Study on the influence of hemodialysis on blood biochemical indexes and complications in middle-aged and elderly patients

Luo Ping; Liu Lan; Li Xiaoyan

doi:10.3969∕j.issn.1674-3245.2023.05.023

Abstract：Objective To study the influence of hemodialysis on blood biochemical indexes and complications in middle-aged and elderly patients.Methods A total of 747 patients receiving maintenance hemodialysis in the department of nephrology Zigong Fourth People's Hospital from September 2019 to September 2022 were selected as the research objects.According to the age of the patients,they were divided into the middle-aged group(170 patients aged 45～59 years old)and the elderly group(577 patients aged≥60 years old).Both groups received maintenance hemodialysis treatment.The changes of dialysis adequacy,biochemical indexes(alanine aminotransferase,aspartate aminotransferase,total bilirubin,uric acid,serum creatinine,urea nitrogen,blood cholesterol,triglycerides,blood glucose,brain natriuretic peptide),and routine blood indexes(hemoglobin,white blood cells,platelets,red blood cell count,and blood fibrin)before and after dialysis were compared between the two groups.At the same time,the incidence of complications(infection,thrombosis,hypotension,hypoproteinemia,gastrointestinal bleeding,arteriovenous fistula occlusion),outcomes after dialysis and survival time in the two groups were compared.Results After dialysis,URR of the middle-aged group was higher than that of the old group(P<0.05).The levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,uric acid,serum creatinine,urea nitrogen,blood cholesterol and triglyceride in the middle-aged group were lower than those in the elderly group(P<0.05),but there was no significant difference in blood glucose and brain natriuretic peptide levels between the two groups(P>0.05).The counts of hemoglobin,platelet and red blood cell in middle age group were higher than those in old age group,while the levels of white blood cell and blood fibrin in middle age group were lower than those in old age group(P<0.05).During dialysis,the complication rate of the middle-aged group was lower than that of the elderly group,the mortality rate was also lower than that of the elderly group,and the survival time was longer than that of the elderly group(P<0.05).Conclusion The dialysis adequacy of elderly patients is slightly worse than that of middle-aged patients,and the older patients show the greater the influence on the blood biochemical indexes after hemodialysis.Moreover,compared with middle-aged people,the elderly have a higher incidence of complications during dialysis,poor outcome and shorter survival time.