The effect of different ways of blood purification on maintenance micro inflammation and renal anemia of hemodialysis patients

Abstract

Objective To investigate the methods of low flux hemodialysis (LFHD) and high flux hemodialysis (HFHD) on maintenance micro inflammation and renal anemia in patients with hemodialysis (MHD).Methods Fifty cases with choice chronic kidney disease(CKD) at stage 5 were selected as our subjects who were received hemodialysis in the Xinjiang Autonomous Region People's Hospital of MHD blood purification center from May 2011 to November 2012.They were randomly divided into LFHD and HFHD group and 25 cases for each group.The levels of the hemoglobin (Hb),urea nitrogen (BUN),Intedeukin-6 (IL-6),creactive protein(CRP) and serum β2 microglobulin(β2MG) were measured before hemodialysis and after 3months treatment.Results There were no significant differences between LFHD and HFHD group in terms of Hb,BUN,IL-6,CRP and β2 MG before hemodialysis (P ＞ 0.05).Compared to before hemodialysis,there were no significant difference in LFHD group at 3 months after hemodialysis in the terms of BUN and IL-6 (P ＞ 0.05),while the levels of β2-MG,CRP and Hb of patient were significantly different(β2-MG:((5.390 ± 0.550) mg/L vs.(4.570 ±0.435) mg/L,t =5.848,P ＜0.01 ;CRP:(1.160 ±0.205) mg/L vs.(2.516 ±0.211) mg/L,t =22.147,P ＜ 0.01 ;Hb:(95.680 ± 13.272) g/L vs.(106.920 ± 5.845) g/L,t =3.186,P ＜ 0.01).The levels of IL-6,β2-MG,CRP and Hb of patients in HFHD groups at 3 months after hemodialysis were (12.170 ±7.863) ng/L,(3.850 ± 0.541) mg/L,(1.479 ± 0.211) mg/L,(114.160 ± 7.386) g/L respectively,significant different from that before hemodialysis ((24.470 ± 18.043) ng/L,(5.740 ± 0.893) mg/L,(1.092± 0.220) mg/L,(95.680 ± 14.185) g/L respectively,t =2.891,5.530,5.329,4.506,P ＜ 0.01).At 3months after hemodialysis,there was no significant difference between the two groups in the term of BUN,while the levels of IL-6,β2-MG,CRP,Hb of patients were significant different between the two groups(IL-6:(27.750± 15.935) ng/L vs.(12.170 ±7.863) ng/L,t =4.382,P ＜0.01 ;β2MG:(4.570 ±0.435) mg/L vs.(3.850±0.541) mg/L,t=5.209,P＜0.01;CRP:(2.516±0.211) mg/L vs.(1.479±0.211) mg/L,t =15.580,P＜0.01,Hb:(106.920±5.845) g/Lvs.(114.160±7.386) g/L,t=3.843,P＜0.01).Conclusion HFHD is proved to be more effectively than LFHD in terms of clearing micro molecular toxins and inflammatory cytokines in renal anemia,and thus significantly improve the micro inflammation state and anemia in patients with MHD. Key words: Maintenance hemodialysis; High flux hemodialysis; Low flux hemodialysis; Micro inflammation state