Influence of hemodiafiltration with different amount of substitute fluid on the β2-microglobulin and parathyroid hormone in hemodialysis patients

Abstract

Objective To observe the clearance effect of hemodiafiltration (HDF) with different amount of substitute fluid on the β2-microglobulin (β2-MG) and parathyroid hormone (PTH) in hemodialysis patients.Methods 30 patients with dialysis time greater than 6 months were randomly divided into 3 groups (n=10):the patients in group A and B received one time post-dilution HDF and two times of hemodialysis every week,the substitute fluid of group A was 10-14.9 L,the substitute fluid of group B was 15-20 L.The patients in group C received 3 times of hemodialysis every week.After being observed continuously for 5 months,the blood density of β2-MG and iPTH were compared before and after the treatment in the 3 groups,and the improvement situation of the cutaneous pruritus was also observed.Results The blood density of iPTH and β2-MG had dropped obviously and the cutaneous pruritus also improved in the HDF groups,the changes were obvious in the high volume HDF group,the difference was statistically significant.The blood density of iPTH had mild drop in HD group,the difference was not statistically significant.The blood density of β2-MG had mild ascension.Conclusion Increasing the amount of substitute fluid could improve the clearance effect of HDF on β2-MG and iPTH in hemodialysis patients,and also improve the cutaneous pruritus.HDF is more superior than HD in cleaning iPTH and β2-MG.HD cannot eliminate β2-MG and iPTH effectively. Key words: Hemodiafiltration (HDF); Hemodialysis (HD); Uremia; β2-microglobulin; Parathyroid hormone (PTH)