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The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients 

  • YIN Yi-Fang ,
  • TANG Jian-Ying
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  • Department of Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University, Chongqing 400715,China

Received date: 2024-01-15

  Revised date: 2024-03-19

  Online published: 2024-06-12

Abstract

The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients   YIN Yi-fang1,MOU Jiao1,YANG Ying1,TANG Jian-ying1    1Department of Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University, Chongqing 400715,China
Corresponding author: TANG Jian-ying, Email:800273@hospital.cqmu.edu.cn
【Abstract】Objective  To investigate the impact of different hemoperfusion (HP) frequencies on protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).  Methods Eighty patients were included and divided based on HP treatment frequency into four groups: no HP (group A), monthly HP (group B), bi-monthly HP (group C) and weekly HP (group D) , with 20 patients in each group. All patients were followed up for six months, then the prevalence of PEW, malnutrition-inflammation score (MIS), and related serum biochemical indicators were analyzed before and after treatment.   Results   Before treatment, there were no significant differences (P>0.05) in MIS scores (F=2.194, P=0.096),  the prevalence of PEW (χ2=0.579, P=0.901), level of pre-albumin (PA) (F=0.258, P=0.855), albumin (Alb) (F=0.187, P=0.905), parathyroid hormone (PTH) (F=0.780, P=0.509), hemoglobin(Hb)(F=1.823,P=0.150), β2-microglobulin (β2-MG) (F=1.833, P=0.148), and C-Reactive protein (CRP) (F=0.432, P=0.731) among the four groups. After treatment, there were 15 patients who withdrew from the trial in Group D. The group C had lower levels of MIS score (C-A: t=4.391, P<0.001;  C-B: t=-2.871,  P=0.006),  PTH (C-A: t=4.098, P=0.001; C-B: t=-2.551,     P=0.047),β2-MG (C-A: t=5.688, P<0.001; C-B: t=-3.207, P=0.002), CRP (C-A:t=4.293, P<0.001; C-B:     t=-2.843, P=0.006) compared with group A and B); and higher level of PA(C-A: t=-3.177, P=0.002; C-B:      t=2.196, P=0.032). Alb (C-A: t=-5.540, P<0.001; C-B: t=2.196, P=0.010) than Groups A and B. Group C had higher level of Hb (t=-3.733, P<0.001) than group A, and  no significant difference with group B (t=1.451,  P=0.152). The prevalence of PEW in group C (χ2=6.465, P=0.011) was significantly lower than group A, but there was no significant difference between group A and group B (χ2=2.506, P=0.113).  Conclusion   Bimonthly HP treatment can obviously improve the nutritional status of patients with MHD and reduce the prevalence of PEW.

Cite this article

YIN Yi-Fang , TANG Jian-Ying . The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients [J]. Chinese Journal of Blood Purification, 2024 , 23(06) : 410 -416 . DOI: 10.3969/j.issn.1671-4091.2024.06.003

References

[1]Carrero JJ, Thomas f, Nagy K, et? al. Global prevalence of protein-energy wasting in kidney disease: a meta-analysis of contemporary observational studies from the international society of renal nutrition and metabolism. J Ren Nutr. 2018;28(6):380–392.
[2]Cao M, Zheng S, Zhang W, et al. Progress in the study of nutritional status and selenium in dialysis patients[J]. Annals of Medicine, 2023, 55(1): 2197296.
[3]He Y, Liu R, Zhu M, et al. The browning of white adipose tissue and body weight loss in primary hyperparathyroidism[J]. EBioMedicine, 2019, 40: 56-66.
[4]Pivari F, Mingione A, Piazzini G, et al. Curcumin supplementation (Meriva?) modulates inflammation, lipid peroxidation and gut microbiota composition in chronic kidney disease[J]. Nutrients, 2022, 14(1): 231.
[5]Van Duong T, Wu P Y, Wong T C, et al. Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients: A prospective cohort study[J]. Medicine, 2019, 98(12).
[6]Hendriks fK, Smeets JSJ, Broers NJH, et? al. End-stage renal disease patients lose a substantial amount of amino acids during hemodialysis. J Nutr. 2020;150(5):1160–1166.
[7]Fouque, D., Kalantar-Zadeh, K., Kopple, J.,et al.A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney international, 2007, 73(4):391-8.
[8]Kir S, Komaba H, Garcia A P, et al. PTH/PTHrP receptor mediates cachexia in models of kidney failure and cancer[J]. Cell metabolism, 2016, 23(2): 315-323.
[9]Sharma B, Dabur R. Role of pro-inflammatory cytokines in regulation of skeletal muscle metabolism: a systematic review[J]. Current medicinal chemistry, 2020, 27(13): 2161-2188.
[10]王萌,蒋红利,何荃等.血液透析联合血液灌流治疗对慢性肾衰竭患者肾功能、微炎症状态和血液净化效果的影响[J].现代生物医学进展,2018,18(08):1511-1514+1413.DOI:10.13241/j.cnki.pmb.2018.08.022.
[11]Snauwaert E, Van Biesen W, Raes A, et al. Haemodiafiltration does not lower protein-bound uraemic toxin levels compared with haemodialysis in a paediatric population[J]. Nephrology Dialysis Transplantation, 2020, 35(4): 648-656.
[12]何琦,梁凌,蒋金玉.血液透析联合血液灌流对尿毒症继发甲状旁腺功能亢进的疗效[J].中国临床研究,2018,31(02):189-192.
[13]Nguyen Huu D, Dao Bui Quy Q, Nguyen Thi Thu H, et al. A Combination of Hemodialysis with Hemoperfusion Helped to Reduce the Cardiovascular-Related Mortality Rate after a 3-Year Follow-Up: A Pilot Study in Vietnam[J]. Blood Purification, 2021, 50(1): 65-72.
[14]Soppert J, Lehrke M, Marx N, et al. Lipoproteins and lipids in cardiovascular disease: from mechanistic insights to therapeutic targeting[J]. Advanced Drug Delivery Reviews, 2020, 159: 4-33.
[15]Li J, Li H, Deng W, et al. The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis[J]. Blood Purification, 2022, 51(9): 739-746.
[16]Mollahosseini A, Abdelrasoul A, Shoker A. A critical review of recent advances in hemodialysis membranes hemocompatibility and guidelines for future development[J]. Materials Chemistry and Physics, 2020, 248: 122911.
[17]陈舜杰,叶朝阳,陈静等. 血浆置换、血液灌流在人工肝支持治疗中的比较 [J]. 实用诊断与治疗杂志, 2006, (10): 725-727.
[18]陶怡婷.血液净化技术在危重患者治疗中的应用进展[J].中国现代医生,2020,58(19):188-192.
[19]Nishikawa H, Enomoto H, Nishiguchi S, et al. Liver cirrhosis and sarcopenia from the viewpoint of dysbiosis[J]. International Journal of Molecular Sciences, 2020, 21(15): 5254.
[20]Zhang Z Y, Li M X, Yu H, et al. Combination of multiple hemodialysis Modes: Better treatment Options for patients under maintenance hemodialysis[J]. Therapeutics and clinical risk management, 2021: 127-133.
[21]周俊,杨文君,刘芳.血液灌流联合血液透析对毒素清除及患者营养状态的影响[J].中国卫生检验杂志,2017,27(16):2356-2358+2361.
[22]Lu W, Jiang G, Shanghai HP-HD Consensus Group. Hemoperfusion in Maintenance Hemodialysis Patients[J]. Blood Purification, 2022, 51(10): 803-811.
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