The Influence Of High-Flux Hemodialysis On Nutritional Status In Older Patients On Maintenance Hemodialysis

Objective: To compare the influence of low-flux hemodialysis (LFHD) and high-flux hemodialysis(HFHD) on nutritional status in older patients on maintenance hemodialysis and explore the function of high-flux hemodialysis on nutritional status in older patients on maintenance hemodialysis.Methods: 36 older patients on low-flux hemodialysis(Polyflux 8LR) were prospectively enrolled and divided randomly into two groups in the Fifth Affiliated Hospital of GuangXi Medical University. Patients in each group received either Polyflux 8LR (low-flux, n=18) or Polyflux 17R (high-flux, n=18) as hemodialysis dialyzers for 6 consecutive months. 18 healthy older persons were enrolled as control. Blood samples and anthropometry were measured and modified quantitative subjective global assessment(MQSGA) was used to evaluate the nutritional status at the start and end of the study. Results: The serum Scr,BUN,TC and CRP levels in LFHD and HFHD groups were significant higher than those in control group, serum ALB and PA levels,BMI,MAC and MAMC were significant lower than those in control group(P<0.05), age and TSF were no significant difference between dialysis groups and control group(P > 0.05). Blood samples,anthropometry and MQSGA scores were no significant difference between LFHD and HFHD groups at the start of the study. After 6 consecutive months, serum TC,CRP levels and MQSGA scores in HFHD group were lower, including'Functional capacity'and'Signs of muscle wasting'scores; serum ALB and PA levels,MAC and MAMC were significant higher than those before 6 months and LFHD group(P<0.05). Blood samples,anthropometry and MQSGA scores were no significant difference in LFHD group between at the start of and at the end of the study.Conclusion: Older patients on maintenance hemodialysis exist malnutrition. HFHD might improve efficiently the nutritional status in older patients on maintenance hemodialysis and the earliest features in the subjective aspect are the improvements of functional capacity and signs of muscle wasting in 6 months.