Study on the effect of hemoperfusion combined with hemodialysis compared with that of hemodialysis alone on patients with uremic pruritus

LI Yue; QU Wei; QIN Li-li; ZHENG Xiao-qing; DU Yin-ke; YAO Li

doi:10.19538/j.nk2024120112

Abstract：Objective To compare the effect of hemoperfusion combined with hemodialysis on relieving uremic pruritus withthat of hemodialysis alone in dialysis patients.Methods The clinical data of 60 patients with uremic pruritus were retrospectively analyzed,who received regular hemodialysis in the Department of Nephrology of China Medical University from Jan.2022 to Jan.2024,and they were divided into a hemodialysis group(HD group,no hemoperfusion,30 cases)and a hemoperfusion group(HP+HD group,hemoperfusion≥ 1 time/month,30 cases)based on whether they received hemoperfusion during the follow-up.Compare and observe the changes in serum urea nitrogen(BUN),creatinine(SCr),calcium,phosphorus,intact parathyroid hormone(iPTH),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)at the starting point and after 6 months of dialysis treatment,and evaluate the relief of uremic pruritus in patients through changes in visual analog scale(VAS)scores.Results After 6 months of treatment with two dialysis methods,the HP+HD group showed a significantly higher effective rate in relieving uremic pruritus(90.00％)than the HD group(53.33％),with a statistically significant difference(P＜0.05).The VAS scores of the HP+HD group[3(3,5)]were lower than those of the HD group[4.5(4,6)],and the difference was statistically significant(P＜0.05).There was no significant difference in serum BUN,SCr,calcium,or phosphorus between the two groups of patients(P＞0.05),but the iPTH level in the HP+HD group[(52.83±8.24)pmol/L]was lower than that in the HD group[(59.77±8.81)pmol/L],the CRP level in the HP+HD group[(8.61±2.74)mg/L]was lower than that in the HD group[(10.35±3.11)mg/L],the TNF-αlevel in the HP+HD group[(12.41±3.16)ng/L]was lower than that in the HD group[(14.21±4.72)ng/L],and the IL-6 level in the HP+HD group[(11.16±3.30)ng/L]was lower than that in the HD group[(14.28±5.59)ng/L],all the differences being statistically significant(P＜0.05).The correlation analysis results showed that the VAS score for uremic pruritus was positively correlated with CRP level,TNF-α level and iPTH level respectively.Conclusion Compared with hemodialysis alone,the combination of hemodialysis with hemoperfusion can better eliminate iPTH and inflammatory factors(CRP,TNF-α,IL-6),thereby effectively relieving uremic pruritus in dialysis patients.It is an effective measure for treating uremic pruritus in maintenance HD patients.