| Objective: The effects of high-flux hemodialysis (HFHD) on maintenance hemodialysis (MHD) patients with the metabolic effects of removal of toxic substances, as well as micro-inflammatory state,Nutritional status,ventricular structure impact. Investigate the role of HFHD in reduce or delay the long-term complications.Methods : Choose patients in the First Affiliated Hospital of Nanchang University from August 2008 to August 2009, 40 cases of hemodialysis patients and in stable condition, all patients were randomly divided into HFHD group and conventional hemodialysis (CHD) group. (1) HFHD group of 20 patients, using jinbao 17R polymer polyamide synthetic membranes dialysis machines, its effective dialysis membrane surface area is 1.7m2, ultrafiltration coefficient of 56mL/(h·mm Hg), blood flow 300-350mL/min. (2) CHD group of 20 cases, using baite 130 hollow fiber composite membrane dialysis machines, its effective dialysis membrane surface area is 1.3m2,ultrafiltration coefficient of 12.7mL/(h·mmHg), blood flow 250-300mL/min. All patients in the two groups have dialysis 3 months to 14 years, an average of 36 months. All using the German Fresenius4008B capacity of ultrafiltration dialysis machine, using autogenous arteriovenous fistula, Low-molecular-weight heparin anticoagulation (Heparins Calcium Injection), dialysis solution was bicarbonate,dialysate flow rate was 500 mL/min, dialysis two times a week, 4.5 hours/times. Recently does not appear infection and other immune diseases, without the use of hormones and cytotoxic drugs, no history of trauma and surgery. All patients were routinely used antihypertensive drugs, erythropoietin (EPO), folic acid, iron and other drugs during the treatment time.Is now a three months observation period,extraction HFHD group and CHD group patients before and after a single dialysis and pre-dialysis blood samples after three months, every time penetrating blood 3ml. Detection the date with two groups patients of serum creatinine (Scr), serum phosphorus (P3+), serumβ2-microglobulin (β2-MG), serum albumin (Alb), triglyceride (TG), hemoglobin (Hb), high-sensitivity C-reactive protein (hs-CRP) levels. Compared the difference before and immediately after in a single dialysis, and pre-dialysis of a single dialysis and after three months in the two groups. Records and compare the beginning and three months after the two-dimensional echocardiography in cardiac left ventricular end-diastolic diameter (LVDd), interventricular septum thickness (IVST) values change. Single-factor analysis the relationship of patients'serum hs-CRP levels with Alb,Hb,TG,LVDd,IVST.Results:1. Whether in a single dialysis or dialysis after three months, there was no statistically significant difference between the two groups in Scr clearance (p>0.05).2. HFHD group compared to CHD group on the removal effect of serum P3 + whether in single dialysis or after three months were to be decreased, the differences were statistically significant (p<0.05).3. HFHD group on the macromolecular material removal effect ofβ2-MG group than in CHD group in both single dialysis and after three months were to decline, the differences were obvious statistically significant (p<0.01).4. After a single dialysis the two groups all make serum Alb increased, no statistically significant difference between them (p>0.05). After three months HFHD group serum Alb increased significantly, the difference between two groups was statistically significant (p<0.05).5. Dialysis after three months HFHD group TG level significantly lower than CHD group, the difference was statistically significant (p<0.05).6. After a single dialysis HFHD group and CHD group all make Hb increased, the difference was no statistically significant (p>0.05). After three months HFHD group Hb level have an increase tendency, but no statistically significant difference between the two groups (p>0.05).7. In both of the two groups, hs-CRP level increased after a single dialysis, the difference was not statistically significant (p>0.05). After three months the two groups all rise hs-CRP level, but the HFHD group only have a low rise, compared to CHD group the difference was statistically significant (p<0.05). 8. Dialysis after three months HFHD group compared with CHD group, the change of LVDd, IVST value have no statistically significant difference (p>0.05).9. Spearman rank correlation analysis showed, serum levels of hs-CRP with Alb and Hb were negatively correlated (p<0.05), TG and LVDd were positively correlated (p<0.05), and IVST was positively correlated (p>0.05).Conclusion:1. There was no significant difference of small molecules Scr clearance between high-flux hemodialysis and conventional hemodialysis; 2.High-flux hemodialysis treatment can effectively remove P3+,β2-MG,may be delayed renal osteodystrophy occurred; 3. High-flux compared with conventional hemodialysis, the high-flux hemodialysis can improve the albumin level and adjust triglycerides level and have an advantages of improving the micro-inflammatory state, may reduce the incidence of cardiovascular system complications; 4. Maintenance hemodialysis patients with a high levels of hs-CRP have an independently associated with malnutrition and anemia and left ventricular hypertrophy; 5. Short-term studies that HFHD have some advantages compared with CHD,but further research is required to confirm.
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