Effect of Different Replenishment Modes of Replacement Fluid on Solute Clearance Efficiency during Online Hemodiafiltration Therapy
Objective To investigate the effect of different replenishment modes of replacement fluid on solute clear-ance and quality of life in patients undergoing online hemodiafiltration therapy.Methods A total of 90 patients with uremia who received maintenance blood purification treatment in Wuchuan People's Hospital from August 2022 to No-vember 2023 were selected as the study subjects.They were divided into group A(pure pre-diluted hemodiafiltration,replacement fluid in front of the filter),group B(hemodiafiltration after pure dilution,and the replacement solution was added after the filter),and group C(3:2 before and after mixed dilution hemodiafiltration)based on different fluid replacement methods,with 30 cases in each group.The filtration status and cardiovascular indicators among three groups were compared.Results After treatment,the blood phosphorus,β2-microglobulin,decrease rates of urea nitro-gen and creatinine in three groups were compared,and the differences were statistically significant(all P<0.05).The blood phosphorus,β2-microglobulin,decrease rates of urea nitrogen and serum creatinine in group A were compared with those in group B and group C,and the differences were statistically significant(all P<0.05).After treatment,the left ventricular ejection fraction(LVEF)in the three groups was increased compared with that before treatment,and the carotid intima-media thickness(CIMT)was reduced compared with that before treatment,the left ventricular mass index(LVMI)in group B and group C after treatment was lower than that before treatment,and the differences were statistically significant(all P<0.05).LVMI[(145.52±10.08)g/m2 vs(130.04±9.85)g/m2 vs(136.25±10.28)g/m2]and LVEF[(62.24±6.61)%vs(69.85±5.74)%vs(65.04±6.52)%]and CIMT[(1.26±0.12)mm vs(1.10±0.10)mm vs(1.18±0.10)mm]of 3 groups were compared,and the differences were statistically significant(F=17.951,11.191,16.740,all P<0.05).Conclusion The solute clearance rate in post-dilution mode was better than that in pre-dilution and mixed dilution,and the cardiovascular parameters of patients were improved.
HemodiafiltrationMixing and diluting before and afterCardiovascular indicatorsβ2-microglobulin
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