Comparison of therapeutic effects among hemodiafiltration,hemodialysis combined hemoperfusion and high flux hemodialysis and uremic refractory hypertension
10.3969/j.issn.1008-0074.2015.05.24
- VernacularTitle:血液透析滤过、透析联合灌流、高通量透析治疗尿毒症难治性高血压的疗效比较
- Author:
Zulian ZHOU
;
Tongwu ZHAO
;
Sicheng RAN
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Uremia;
Hypertension
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2015;24(5):553-557
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare therapeutic effects of hemodiafiltration (HDF) ,hemoperfusion combined hemodi‐alysis (HP+ HD) and high flux hemodialysis (HFHD) on uremic refractory hypertension (URH) .Methods :A total of 60 URH patients undergoing maintenance hemodialysis (MHD) were selected from three hospitals .They were randomly and equally divided into HDF group ,HP+ HD group and HFHD group .The 24h ambulatory blood pres‐sure ,concentrations of parathyroid hormone (PTH) andβ2‐microglobulin (β2‐MG) were detected and compared a‐mong three groups before ,after first treatment and 12 weeks after treatment .Results:Compared with before treat‐ment ,after the first treatment ,there were significant reductions in blood pressure ,blood concentrations of PTH andβ2‐MG in three groups , P< 0.05 or <0.01 ,and therapeutic effect was most significant in HP + HD group ;compared with after first treatment ,12 weeks later ,blood concentrations of PTH and β2‐MG further significantly reduced in three groups (P<0.05 or <0.01) ,compared with HDF group and HFHD group ,there was significant reductions in blood concentrations of PTH [(211.12 ± 50.05) pg/L ,(195.49 ± 48.32) pg/L vs .(75.43 ± 14.38) pg/L] andβ2‐MG [ (9.16 ± 5.02) mg/L ,(9.92 ± 5.37) mg/L vs .(5.39 ± 2.09) mg/L] in HP+ HD group , P<0.01 all .In HDF、HP+ HD、 HFHD groups ,the DBP were [ (86.70 ± 12.76) mmHg)、 (86.10 ± 9.84) mmHg)、(90.95 ± 10.15) mmHg] respectively ,those were return to normal mainly ,and no significant difference ,the SBP were [ (140.75 ± 10.85) mmHg)、(146.20 ± 8.31) mmHg)、(146.30 ± 9.65) mmHg) ,those were close to normal and no significant difference also .Adverse reactions were mild in three groups ,that of HDF group was significantly less than those of HP+ HD group and HFHD group [0 vs .40% ,45% , P<0.05 all] .Conclusion:HDF ,HP+ HD and HFHD could effectively remove blood PTH and β2‐MG ,and lower blood pressure in URH patients .Hospital may choose therapeutic plan according to specific needs of patients and HD room condition .
