Research on the Application of Controlled Medical Oxygen Concentration Gradients in Hemodialysis

ZHOU Enzheng

doi:10.3969/j.issn.2097-7026.2026.01.002

Abstract：Objective This study aimed to investigate the effects of gradient-controlled oxygen therapy on oxidative stress markers and anemia-related parameters in patients undergoing maintenance hemodialysis(MHD),to provide evidence-based support for optimizing clinical care protocols.Methods Using prospective randomized controlled trial design,the research included 100 maintenance hemodialysis(MHD)patients treated at the Nephrology Department of Guizhou Provincial People's Hospital between December 2023 and December 2024.Patients were randomly assigned to an observation group and a control group(50 cases each)using a random number table.The control group received standard hemodialysis treatment and routine oxygen therapy(maintaining oxygen concentration at 28％-30％).The observation group received a dynamic oxygen concentration adjustment protocol:35％-40％oxygen concentration 30 minutes before dialysis,28％-30％concentration maintained for 2-3 hours during dialysis,and adjusted to 32％-35％concentration 30 minutes after dialysis.Both groups underwent 12-week intervention cycles.Primary observation indicators included:oxidative stress markers(superoxide dismutase SOD,malondialdehyde MDA,glutathione peroxidase GSH-Px),anemia-related parameters(hemoglobin Hb,hematocrit HCT,serum erythropoietin EPO),and adverse reaction incidence.Results Baseline data showed no significant differences in oxidative stress markers or anemia parameters between the two groups(P>0.05).After 12 weeks of intervention,the observation group demonstrated significant improvements:SOD levels(128.64±15.32 U/mL vs 105.28±14.67 U/mL)and GSH-Px levels(86.35±10.24 U/mL vs 72.16±9.85 U/mL)were significantly higher than those in the control group,while MDA levels(5.23±1.05 nmol/mL vs 7.86±1.23 nmol/mL)were significantly lower(P<0.05).In terms of anemia improvement,the observation group showed significantly higher Hb levels(112.56±10.34 g/L vs 98.67±9.85 g/L),HCT(33.85±3.21％vs 29.67±3.05％),and EPO levels(186.35±25.67 mIU/mL vs 152.46±23.85 mIU/mL)compared to the control group(P<0.05).Safety assessments revealed that the incidence of adverse reactions in the observation group(6.00％)were significantly lower than in the control group(20.00％)(P<0.05).Correlation analysis indicated that SOD and GSH-Px showed significant positive correlations with Hb,HCT,and EPO,while MDA exhibited significant negative correlations with these anemia indicators(P<0.001).Conclusion The gradient-controlled medical oxygen therapy effectively improved oxidative stress status and enhanced anemia correction in MHD patients,demonstrating a high safety margin and broader clinical adoption.