首页|不同频率血液透析滤过联合HFHD治疗终末期肾病的效果

不同频率血液透析滤过联合HFHD治疗终末期肾病的效果

Effectiveness of different frequency of hemodiafiltration combined with high flux hemodialysis in the treatment of end-stage renal disease

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目的 探讨不同频率血液透析滤过联合高通量血液透析(high flux hemodialysis,HFHD)技术治疗终末期肾病的效果.方法 回顾性选取福建省立医院2019年1月-2022年8月108例终末期肾病患者,按照血液透析滤过频率分为3组,各36例.3组均给予HFHD,低频率组、中频率组、高频率组血液透析滤过频率分别为1次/m、2次/m、4次/m.3组均治疗6个月.比较3组透析充分性、残余肾功能(re-sidual renal function,RRF)、营养状况、炎性因子水平及并发症发生情况.结果 治疗后6个月3组总尿素清除指数(Kt/V)、β 2微球蛋白(β 2-microglobulin,β2-MG)清除率、尿素氮下降率(urea reduc-tion rate,URR)比较,差异有统计学意义(F=33.410、27.559、35.226,均P<0.001);治疗后6个月3组RRF、尿量、残余肾Kt/V、残余肾肌酐清除率(creatinine clearance rate,CCR)比较,差异有统计学意义(F=34.159、27.911、25.084、23.342,均P<0.001);治疗6个月后3组血清总蛋白、前白蛋白、白蛋白、白细胞介素-6、肿瘤坏死因子-a、C反应蛋白比较,差异有统计学意义(F=28.404、39.842、25.968、41.864、25.074、39.240,均P<0.001);高频率组并发症发生率高于中频率组、低频率组(x2=8.826,P=0.012).结论 不同频率血液透析滤过联合HFHD技术可改善终末期肾病患者透析充分性、RRF及营养状况,其中高频率效果较优,还可降低患者炎性因子表达,但并发症发生率较高.
Objective To investigate the effect of different frequency of hemodiafiltration combined with high flux hemodialysis(HFHD)in the treatment of patients with end-stage renal(ESRD)disease.Meth-ods A total of 108 ESRD patients treated in Fujian Provincial Hospital from January 2019 to August 2022 were retrospectively studied.They were treated with hemodiafiltration combined with HFHD,and divided ac-cording to the frequency of hemodiafiltration into low frequency group(n=36,hemodiafiltration once per month),medium frequency group(n=36,hemodiafiltration twice per month),and high frequency group(n=36,hemodiafiltration thrice per month).The treatment lasted for 6 months.The adequacy of dialysis(includ-ing Kt/V,β2-microglobulin clearance rate and urea reduction rate),residual renal function(including urine vol-ume,residual renal Kt/V and residual renal creatinine clearance rate),nutritional status(including serum total protein,prealbumin and albumin),inflammatory factors(including interleukin-6,tumor necrosis factor-α and C-reactive protein),and complications were compared among the three groups.Results After 6 months of the treatment,the total urea clearance index(Kt/V),β2-microglobulin clearance rate,and urea reduction rate(URR)were statistically different among the three groups(F=33.410,27.559 and 35.226 respectively;P<0.001);residual renal function,urine volume,residual renal Kt/V and residual renal creatinine clearance rate were different among the three groups(F=34.159,27.911,25.084 and 23.342 respectively;P<0.001);serum total protein,prealbumin and albumin,interleukin-6,tumor necrosis factor-α and C-reactive protein were also different among the three groups(F=28.404,39.842,25.968,41.864,25.074 and 39.240 respectively,P<0.001);the incidence of complications was higher in the high frequency group than in the medium frequency and low frequency groups(x2=8.826,P=0.012).Conclusion Different frequency of hemodiafiltration com-bined with HFHD can improve the dialysis adequacy,residual renal function,and nutritional status in ESRD patients,with the higher frequency of hemodiafiltration being more effective.It can also reduce the expression of inflammatory factors.However,the incidence of complications remains higher.

Hemodialysis filtrationHigh flux hemodialysisDialysis adequacyResidual renal func-tionNutritional status

杨峥嵘、林苗、曹芳

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362200 晋江,福建中医药大学附属晋江中医院肾病科

350000 福州,福建省立医院肾内科

血液透析滤过 高通量血液透析 透析充分性 残余肾功能 营养状况

福建省高等教育和科研项目(第二批)(2022)

闽财指[2022]840号

2024

中国血液净化
中国医院协会

中国血液净化

CSTPCD
影响因子:1.54
ISSN:1671-4091
年,卷(期):2024.23(4)
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