Effects Of High-flux Hemodialysis On Nutrition Status And Prevalence Of Periodontitis In Maintenance Hemodialysis Patients

Objective:To investigate the effects of high-flux hemodialysis?HFHD?on nutritional status,microinflammation status and prevalence of periodontitis in patients with maintenance hemodialysis?MHD?,and provide reasonable dialysis mode for patients to correct micro-inflammatory state,improve nutritional status,thereby improving patient quality of life and improving long-term prognosis.Methods:In this study,50 patients with end-stage renal diseases treated with MHD from January2016 to December 2016 in Linyi central hospital were enrolled.By using simple random method,25 and 25 patients were divided into two groups,according to different dialysis approach,respectively.All patients were treated with low-flux hemodialysis?LFHD?before the experiment.Patients in group HFHD changed to HFHD for 1 year at the beginning of the experiment,and continuous LFHD for 1 year in group LFHD.The nutritional status of patients was assessed by the modified quantitative subjective global assessment?MQSGA score?,anthropometry,serum albumin?Alb?,prealbumin?PA?,hemoglobin?Hb?,totalcholesterol?TC?,triglyceride?TG?,parathyroid hormonr?PTH?,?₂-microglobulin??₂-MG?and high sensitive C reactive protein?hs-CRP?,tumor necrosis factor?TNF-??and interleukin-6?IL-6?after 1 year of dialysis were detected.The use of simplified oral hygiene index such as debris index?DI?,calculus index?CI?,gingiva index?GI?,plaque index?PLI?,etc.The periodontal condition of the patients was recorded by the observation index.Results:?1?MQSGA score of nutritional status:compared with pre dialysis,the activity ability and muscle consumption score of group HFHD decreased significantly after 1 year of dialysis?P<0.05?,and there was no significant change in other indexes?P>0.05?,and there was no significant change in the indexes in group LFHD after 1 year of dialysis?P>0.05?.After 1 year of dialysis,the total score of group HFHD was lower than that of group LFHD?P<0.05?.?2?Anthropometry:compared with pre dialysis,the upper arm circumference?MAC?and upper arm muscle circumference?MAMC?of the HFHD group increased significantly?P<0.05?after 1year of dialysis,and there was no significant change in the thickness of the triceps brachii?TSF??P>0.05?,and there was no statistical difference between the LFHD group and the 1 year before and after the treatment?P>0.05?.?3?Serological indexes:hemoglobin,albumin,prealbumin high density lipoprotein increased?P<0.05?after dialysis 1 year before dialysis,high sensitive C-reactive protein,tumor necrosis factor–?,interleukin-6?IL-6?,triglyceride,total cholesterol,low density lipoprotein,total parathyroid hormone,serum beta 2 microglobulin,serum creatinine and urea nitrogen reduction?P<0.05?.The above indexes in group LFHD after dialysis were 1year dialysis no significant changes were found?P>0.05?.In group HFHD,hemoglobin,albumin prealbumin and high density lipoprotein were higher than the LFHD group after 1 year of dialysis?P<0.05?.High sensitive C-reactive protein,triglyceride,total cholesterol,low density lipoprotein,total parathyroid hormone,and serum beta 2 microglobulin were lower than those in group LFHD?P<0.05?.?4?Periodontal status:periodontal status in group HFHD after dialysis for 1 year was better than that in group LFHD,and the prevalence of periodontitis in group HFHD was lower than that in group LFHD?P<0.05?.?5?Multivariate linear regression showed that MQSGA,MAC,TG,ALB,PA,Scr and BUN were independent influencing factors of total OHI-S score before and after treatment.Conclusions:High-flux hemodialysis can improve the nutritional status and micro inflammatory state in maintenance hemodialysis patients.It can also effectively improve the periodontal status and reduce the prevalence of periodontitis of patients,thus making more benefit in maintenance hemodialysis patients.