of leptin, endothelin-1 (ET-1), parathyroid hormone (PTH) and β-2 microglobulin were observed pre and post-treatment. And sensory conduction velocity (SCV) was detected simultaneously. After 12-week treatment, the clinical symptoms of group HP+HD improved significantly with an effective rate of 90.91% while improvement was not obvious in groups high-flux and low-flux HD with effective rates of 31.82% and 13.64%. In HP+HD group, the levels of leptin, ET-1, PTH and β-2MG decreased, sensory conduction velocity increased (P<0.05) and clinical symptoms improved apparently. While in low-flux HD and high-flux HD groups, leptin, ET-1, PTH and β-2MG had no decrease and SCV showed no improvement (P>0.05). Correlation analysis showed that the levels of leptin, ET-1 and β-2MG were negatively correlated with SCV (r=-0.57, r=-0.47, r=-0.56). Yet PTH had no correlation with SCV (r=-0.23). Hemoperfusion plus hemodialysis may improve the clinical symptoms of peripheral neuropathy of uremic patients on maintenance hemodialysis. And it is probably due to the fact that HP+HD effectively removes such plasma middle and macromolecular toxins as leptin, ET-1, PTH and β-2MG.