Comparison of the curative effect of different flux hemodialysis combined with hemodiafiltration on patients with insulin resistance uremia

doi:10.3877/cma.j.issn.2095-9605.2021.01.007

Abstract

Abstract:

Objective

To compare the effects of different fluxes of hemodialysis combined with hemodiafiltration on insulin-resistant uremia patients.

Methods

A total of 60 insulin-resistant uremia patients from Jiangmen People's Hospital from May 2019 to August 2020 were selected as the research subjects. They were randomly divided into two groups, 30 cases in each group, and they were treated with low-flux hemodialysis combined with hemodiafiltration. (LFHD+HDF) and high flux hemodialysis combined with hemodiafiltration (HFHD+HDF) intervention. The fasting blood glucose (FPG), fasting plasma insulin (FINS), insulin resistance index (HOMA-IR) before treatment and 3 months and 6 months after treatment were compared between the two groups, as well as their cholesterol (TC) and triacyl Glycerin (TG), serum albumin (ALB), blood urea nitrogen (BUN), creatinine (SCr), β2-microglobulin (β2-MG), parathyroid hormone (PTH), hypersensitive C-reactive protein (Hs) -CRP) and other related indicators.

Results

The FINS and HOMA-IR levels of the HFHD+HDF group after 3 and 6 months of treatment were lower than those of the LFHD+HDF group (P<0.05). And the levels of TC, TG, PTH and Hs-CRP in the HFHD+HDF group after 3 and 6 months of treatment were significantly lower than those in the LFHD+HDF group, the difference was statistically significant (P<0.05); the HFHD+HDF group was The levels of TC, TG, PTH and Hs-CRP after 3 and 6 months of treatment were significantly lower than those of the LFHD+HDF group (P<0.05), and the Kt/V levels of the LFHD+HDF group were significantly lower than the treatment for 6 months Before, the Kt/V level of the HFHD+HDF group was significantly higher than that before treatment, and was significantly higher than that of the LFHD+HDF group, the difference was statistically significant (P<0.05).

Conclusions

High-flux hemodialysis combined with hemodiafiltration (HFHD+HDF) compared with low-flux hemodialysis combined with hemodiafiltration (LFHD+HDF) can improve insulin resistance and body lipid metabolism in patients with insulin resistance uremia, and improve renal function.

Key words: Different fluxes, Hemodialysis, Hemodiafiltration, Insulin resistance, Uremia

Yanqi Huang, Yanming Lin, Danhong Yu. Comparison of the curative effect of different flux hemodialysis combined with hemodiafiltration on patients with insulin resistance uremia[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(01): 36-40.

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References 12

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组别	n（例）	年龄（岁）	性别（男/女）	BMI（kg/m²）	高血压	高血糖	高血脂	病程（年）
LFHD+HDF组	30	52.6±4.1	13/17	23.6±2.1	16(42.5)	10(42.5)	8(42.5)	3.1±1.5
HFHD+HDF组	30	51.7±4.6	11/19	23.3±1.7	14(35.0)	7(35.0)	12(35.0)	3.3±1.7
t/χ²值		0.800	0.278	0.608	0.267	0.739	1.200	0.483
P值		0.427	0.598	0.545	0.606	0.390	0.273	0.631

组别	n（例）	年龄（岁）	性别（男/女）	BMI（kg/m²）	高血压	高血糖	高血脂	病程（年）
LFHD+HDF组	30	52.6±4.1	13/17	23.6±2.1	16(42.5)	10(42.5)	8(42.5)	3.1±1.5
HFHD+HDF组	30	51.7±4.6	11/19	23.3±1.7	14(35.0)	7(35.0)	12(35.0)	3.3±1.7
t/χ²值		0.800	0.278	0.608	0.267	0.739	1.200	0.483
P值		0.427	0.598	0.545	0.606	0.390	0.273	0.631

组别	时间	n（例）	FPG（mmol/L）	FINS（mU/L）	HOMA-IR
	治疗前		9.6±2.1	20.4±4.8	2.7±0.7
LFHD+HDF组	治疗3月	30	7.3±1.6*	16.3±5.2^*	2.6±0.6^*
	治疗6月		6.4±1.5*	14.2±3.7^*	2.2±0.5^*
	治疗前		9.8±2.3	21.3±5.1	2.8±0.9
HFHD+HDF组	治疗3月	30	7.4±1.9*	13.6±3.6^*#	2.2±0.6^*#
	治疗6月		6.0±1.7*	10.3±2.9^*#	1.6±0.4^*#

组别	时间	n（例）	FPG（mmol/L）	FINS（mU/L）	HOMA-IR
	治疗前		9.6±2.1	20.4±4.8	2.7±0.7
LFHD+HDF组	治疗3月	30	7.3±1.6*	16.3±5.2^*	2.6±0.6^*
	治疗6月		6.4±1.5*	14.2±3.7^*	2.2±0.5^*
	治疗前		9.8±2.3	21.3±5.1	2.8±0.9
HFHD+HDF组	治疗3月	30	7.4±1.9*	13.6±3.6^*#	2.2±0.6^*#
	治疗6月		6.0±1.7*	10.3±2.9^*#	1.6±0.4^*#

组别	时间	n（例）	TC（mmol/L）	TG（mmol/L）	ALB（g/L）	PTH（pmol/L）	Hs-CRP（mg/L）
	治疗前		4.7±1.2	2.5±0.5	37.2±2.3	843.5±184.7	11.4±3.7
LFHD+HDF组	治疗3月	30	4.3±0.8^*	2.3±0.4	36.4±2.9	742.5±134.5^*	9.2±2.9^*
	治疗6月		4.0±0.6^*	2.1±0.3^*	34.5±2.7^*	601.2±96.3^*	6.6±3.1^*
	治疗前		4.8±1.4	2.6±0.6	37.5±3.1	852.1±194.5	11.9±4.1
HFHD+HDF组	治疗3月	30	3.8±0.6^*#	1.9±0.4^*#	36.6±2.6	634.7±117.4^*#	6.8±2.7^*#
	治疗6月		3.5±0.4^*#	1.7±0.3^*#	35.1±1.9^*	492.3±83.6^*#	4.3±2.3^*#

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