Effect of different types of blood purification on clearance of homocysteine in maintenance hemodialysis patients

Objective To observe the effect of different types of purification on clearance of homocysteine in maintenance hemodialysis (MHD) patients.Methods A total of 70 MHD patients were randomly divided into 3 groups:regular hemodialysis group (n=24), hemodialysis and hemoperfusion group (n=23) and hemodiafiltration group (n=23). A series of biochemical tests were performed and compared before and after first hemodialysis and one year after hemodialysis.Results Compared the serum homocysteine(Hcy) before the therapy and after first hemodialysis(HD), there was no significant difference among three groups(P>0.05). Before and after first hemodialysis compared the serum homocysteine, there was significant difference among three groups(P<0.01). Clearance of homocysteine in hemodialysis and hemoperfusion(HD+HP) group higher than in hemodialysis group(P<0.01) and hemodiafiltration(HDF) group(PP<0.05). There was significant difference. Compared clearance of homocysteine in HDF group and HD group, there was no significant difference(P>0.05). The URR and spKt/V showed no significant difference among three group(P>0.05). After treatment for one year compare to the before serum Hcy in HD group showing no significant difference (P>0.05). Serum Hcy in HD+HP,and HDF group significantly lower than that before treatment (P<0.01).The drop of Hcy in HD+HP group and HDF group was significantly higher than in HD group (P<0.05). There was no significant difference between HD+HP group and HDF group(P>0.05).Conclusions Hyperhomocysteinemia is prevalent in MHD patients. Hemodialysis and hemoperfusion, as well as hemodiafiltration significantly increase the clearance of serum homocysteine.