| Objective To explore the effects of High-flux hemodialysis （HFHD） on fibroblast growthfactor23（FGF23） and micro-inflammatory state in end-stage renal diseases（ESRD）patients; to analyze the influence of different kinds of hemodialysis on FGF23,micro-inflammatory state and calcium and phosphorous metabolic disorder, etc. in order todiscover the advantages of HFHD in reducing complications in ESRD patients.Methods60subjects selected to take hemodialysis at Wuxi people’s Hospital in2012wererandomly divided into two groups.30of them took HFHD for3months, and the otherstook Low-flux hemodialysis （LFHD） for3months. Levels of certain factors were observedbefore and after three months hemodialysis such as Hb, ALB, Ca2+,P3-,CRP, IL-6,1,25-（OH）2VitD3,PTH, and FGF23, etc. KT/Vs after hemodialysis were observed,together with Hb and so on, so as to evaluate hemodialysis sufficiency of the two groups,and to analyze the effects of FGF23-related factors as well as different kinds ofhemodialysis on micro-inflammatory state, biochemical index and dialysis sufficiency.Furthermore,30healthy people were selected as the normal control group with their age,sex, and levels of Hb, ALB, Ca2+,P3-, CRP, IL-6,1,25-（OH）2VitD3,PTH, and FGF23, etc.well-documented.Results①Before hemodialysis, compared with the control group, the hemodialysis groups,though exhibited no significant difference in age or sex, demonstrated significantlyelevated levels of FGF23and PTH, lower levels of serum calcium and1,25-（OH）2VitD3,higher levels of serum phosphorus, CRP and IL-6and showed anaemia and low serumalbumin. There were no statistical difference （P＞0.05） between two hemodialysis groupsin age, sex, basic disease, nutriture and levels of Hb, ALB, eGFR, Ca2+, P3-, PTH andFGF23before medical treatment.②After3-month-hemodialysis of two groups of patients,bivariate correlation analyses were conducted concerning FGF23and other variables with the resultsshowing a negative correlation between FGF23and Ca2+or1,25-（OH）2VitD3,a positive correlation between FGF23and ALB, P3-, PTH, CRP, or IL-6respectively, a negative correlationbetween FGF23and HFHD group（P<0.05）, and no significant correlation between FGF23and Hb or KT/V（P<0.05）.③Variance analyses were conducted between indexes of eachfactor before and after hemodialysis, indicating that Hb, ALB and Ca2+in both groupssignificantly increased after3-month-hemodialysis（P<0.05）,1,25-（OH）2VitD3significantly elevated in HFHD group （P<0.05） but not in LFHD（P>0.05）, Serum phosphatesignificantly decreased after3-month-hemodialysis in both groups（P<0.05）, and CRP, IL-6, PTH andFGF23significantly decreased in HFHD group（P<0.05）, but not in LFHD group（P>0.05）.④The t test analysis demonstrated that levels of P3-, CRP, IL-6, PTH, FGF23in HFHD groupafter3-month-hemodialysis were significantly lower than those in LFHD group（P<0.05）,while levels of Hb and1,25-（OH）2VitD in HFHD group after3-month-hemodialysis weresignificantly elevated compared with those in LFHD group（P<0.05） and there were nosignificant difference in levels of Ca2+, ALB and KT/V between two hemodialysis groups.Conclusions①Compared with healthy people, ESRD patients, before receivinghemodialysis treatment, exhibited significantly elevated FGF23and PTH,micro-inflammatory state, calcium and phosphorous metabolic disorder, decreased1,25-（OH）2VitD3,anaemia, and hypoalbuminemia, etc.②Analysis of FGF23-related factorsdemonstrated a negative correlation between FGF23and Ca2+or1,25-（OH）2VitD3,a positivecorrelation between FGF23and ALB, P3-, PTH, CRP, or IL-6respectively, a negativecorrelation between FGF23and HFHD group, and no significant correlation betweenFGF23and Hb or KT/V.③Compared with LFHD, HFHD does better in treating anaemiaand improving nutrition. Besides, HFHD can better decrease FGF23and correct calciumand phosphorous metabolic disorder, improve micro-inflammatory state, reduce risks ofCVD as well as complications of ESRD, enhance ESRD patients’ quality of life, reduce theneed for hospitalization and cut the cost of treatment. |
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