Effect of different hemodialysis modalities on resistin and nutritional status

Objective To investigate the level of resistin in the patients with different hemodialysis modalities and its influence on nutritional status. Methods A total of 55 hemodialysis patients were randomly divided into low flux hemodialysis group (LFHD, n=27) and high flux hemodialysis group (HFHD, n=28), and compared with 30 healthy volunteers (normal control group). All of them were selected as the study objects in the First Affiliated Hospital of Shihezi University. The levels of serum resistin before and after dialysis were determined by enzyme-linked immunosorbent assay(ELISA). Fasting samples of venous blood were obtained in 55 hemodialysis patients before dialysis and the following biochemical indexes were measured:for nutrition index, total protein(TP), albumin (Alb), prealbumin (PA), hemoglobin(Hb); for inflammation indicators, C reactive protein (CRP), ferritin (Fer); for blood lipids, serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL); for renal function and electrolyte, renal urea nitrogen(BUN), serum creatinine (SCr), uric acid (UA), kalium (K), calcium (Ca), phosphorus (P), magnesium (Mg). The differences in resistin levels and biochemical indexes were compared between the two groups. All of the patients underwent subjective comprehensive nutritional assessment by specially-assigned person and according to the guidelines, at the same time the clinical data of the subjects were collected. The changes of resistin levels in each dialysis group were analyzed and their relationships with the above biochemical indexes were analyzed.Results (1)As compared with the normal control group, the resistin level in LFHD group and HFHD group was significantly increased. There was no statistically significant difference between LFHD group and HFHD group in the level of pre-dialysis resistance and the level of resistin. There was no significant difference in resistin level between LFHD group and HFHD group before and after dialysis. There were statistically significant differences in the level of resistin before and after dialysis in HFHD group. (2) The differences in Alb, PA and SGA in patients undergoing different hemodialysis methods were statistically significant. As compared with LFHD group, HFHD group had higher Alb and PA but lower SGA scores; (3)Single factor analysis revealed that serum resistin was positively correlated with SCr and CRP (r=0.768, and r=0.473, P<0.05), and negatively correlated with glomerular filtration rate (eGFR) (r=-0.813, P<0.05). Serum resistin was positively correlated with TC, TG, LDL and SGA (r=0.408, r=0.294, r=0.397, and r=0.286 respectively, P<0.05). (4) Multiple linear regression analysis demonstrated that eGFR and CRP had influence on the level of resistin, and the dialysis mode had no significant effect on it.Conclusions High flux dialysis may eliminate some of the resistin. Resistin in hemodialysis patients is closely related to their nutritional status.