Application of high throughput hemodialysis in maintenance hemodialysis patients with renal anemia
10.3760/cma.j.cn115455-20240117-00079
- VernacularTitle:高通量血液透析治疗在维持性血液透析伴肾性贫血患者中的应用分析
- Author:
Yan LI
1
;
Zhiping WU
;
Chen NI
;
Yueda LI
;
Ping WANG
Author Information
1. 杭州市第三人民医院（浙江中医药大学附属杭州第三医院）肾内科，杭州 310000
- Keywords:
Hemodiafiltration;
Renal anemia;
Ferritin;
Ferromodultin
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(9):828-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of high-throughput hemodialysis (HFHD) therapy on the application of serum ferritin (SF), transferrin saturation (TSAT), ferromodultin (Hepc) and soluble transferrin receptor (sTfR) levels in maintenance hemodialysis (MHD) with renal anemia.Methods:The uremic patients with MHD treatment in the Third People′s Hospital of Hangzhou City from August 2020 to July 2023 were selected as the study object. They were divided into high throughput (30 cases) and low throughput (30 cases) according the treatment methods. The general data; anemia indexes, including red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT), percentage of reticulocytes (Ret); iron metabolism indexes (SF, TSAT, Hepc and sTfR); inflammations indexes, including β 2-microglobulin (β 2-MG), C-reactive protein (CRP), interleukin-6 (IL-6); renal function indexes, including blood creatinine (SCr), urine creatinine (Cr), blood urea nitrogen (BUN); and adverse reaction were collected. Results:After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the high-throughput group were increased compared with those before treatment: (3.33 ± 0.43) × 10 12/L vs. (2.12 ± 0.24) × 10 12/L, (118.08 ± 11.36) g/L vs. (98.23 ± 8.58) g/L, 0.354 ± 0.030 vs. 0.228 ± 0.037, (486.23 ± 68.22) μg/L vs. (149.34 ± 39.62) μg/L, (36.24 ± 5.82)% vs. (18.72 ± 6.14)%, After treatment, the levels of RBC, Hb, HCT, SF and TSAT in the low-throughput group were increased compared with those before treatment: (2.79 ± 0.32) × 10 12/L vs. (2.19 ± 0.27) × 10 12/L, (111.98 ± 9.07) g/L vs. (97.60 ± 8.33) g/L, 0.330 ± 0.036 vs. 0.214 ± 0.037, (332.73 ± 56.35) μg/L vs. (151.25 ± 39.90) μg/L, (22.23 ± 6.60)% vs. (17.97 ± 5.72)%. In the high-throughput group, after treatment compared with before treatment, Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels all decreased: (1.02 ± 0.58)% vs.(1.64 ± 0.99)%, (71.56 ± 5.67) μg/L vs. (89.56 ± 7.62) μg/L, (395.07 ± 37.10) μg/L vs. (471.37 ± 41.18) μg/L, (8.38 ± 1.94) μg/L vs. (13.79 ± 2.09) μg/L, (1.07 ± 0.23) mg/L vs. (2.28 ± 0.20) mg/L, (11.40 ± 2.84) ng/L vs. (22.74 ± 6.38) ng/L, (351.54 ± 62.05) μmol/L vs. (530.04 ± 85.06) μmol/L, (6.32 ± 1.49) nmol/L vs. (11.52 ± 2.37) nmol/L, (6.75 ± 1.51) mmol/L vs. (18.37 ± 4.52) mmol/L, compared with before and after treatment in low throughput group, Ret value, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels decreased: (1.40 ± 0.65)% vs. (1.67 ± 0.78)%, (84.33 ± 7.45) μg/L vs. (88.97 ± 7.79) μg/L, (431.20 ± 37.59) μg/L vs. (459.56 ± 42.22) μg/L, (11.35 ± 1.06) μg/L vs. (14.00 ± 1.90) μg/L, (1.57 ± 0.27) mg/L vs. (2.19 ± 0.23) mg/L, (16..85 ± 3.02) ng/L vs. (23.38 ± 6.17) ng/L, (389.48 ± 67.03) μmol/L vs. (531.02 ± 78.07) μmol/L, (9.80 ± 1.33) nmol/L vs. (11.34 ± 2.18) nmol/L, (7.55 ± 1.21) mmol/L vs. (18.37 ± 4.52) mmol/L, In addition, RBC, Hb, HCT, SF and TSAT levels in high-flux group were higher than those in low-flux group ( P<0.05), while Ret, Hepc, sTfR, β 2-MG, CRP, IL-6, SCr, Cr and BUN levels were lower than those in low-flux group, with statistical significance ( P<0.05). There was no significant difference in the incidence of adverse drug effects between the two groups ( P>0.05). Conclusions:HFHD treatment for patients with renal anemia in MHD has better treatment effect than LFHD, which can effectively correct the anemia state of patients, improve the body iron metabolism response, reduce inflammatory response and improve kidney function, and has certain clinical application value.
