Effects of three different blood purification modes on nutritional status and insulin resistance in patients with end-stage diabetes nephropathy
10.3760/cma.j.cn115455-20230413-00379
- VernacularTitle:三种不同血液净化模式对糖尿病肾病终末期患者营养状况、胰岛素抵抗的影响
- Author:
Ye ZHANG
1
;
Wenjun YANG
;
Fan HE
;
Shun WANG
Author Information
1. 新疆医科大学第一附属医院肾病三科，乌鲁木齐 830011
- Keywords:
Diabetic nephropathies;
High throughput hemodialysis;
Sequential hemodialysis;
Hemoperfusion
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(12):1072-1076
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effects of three different blood purification modes on nutritional status and insulin resistance in patients with end-stage diabetes nephropathy (DN).Methods:From January 2019 to January 2022, 150 patients with end-stage DN admitted to the First Affiliated Hospital of Xinjiang Medical University were retrospectively selected. All patients were divided into three groups according the treatment methods, the group A was treated with high-throughput hemodialysis, the group B was treated with sequential hemodialysis, the group C was treated with hemodialysis combined with hemoperfusion, with 50 patients in each group. After 3 months of treatment with different blood purification modes, the nutritional status, insulin resistance, inflammatory factors and adverse reactions of the patients in the three groups were evaluated.Results:After treatment, the levels of serum prealbumin (PA) and albumin (ALB) in the group C were higher than those in the group A and group B: (328.19 ± 34.82) mg/L vs. (241.87 ± 23.75), (246.35 ± 24.06) mg/L; (36.82 ± 9.51) g/L vs. (30.07 ± 8.73), (29.54 ± 8.14) g/L, there were statistical differences ( P<0.05). After treatment, the levels of fasting insulin (FINS), fasting blood glucose (FBG) and homeostatic model assessment insulin resistance index (HOMA-IR) in the group C were lower than those in the group A and group B: (6.82 ± 1.46) mU/L vs. (8.79 ± 1.1), (8.34 ± 1.08) mU/L; (7.57 ± 1.13) mmol/L vs. (9.51 ± 1.25), (9.28 ± 1.21) mmol/L; 2.29 ± 0.75 vs. 4.11 ± 0.84, 3.81 ± 0.79, there were statistical differences ( P<0.05). After treatment, the levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in the group C were lower than those in the group A and group B: (9.28 ± 2.96) μg/L vs. (16.34 ± 3.13), (17.52 ± 4.08) μg/L; (5.17 ± 1.1) mg/L vs. (7.81 ± 1.25), (7.36 ± 1.21)mg/L; (36.06 ± 4.7) ng/L vs. (42.07 ± 5.84), (43.23 ± 5.79) ng/L, there were statistical differences ( P<0.05). After treatment, the rate of adverse reactions in the group A, group B and group C was 20.00%(10/50), 16.00%(8/50), 4.00%(2/50), there was statistical difference ( χ2 = 6.31, P = 0.043). Conclusions:Compared with high-throughput hemodialysis and sequential hemodialysis, hemodialysis combined with hemoperfusion can effectively improve the nutritional status of patients, reduce their blood sugar level and insulin resistance, reduce their micro inflammatory state, and reduce adverse reactions.
