Effect Of Hemodialysis And Hemofiltration Treatments On The Activity Of Neutrophils

Objective: To observe the effects of hemodialysis (HD)andhemofiltration(HF) therapy on the activity of neutrophil alkaline phosphatase(NAP) and serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA),blood phosphorus (P3-) level during and after treatment. And discuss thepossible mechanism of both hemodialysis and hemofiltration affect theactivities of neutrophil alkaline phosphatase (NAP).Method:20patients included in the study who were randomly selectedfrom180qualified patients with end-stage renal disease (ESRD) whosetreatments were in the first affiliated hospital of GuangXi Medical Universityblood purification center from June2013to September2013. Taking theforward-looking and cross design, the20maintenance dialysis (MHD)patients were randomly divided into two groups, each group of10cases with5male,5female. In the first phase, treated one group with hemodialysis (HD)and another group with hemofiltration (HF) treatment; and interchanged dialysissolutions three days after which means entering the second stage. To compare the influence of two kinds blood purification treatment on the level of theactivity of neutrophil alkaline phosphatase (NAP) and serum creatinine (Scr),blood urea nitrogen (BUN), uric acid (UA), blood phosphorus (P3-) beforetreatment, after filter, after treatment.Result: Before two blood purification treatment the neutrophils alkalinephosphatase (NAP) score in blood were higher than normal range; however, theminute through the filter, as well as after treatment, NAP integral reducedwhich difference was statistically significant (P <0.01) and can return to normallevels. But filter made the integral decline rate most obvious. In the process ofthe treatment, NAP integral decline rate of Hemofiltration (HF) group werehigher than in hemodialysis (HD) group, the difference was statisticallysignificant (P <0.01).Before the two kinds of blood purification treatments,serum creatinine (Scr), blood urea nitrogen (BUN) and blood uric acid (UA),phosphorus (P3-) levels were higher than the normal range, and showed sameoutcomes as the NAP integral. In the process of treatment the decline rate ofScr, BUN, blood UA and P3-in Hemodialysis (HD) group were higher thanin hemofiltration (HF) group, the difference was statistically significant (P <0.01),while blood phosphorus decrease rate differences had no statisticalsignificance (P>0.05). In Hemodialysis (HD) treatment group, before and afterthe treatment the change of NAP was positively relationship with BUN and UA(P＜0.05), but without correlation after the filtering process (P>0.05); NAP has no correlation with Scr and P3-in the whole treatment process (P>0.05).In Hemofiltration (HF) treatment group, NAP had no correlation with Scr, BUN,UA and P3-during the whole treatment (P>0.05).Conclusion: Uremic Patients by the treatment of hemodialysis (HD) orhemofiltration (HF) may have effective removal of serum creatinine (Scr),blood urea nitrogen (BUN), uric acid (UA), blood phosphorus (P3-) and othertoxins, and hemodialysis (HD) treatment had better curative effect thanhemofiltration (HF) therapy. Hemodialysis (HD), hemofiltration (HF) treatmentcan cut neutrophil alkaline phosphatase (NAP) integral to normal that showedhemodialysis (HD) and hemofiltration (HF) treatment could improve theactivity of neutrophils (PMN), and hemofiltration (HF) was better thanhemodialysis (HD), which explained hemofiltration (HF) treatment in the aspectof improve the immune function of patients with uremia had an obviousadvantage. Serum creatinine, blood urea nitrogen and other small moleculetoxins had no obvious effect on the activity of neutrophil alkalinephosphatase.