关键词: 高通量透析, 左心室结构与功能, 全段甲状旁腺激素, β2-微球蛋白, 瘦素

Abstract: Objective To prospectively investigate the efficacy of high flux dialysis in maintenance hemodialysis patients. Methods Sixty cases of hemodialysis patients were randomly and equally divided into two groups: high flux hemodialysis (HFHD) group and low flux hemodialysis (LFHD) group. Among them, 12 cases were changed to HFHD for one year after they had been treated with LFHD for 1-1.5 years. Fresenius F60 polysulfone dialyzer was used for HFHD group, and Fresenius F6HPS polysulfone dialyzer was used for LFHD group. Before and after the first dialysis, blood urea nitrogen, serum creatinine, lipids, calcium, phosphate, intact parathyroid hormone (iPTH), β2-microglobulin (β2-MG), leptin and echocardiography were measured. After one year of dialysis, these examinations were repeated. Results In HFHD group, skin itching, arthralgia, headache, low blood pressure, muscle spasm, arrhythmia and stagnant fluid in cavities were significantly improved. The clearance of serum phosphate, lipids, iPTH, β2-MG and leptin also increased remarkably after the first dialysis and after the dialysis for one year as compared with the results before the dialysis and those in the LFHD group (P<0.05). The left ventricular mass index and left ventricular end diastolic volume lowered after one dialysis in both groups (P>0.05), but the two indexes were better in HFHD group than in LFHD group after the dialysis for one year. Conclusion HFHD is better than LFHD in the clearance of larger molecules such as iPTH, β2-MG and leptin, in the recovery of calcium, phosphate and lipid metabolism and in the improvement of 1eft ventricular diastolic and systolic functions. Therefore, HFHD may be better than hemofiltration and hemodialysis filtration in some cases.

Key words: Left ventricular structure and function, Intact parathyroid hormone, β2-microglobulin, Leptin