Comparison of effects of three dialysis modes on clearance of mid-molecule substance and macromolecular substance related to renal function in patients with renal failure
GAO Xiumei
ZHANG Ping
WANG Shuchun
CHEN Yawei
LIU Ping
Abstract：Objective To compare the effects of high-flux hemodialysis(HFHD),hemodiafiltration(HDF)and continuous hemodialysis(CHD)on clearance of mid-molecule substance and macromolecular substance related to renal function in patients with renal failure.Methods A total of 100 patients with renal failure who were admitted to the 983rd Hospital of Joint Logistic Support Force of PLA from January 2021 to December 2022 and received regular hemodialysis treatment were recruited.These patients' mid-molecule substance and macromolecular substance related to renal function remained at sustained high levels.After fully informing the patients of their conditions,they were divided into CHD group(33 cases),HDF group(33 cases)and HFHD group(34 cases)according to their treatment wishes.The levels of small-molecule substance related to renal function(creatinine,urea nitrogen,phosphorus),mid-molecule substance and macromolecular substance related to renal function(albumin,β2-microglobulin,C-reactive protein),and oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),catalase,thioredoxin]were compared among the three groups before adjusting the dialysis modes and 6 months after adjusting the dialysis modes.The occurrence of complications in the two groups were recorded.Results After adjusting the dialysis modes,the levels of creatinine,urea nitrogen and phosphorus in the three groups were significantly lower than those before adjusting the dialysis modes(P＜0.05),but there were no statistically significant differences in the levels of creatinine,urea nitrogen and phosphorus among the three groups after adjusting the dialysis modes(P＞0.05).After adjusting the dialysis modes,the levels of albumin,SOD,catalase and thioredoxin in the three groups were significantly increased compared with those before adjusting the dialysis modes(P＜0.05),and the levels of β2-microglobulin,C-reactive protein and MDA in the three groups were significantly decreased compared with those before adjusting the dialysis modes(P＜0.05).After adjusting the dialysis modes,the levels of β2-microglobulin,C-reactive protein and MDA in the HDF group were significantly lower than those in the CHD group and the HFHD group(P＜0.05).After adjusting the dialysis modes,the levels of SOD,catalase and thioredoxin in the HDF group were significantly higher than those in the CHD group and the HFHD group(P＜0.05).After adjusting the dialysis modes,there was no statistically significant difference in the level of albumin among the three groups(P＞0.05).The total incidence of complications in the CHD group,the HDF group and the HFHD group was 18.18％,12.12％and 14.71％respectively,and there was no statistically significant difference in the total incidence of complications among the three groups(x2=0.478,P=0.788).Conclusion Among the three dialysis modes of HFHD,HDF and CHD,HDF is the most effective in clearing the mid-molecule substance and macromolecular substance related to renal function and is the most effective in improving the oxidative stress state,and has good safety.
Keywords：Renal failureHigh-flux hemodialysis(HFHD)Hemodiafiltration(HDF)Continuous hemodialysis(CHD)β2-microglobulinC-reactive protein
Publication Date：2025-05-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 538-543 )