Abstract: 【Abstract】Objective To investigate the effects of different blood purification methods on serum fetuin A and apelin levels in uremic patients. Methods A total of 114 of uremic patients admitted to Chengde Central Hospital from February 2017 to February 2019 were recruited as the research subjects. They were assigned into high throughput hemodialysis (HFHD, n=38), hemodiafiltration (HDF, n=38), and hemodialysis plus hemoperfusion (HD+HP, n=38) by the random number list method. After the treatment, serum fetuin A and apelin, urea nitrogen (BUN), serum creatinine (Scr), Kt/V, serum phosphorus and calcium, calcium-phosphorus product, β2- microglobulin (β2-MG) and parathyroid gland (PTH) levels, and overall therapeutic efficiency
were compared among the three groups. Results After the treatment, serum fetuin A was significantly higher (F=48.814, P<0.001) and serum apelin was significantly lower (F=8.578, P <0.001) in HD+HP group than in HFHD group and HDF group; BUN was lower (F=3.001, P =0.053) and Scr was higher (F=1.206, P =0.303) in HD+HP group than in HFHD group and HDF group. There were no significant differences in Kt/V index among the three groups (F=1.942, P=0.148). After the treatment, serum phosphorus and phosphorus-calcium product were significantly different among the three groups (serum phosphorus: F=14.144, P=0.000; calcium-phosphorus product: F=11.590, P =0.000), but there were no significant differences in serum calcium level among the three groups (F=0.045, P =0.956); serum β2-MG and PTH were significantly lower in HD+ HP group than in HFHD group and HDF group (F=355.820, P<0.001; F=182.270, P<0.001). The overall effective rates were 92.11%, 89.47% and 63.16% in HD+HP group, HFHD group and HDF group respectively (χ2=34.100, P<0.001). Conclusion Uremic patients treated with either HD+HP, HFHD or HDF showed better effects, with the increase of serum fetuin A and decrease of serum apelin. HD+HP had the best blood purification effects, followed by HFHD and HDF methods.

Key words: Blood purification, Uremia, Serum fetuin A, serum apelin, Curative effect