Effects of different hemodialysis modes on the micro-inflammatory status,coagulation function,and prognosis of end-stage renal disease patients

SUN Zheng-min; PANG Jia-liang; LIAO Wei

doi:10.13820/j.cnki.gdyx.20242188

Abstract：Objective To explore the effects of different hemodialysis modes on the micro-inflammatory status,coagulation function,and prognosis of end-stage renal disease(ESRD)patients.Methods From June 2021 to Decem-ber 2023,a prospective study was conducted with 166 ESRD patients.The patients were randomly assigned into three groups:Group A(55 cases,receiving hemodialysis treatment),Group B(55 cases,receiving hemodiafiltration treat-ment),and Group C(56 cases,receiving high-flux hemodialysis treatment).The differences in micro-inflammatory status,coagulation function,adverse reactions,complications,and prognosis among the three groups were compared.Re-sults After treatment,the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),andsolubleinterleukin-2 receptor(sIL-2R)decreasedsignificantlyinallthreegroups(P<0.05).Ad-ditionally,Group B and Group C had lower levels of IL-6,CRP,and sIL-2R than Group A(P<0.05),while other comparisons between groups showed no significant differences(P>0.05).After treatment,von Willebrand factor(vWF),activated partial thromboplastin time(APTT),d-dimer(D-D),and fibrinogen(Fbg)decreased in all three groups(P<0.05).Group B and Group C showed lower levels of vWF,APTT,D-D,and Fbg compared to Group A(P<0.05).There were no significant differences in the incidence of adverse reactions(e.g.,rash,dizziness,gastroin-testinal reactions,skin itching,and total incidence)and complications(e.g.,hypotension,arrhythmia,hypertension,muscle cramps)among the three groups(P>0.05).However,the total incidence of complications in Group B and Group C was significantly lower than in Group A(P<0.05).The follow-up period lasted from1 to31 months(until January 2024),with no cases lost to follow-up.Group B and Group C had lower mortality rates compared to Group A(P<0.05).Furthermore,Group C had a lower cardiovascular-related mortality than Group A(P<0.05).Kaplan-Meier survival analysis indicated that the overall survival rate in Group B and Group C was better than in Group A,with statisti-cally significant differences(P<0.05).Conclusion High-flux hemodialysis and hemodiafiltration therapies for ESRD patients both show favorable effects.They effectively alleviate the micro-inflammatory state,improve coagulation func-tion,reduce the incidence of complications,and improve the prognosis of patients.