Prognosis in diabetic patients with end-stage renal disease treated by hemodialysis combined with hemoperfusion

Objective To investigate the prognosis of diabetic patients with end-stage renal disease (ESRD) treated by hemodialysis (HD) or hemodialysis combined with hemoperfusion (HD+HP).Methods We retrospectively studied the clinical data of 135 dialysis patients secondary to diabetic nephropathy (52 given HD, and 83 given HD+HP) treated in the First People's Hospital of Zhaoqing during the period between October 2009 and January 2017. The clinical parameters, incidence of adverse events, survival rate, mortality and its causes were compared between HD and HD+HP groups before and after the dialysis.Results At the beginning of dialysis, there were no significantly differences in baseline parameters before the dialysis between the two groups, including age, history of diabetes, red blood cells (RBC), hemoglobin (Hb), serum creatinine, serum albumin (Alb), etc. At the end of observation period, the serum levels of RBC and Hb were significantly higher than those before the dialysis (P<0.05), but there were no significance differences in other indictors in HD group (P>0.05). In HD+HP group, the serum levels of RBC, Hb, Alb and Ca were significantly higher than those before the dialysis when the serum levels of P, PTH, CRP, IL-6 and TG were significantly decreased (P<0.05), but there were no significance differences in the serum levels of TC and LDL-L (P>0.05). The serum levels of RBC, Hb, P, PTH, CRP, IL-6 and TG were significantly lower in HD+HP group than in HD group, but the Alb and Ca were significantly higher in HD+HP group than in HD group. Except for the incidence of infection, the incidence of death, cerebral infarction, bleeding and cardiac insufficiency was higher in HD patients than in HD+HP patients, but the causes of death were significantly indifferent between the two groups. The 1-and 3-year survival rate were statistically indifferent between the two groups, but the 5-and 7-year survival rate was significant higher in HD+HP group than in HD group. The survival time and the total score of life quality were higher in HD+HP group than in HD group.Conclusions HD+HP have a better efficacy than HD, and have a potential role in reducing the incidence of adverse events and improving survival rate and the quality of life of diabetic patients with ESRD.