Abstract: 【Abstract】 Objective To evaluate the effect of different blood purification profiles on peripheral neuropathy and the curative mechanism in end-stage renal disease (ESRD) patients. Methods A total of 38 ESRD patients with peripheral neuropathy were randomly assigned to hemodialysis group (HD), hemodialysis + hemoperfusion group (HD+HP) or peritoneal dialysis group (PD). Changes of clinical symptoms, sensory nerve conduction velocity (SCV), were respectively monitored in the patients before blood purification and after hemodialysis for 4 months, hemoperfusion for 4 months, or peritoneal dialysis for 4 months. Results By mean of Ridit analysis, clinical symptoms improved after blood purification than before in the HD, HD+HP and PD groups (the mean R value: R1=0.48, R2 =0.41, R3 =0.40, respectively, and total R =0.50; 95% CI.：0.42～0.63, 0.26～0.57, 0.24～0.57, respectively; χ2 =7.36, P=0.025). The curative effect were significantly better in PD and HD+HP groups than in HD group (U =2.490, P=0.010, and U=2.470, P=0.010, respectively), but were statistically indifferent between PD group and HD+HP group (U=0.070, P=0.946). In HD group, SCV in median, anterior tibial, and common peroneal nerves became faster after the treatment for 4 months than before hemodialysis, but the differences were statistically insignificant (t=0.500, 0.700 and 0.700, respectively; P＞0.05). In HD+HP and PD groups, SCV in the 3 nerves improved significantly after the treatment (for HD+HP group, t=3.02, 3.130 and 2.920, respectively; for PD group, t=3.390, 3.550 and 4.010, respectively; P＜0.01), and the improvement was better in HD+HP and PD groups than in HD group
(for comparison of HD+HP and HD groups: t=5.560, 5.230 and 4.58, respectively; for comparison of PD and HD groups: t=5.030, 4.61 and 5.570, respectively; P＜0.01). Conclusion PD and HD+HP are superior to HD for the treatment of uremic peripheral neuropathy in ESRD patients. The peripheral neuropathy may
result from the large and middle toxic molecules accumulated in ESRD patients.

Key words: Hemoperfusion, ESRD, Peripheral neuropathy, Peritoneal dialysis