The Change Of Serum Hepcidin Level With Hemodialysis Mode Research On Influence And Related Factors

Objective:Through the study of the different modes of maintenance hemodialysis dialysis intervention,and to explore different ways of hemodialysis in maintenance hemodialysis patients state of iron metabolism in the body,the effect of further intervention,improve the dialysis patients with renal anemia status,better correction of renal anemia.Methods: 2017.1 to 2018.1 under treatment in hospital urology department blood purification center during the 150 maintenance hemodialysis patients as the research object,by grouping contrast method,observation from low flux hemodialysis way to change the way of high flux hemodialysis and hemodialysis filtration method of iron element level change.All selected objects are started before the trial and experiment 2,6,12 months,respectively,on the first day of dialysis before fasting 8 h,the next day morning fasting blood samples to detect serum iron element and other biochemical indicators.Using the experimental data with statistics software SPSS21.0 statistical analysis and processing.Results:1.three groups of patients in terms of age,sex and disease composition,there was no significant difference(P > 0.05)2.The serum iron level of high-flux hemodialysis patients and hemodiafiltration patients increased.,the second month,6 months and 12 months average not all equal(F = 18.17;P < 0.01),and other iron metabolism indexes such as ferritin and serum iron,transferrin saturation and total iron binding force at all time points were no significant differences(P > 0.05);As the dialysis time extended,hemoglobin level increases gradually,then(P < 0.05).3.relevant analysis showed that: In low flux hemodialysis patients,serum hepcidin level and total iron binding capacity,hemoglobin,serum iron was negatively correlated(r =-0.269,-0.607,-0.207,P < 0.05)and serum ferritin,transferrin saturation,serum HS CRP,IL-6,urea nitrogen and creatinine positively(R respectively.0.503,0.212,0.545,0.501,0.427,0.040,P < 0.05);and the IL-6,parathyroid hormone and HS CRP significant correlation(P < 0.01).In high flux hemodialysis patients,serum hepcidin level and total iron binding capacity,hemoglobin,serum iron was negatively correlated(r =-0.264,-0.618,-0.376,P < 0.05)and serum ferritin,transferrin saturation,serum HS CRP,IL-6,parathyroid hormone,blood urea nitrogen and creatinine positively(r = 0.560,0.116,0.487,0.446,0.472,0.451,0.037,P < 0.05);and the IL-6 and HS CRP significant correlation(P < 0.01).In hemodialysis patients,the serum level of hepcidin and total iron binding capacity,hemoglobin,serum ferritin was negatively correlated(r =-0.260,-0.621,-0.274,P < 0.05),and serum ferritin,transferrin saturation,HS CRP,IL-6,parathyroid hormone,blood urea nitrogen and creatinine positive(r = 0.638,0.158,0.542,0.453,0.449,0.483,0.034,P < 0.05),and the intact parathyroid hormone,IL-6 significantly correlated(P < 0.01).4.multiple stepwise regression analysis showed that in high flux hemodialysis patients,hypersensitive c-reactive protein level,level of IL-6 is one of the important factors affect the level of serum iron adjustable element;In patients with hemodialysis filtration,segment parathyroid hormone IPTH,IL-6 level is one of the important factors affect the level of serum iron adjustable element.Conclusion: Three groups of different hemodialysis methods have different effects on the level of serum iron in maintenance hemodialysis patients.High flux hemodialysis and low flux hemodialysis are more effective in reducing the level of serum iron in hemodialysis patients and better improving the status of renal anemia in dialysis patients.