A Comparative Study On The Clearance Effect Of Uremia Toxin Between HFHD And Intermittent HDF

Objective: The aim of this study is to compare the clearance effect ofuremia toxin and the improvement of micro-inflammatory state(MIS)between high flux hemodialysis(HFHD)and intermittent hemodiafiltration(LFHD+HDF)in maintenance hemodialysis(MHD)patients,especially the difference of the clearance effect of large and medium molecular toxin.In order to find a more effective,more economical and more suitable blood purification mode.Methods:Sixty-five MHD patients with low flux hemodialysis(LFHD)were selected as subjects.The patients were randomly divided into three groups: LFHD group includes 23 patients,HFHD group includes 22 patients and LFHD+HDF group includes 20 patients.LFHD group patients were treated with low flux hemodialysis as before,three times a week and each time for four hours;HFHD group patients were changed to high flux hemodialysis treatment,three times a week and each time for four hours;LFHD+HDF group patients were treated with low flux hemodialysis(twice a week)and hemodiafiltration(once a week),each time for four hours.The levels of blood urea nitrogen(BUN),serum creatinine(Scr),intact parathyroid hormone(i PTH),?2-microglobulin(?2M),C reactive protein(CRP),interleukin-6(IL-6)were detected at the beginning of the experiment,three months and six months after the experiment.Results: In LFHD group,the levels of i PTH,?2M,CRP and IL-6 at three months and six months after the experiment were slightly higher than the previous levels at the beginning of the experiment,but the difference was no statistics significance(P>0.05).In HFHD and LFHD+HDF groups,the levels of i PTH,?2M,CRP and IL-6 at three months and six months after the experiment were reduced obviously than the previous at the beginning of the experiment,with statistical significance(P<0.05).The levels of BUN and Scr at three months and six months after the experiment were no significant difference compare to the previous at the beginning of the experiment in three groups(P>0.05).Conclusions: 1.Compare with LFHD mode,HFHD mode and LFHD+HDF mode are better at the clearance effect of large and medium molecular uremia toxin and inflammatory mediator.2.HFHD mode and LFHD+HDF mode are equal to the clearance effect of large and medium molecular uremia toxin and inflammatory mediator.