高通量血液透析与低通量血液透析对糖尿病肾病患者的影响

Effects of high flux hemodialysis and low flux hemodialysis for patients with diabetic nephropathy

  • 摘要:
      目的  探讨高通量血液透析(HFHD)与低通量血液透析(LFHD)对糖尿病肾病(DN)患者代谢及肾功能的影响。
      方法  将60例DN患者按照随机数字表分为HFHD组与LFHD组,每组30例。比较2组肾功能指标及代谢指标水平。
      结果  透析前,2组血尿素氮(BUN)、血肌酐(SCr)、β2-微球蛋白(β2-MG)比较,差异无统计学意义(P>0.05);透析后,HFHD组以上指标均高于LFHD组,差异均有统计学意义(P < 0.05)。2组透析前后血红蛋白(Hb)、血清白蛋白(Alb)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、血尿酸(BUA)、血钙(Ca)、血磷(P)、甲状旁腺素(PTH)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)比较,差异均有统计学意义(P < 0.05);HFHD组透析后TC、hs-CRP、P、PTH、IL-6、TNF-α水平低于LFHD组,差异有统计学意义(P < 0.05),其余指标差异均无统计学意义(P>0.05)。
      结论  相较于LFHD,HFHD治疗DN能够有效清除毒素,调节机体代谢,显著改善患者肾功能及炎症状态。

     

    Abstract:
      Objective  To explore the effects of high flux hemodialysis (HFHD) and low flux hemodialysis (LFHD) on metabolism and renal function in patients with diabetic nephropathy(ND).
      Methods  A total of 60 DN patients were selected and divided into HFHD group and LFHD group according to random number table method, with 30 cases in each group, and the levels of renal function indexes and metabolic indexes were compared between the two groups.
      Results  Before dialysis, there were no significant differences in blood urea nitrogen (BUN), serum creatinine (SCr), β2-microglobulin (β2-MG) between the two groups (P>0.05); after dialysis, the above indexes were significantly higher in the HFHD group than those in the LFHD group(P < 0.05). There were statistically significant differences in hemoglobin (Hb), serum albumin (Alb), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), hypersensitive C-reactive protein (hs-CRP) and blood uric acid (BUA), blood calcium (Ca), phosphorus (P) and parathyroid hormone (PTH), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) between the two groups before and after dialysis (P < 0.05). The levels of TC, hs-CRP, P, PTH, IL-6 and TNF-α in the HFHD group after dialysis were significantly lower than those in the LFHD group (P < 0.05), but there were no statistically significant differences in other indexes (P>0.05).
      Conclusion  Compared with LFHD, HFHD in treatment of DN can effectively remove toxin, regulate body metabolism, and significantly improve the patient's renal function and inflammation.

     

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