Effect of high-throughput hemodialysis on renal metabolism and sarcopenic obesity in the elderly

doi:10.3877/cma.j.issn.2095-9605.2023.02.009

Abstract

Abstract:

Objective

To observe the effect of high-throughput hemodialysis on renal metabolism and oligomeric obesity in the elderly.

Methods

Elderly patients with uremia combined with oligomyogenic obesity were randomly divided into conventional hemodialysis group (HD group, n=60) and high-throughput hemodialysis group (HFHD, n=60). The patients were evaluated before treatment and 3 months after treatment. To compare the changes of renal metabolic indexes such as serum creatinine (Scr), blood urea nitrogen (BUN), β2-microglobulin (β2-MG), C-reactive protein (CRP), interleukin-6 (IL-6), etc. The changes of mean daily energy intake (DEI), muscle mass, visceral fat area, BMI, grip strength and skeletal muscle mass index (SMI) were compared.

Results

There were no statistically significant differences (P>0.05) in age, height, grip strength, gait speed, serum creatinine, blood urea nitrogen, skeletal muscle mass index, and body fat percentage between the two groups of patients before treatment, indicating comparability between the two groups. After 3 months of treatment, both the HD and HFHD groups showed improved renal metabolic indicators compared to before treatment (P<0.05). The HFHD group had significantly lower levels of serum creatinine (398.05±155.79) μmol/L, β2-microglobulin (20.14±6.58) mg/L, C-reactive protein (2.47±1.18) mg/L, and interleukin-6 (16.57±6.36) pg/mL than the HD group (P<0.05). Compared to the HD group, the HFHD group had significantly higher muscle mass (45.87±5.24) kg and skeletal muscle mass index (8.57±1.36) after 3 months of treatment (P<0.05).

Conclusions

High-throughput hemodialysis can effectively improve the muscle level and renal metabolic function in elderly patients with uremia and oligomyogenic obesity.

Key words: High-throughput hemodialysis, Renal metabolism, Hypomuscular obesity, The elderly

Yanqu Huang, Duimiao Situ, Danhong Yu, Yanming Lin. Effect of high-throughput hemodialysis on renal metabolism and sarcopenic obesity in the elderly[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2023, 09(02): 126-130.

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References 20

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指标		HD组（n=60）	HFHD组（n=60）	χ²/t值	P
性别	男/女	32/28	34/26	0.044	0.83
平均年龄（岁）		66.01±4.14	68.15±6.22	0.732	0.41
身高（cm）		166.5±4.14	162.5±4.14	0.523	0.73
握力（kg）		15.92±8.26	16.32±7.52	1.803	1.81
步速（m/s）		1.01±0.24	1.05±0.18	0.832	1.02
血清肌酐（μmol/L）		685.57±234.08	715.26±217.52	1.251	0.62
尿素氮（mmol/L）		43.01±11.14	41.15±10.22	0.064	0.95
SMI（kg/m²）		6.29±1.57	5.85±1.26	0.732	0.97
TBF（%）		25.96±2.34	26.38±3.36	0.792	1.08

指标		HD组（n=60）	HFHD组（n=60）	χ²/t值	P
性别	男/女	32/28	34/26	0.044	0.83
平均年龄（岁）		66.01±4.14	68.15±6.22	0.732	0.41
身高（cm）		166.5±4.14	162.5±4.14	0.523	0.73
握力（kg）		15.92±8.26	16.32±7.52	1.803	1.81
步速（m/s）		1.01±0.24	1.05±0.18	0.832	1.02
血清肌酐（μmol/L）		685.57±234.08	715.26±217.52	1.251	0.62
尿素氮（mmol/L）		43.01±11.14	41.15±10.22	0.064	0.95
SMI（kg/m²）		6.29±1.57	5.85±1.26	0.732	0.97
TBF（%）		25.96±2.34	26.38±3.36	0.792	1.08

指标	HD组		HFHD组		P¹	P²	P³	P⁴
指标	治疗前	治疗3月	治疗前	治疗3月	P¹	P²	P³	P⁴
血清肌酐（μmol/L）	685.57±234.08	438.35±105.14	715.26±217.52	398.05±155.79	0.02	<0.01	0.247	0.015
尿素氮（mmol/L）	43.01±11.14	15.05±5.21	41.15±10.22	12.87±5.24	0.04	<0.01	0.244	0.205
β2-微球蛋白（mg/L）	46.86±5.57	24.95±4.58	48.27±6.53	20.14±6.58	<0.01	<0.01	0.125	0.007
C反应蛋白（mg/L）	4.57±1.15	9.27±3.25	4.15±0.68	2.47±1.18	<0.01	<0.01	0.523	<0.01
白细胞介素-6（pg/mL）	26.49±4.57	20.79±5.35	25.85±8.26	16.57±6.36	<0.01	<0.01	0.032	0.022

指标	HD组		HFHD组		P¹	P²	P³	P⁴
指标	治疗前	治疗3月	治疗前	治疗3月	P¹	P²	P³	P⁴
血清肌酐（μmol/L）	685.57±234.08	438.35±105.14	715.26±217.52	398.05±155.79	0.02	<0.01	0.247	0.015
尿素氮（mmol/L）	43.01±11.14	15.05±5.21	41.15±10.22	12.87±5.24	0.04	<0.01	0.244	0.205
β2-微球蛋白（mg/L）	46.86±5.57	24.95±4.58	48.27±6.53	20.14±6.58	<0.01	<0.01	0.125	0.007
C反应蛋白（mg/L）	4.57±1.15	9.27±3.25	4.15±0.68	2.47±1.18	<0.01	<0.01	0.523	<0.01
白细胞介素-6（pg/mL）	26.49±4.57	20.79±5.35	25.85±8.26	16.57±6.36	<0.01	<0.01	0.032	0.022

指标	HD组		HFHD组		P¹	P²	P³	P⁴
指标	治疗前	治疗3月	治疗前	治疗3月	P¹	P²	P³	P⁴
DEI（kcal/kg/d）	20.52±4.12	22.35±5.15	19.74±6.14	21.05±5.79	0.253	<0.01	0.247	0.055
肌肉量（kg）	38.35±5.45	42.05±5.21	36.22±4.15	45.87±5.24	0.04	<0.01	0.365	0.034
体脂百分比（%）	25.96±2.34	22.50±3.32	26.38±3.36	21.35±4.11	0.152	<0.01	0.068	0.071
内脏脂肪面积（cm²）	79.86±15.57	66.95±10.58	81.27±6.53	69.14±8.58	<0.01	<0.01	0.412	0.324
握力（kg）	15.92±8.26	22.59±6.26	16.32±7.52	23.18±5.24	<0.01	<0.01	0.087	0.427
三头肌皮褶厚（mm）	11.25±4.40	14.53±4.25	10.23±3.42	14.26±4.17	0.124	0.062	0.072	0.574
BMI（kg/m²）	22.57±5.15	21.25±6.27	23.57±6.68	21.47±5.18	0.274	0.128	0.435	0.653
SMI（kg/m²）	6.29±1.57	7.85±1.35	5.85±1.26	8.57±1.36	0.03	<0.01	0.062	<0.01

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