Abstract: The Influence of Different Frequency of Hemoperfusion on Protein-energy Wasting of Maintenance Hemodialysis Patients   YIN Yi-fang1,MOU Jiao1,YANG Ying1,TANG Jian-ying1    1Department of Nephrology and Urology Center,University Town Hospital Affiliated to Chongqing Medical University, Chongqing 400715,China
Corresponding author: TANG Jian-ying, Email:800273@hospital.cqmu.edu.cn
【Abstract】Objective  To investigate the impact of different hemoperfusion (HP) frequencies on protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).  Methods Eighty patients were included and divided based on HP treatment frequency into four groups: no HP (group A), monthly HP (group B), bi-monthly HP (group C) and weekly HP (group D) , with 20 patients in each group. All patients were followed up for six months, then the prevalence of PEW, malnutrition-inflammation score (MIS), and related serum biochemical indicators were analyzed before and after treatment.   Results   Before treatment, there were no significant differences (P＞0.05) in MIS scores (F=2.194, P=0.096),  the prevalence of PEW (χ2=0.579, P=0.901), level of pre-albumin (PA) (F=0.258, P=0.855), albumin (Alb) (F=0.187, P=0.905), parathyroid hormone (PTH) (F=0.780, P=0.509), hemoglobin(Hb)(F=1.823，P=0.150), β2-microglobulin (β2-MG) (F=1.833, P=0.148), and C-Reactive protein (CRP) (F=0.432, P=0.731) among the four groups. After treatment, there were 15 patients who withdrew from the trial in Group D. The group C had lower levels of MIS score (C-A: t=4.391, P＜0.001;  C-B: t=-2.871,  P=0.006),  PTH (C-A: t=4.098, P=0.001; C-B: t=-2.551,     P=0.047),β2-MG (C-A: t=5.688, P＜0.001; C-B: t=-3.207, P=0.002), CRP (C-A:t=4.293, P＜0.001; C-B:     t=-2.843, P=0.006) compared with group A and B); and higher level of PA(C-A: t=-3.177, P=0.002; C-B:      t=2.196, P=0.032). Alb (C-A: t=-5.540, P＜0.001; C-B: t=2.196, P=0.010) than Groups A and B. Group C had higher level of Hb (t=-3.733, P＜0.001) than group A, and  no significant difference with group B (t=1.451,  P=0.152). The prevalence of PEW in group C (χ2=6.465, P=0.011) was significantly lower than group A, but there was no significant difference between group A and group B (χ2=2.506, P=0.113).  Conclusion   Bimonthly HP treatment can obviously improve the nutritional status of patients with MHD and reduce the prevalence of PEW.

Key words: Maintenance hemodialysis, Protein-energy wasting, Hemoperfusion, Uremic toxins