Abstract: Objectives  To investigate the effects of High-Flux Hemodialysis (HFHD) on Serum Hepcidin and Hypoxia Inducible Factor (HIF) in Maintenance Hemodialysis (MHD) Patients.  Methods  Sixty MHD patients in the First People's Hospital of Kunming Blood Purification Center between May 2018 and April 2020 were randomly divided into the HFHD group and the Low Flux Hemodialysis (LFHD) group (30 patients in each group). Pre- and post-dialysis whole blood specimens were collected from both groups at the beginning of the trial, 6 months into the trial, 12 months into the trial, and 18 months into the trial respectively. The differences in serum hepcidin, Hypoxia Inducible Factor (HIF), Interleukin-6 (IL-6), and Tumor necrosis factor-α (TNF-α) were examined and compared between the two groups.  Results   The hepcidin level :  ①There was a statistically significant difference (Z=-2.927,P=0.003) between the HFHD group and the LFHD group [31.5 (21.4, 54.2) vs. 49.1 (36.9, 68.8)] at 18 months. ② There was a statistical difference of serum hepcidin at different time points in the HFHD group (H=50.992,P＜0.001) and the lowest at 18 months. Hypoxia Inducible Factor (HIF): The results were not statistically different (P＞0.05) between the HFHD and LFHD groups at each time point (Z=-1.442，-1.952，-0.834 and -3.152，P=0.149，0.051，0.404 and 0.912) or between different time points of the same group (H=13.212 and 6.369，P=0.808 and 0.095), and no significant trend over time was found. When compared between the two groups, IL-6 and TNF-α were lower in the HFHD group than in the LFHD group at 18 months (Z=-1.996, P=0.046, Z=-4.140,P＜0.001).  Conclusion  The effects of HFHD and LFHD on HIF were not significant. Compared with LFHD, HFHD decreased the levels of hepcidin, the levels of inflammatory factors IL-6 and TNF-α in patients with MHD which probably due to the preferential clearance of serum hepcidin and inflammatory factors by high-flux dialysis membranes, also improved the microinflammatory state in patients, thus reducing the high expression of hepcidin in the liver.

Key words: High-flux hemodialysis, Maintenance dialysis patients, Serum hepcidin, Hypoxia inducing factor