Study on effect of hemodiafiltration combined with hemoperfusion on complications associated with hemodialysis in patients with maintenance hemodialysis

Objective To observe the efficacy of hemodiafiltration combined with hemoperfusion(HDF+HP) for treatment of complications associated with hemodialysis in patents with maintenance hemodialysis(MHD). Methods A total of 80 patients with MHD in our center were selected. The treatment regimens were all a combined dialysis scheme, including hemodialysis (HD, twice a week), hemodiafiltration (HDF, once a week) and hemodialysis combined with hemoperfusion (HD+HP, fortnightly).The subjects were randomly divided equally into two groups, named group A and group B. Group A continued the original regimen The regimen for group B was adjusted to HD (twice a week), HDF (once a week) and HDF+HP (fortnightly), with an observation period of 3 months. Blood samples were selected to detect the related indices, and to record dialysis-associated complications; meanwhile, the expense during the treatment was summarized. Results There was no significant difference in various indexes before grouping between group A and group B(P>0.05). During the observation, there was no significant difference in the incidence of dialysis related complications(P>0.05).After 3 months of observation, we found that:(1) systolic blood pressure and diastolic blood pressure in group B were significantly lower than those in group A, with difference of statistical significance (P<0.05). (2) Compared with group A, the levels of iPTH, phosphorus and β-2 microglobulin in group B were significantly decreased (P<0.05), Hb significantly increased (P<0.05), and skin pruritus improved significantly (P<0.05). (3) CRP in group B was lower than that in group A (P<0.05). (4) There was no significant difference in plasma albumin level and total treatment cost between group A and B group (P>0.05). Conclusions HDF+HP can better remove metabolic products and uremia toxin from the body, rectify renal anemia and chronic kidney disease mineral and bone disorder(CKD-MBD), improve the state of microinflammation, nutritional status and skin pruritus, and control blood pressure more ideally. Therefore, HDF+HP can better improve the long-term complications in MHD patients, does not relatively increase the cost of treatment and so is worth popularizing.