Effects of hemodialysis combined with hemoperfusion on nutrition and calcium and phosphorus metabolism disorders in patients with uremia

doi:10.3877/cma.j.issn.2095-9605.2022.03.005

Abstract

Abstract:

Objective

To investigate the effect of hemodialysis combined with hemoperfusion on iron metabolism and internal environment metabolism in patients with uremia.

Methods

A total of 100 uremic patients who underwent dialysis in me from May 2019 to January 2021 were selected and randomly divided into two groups with 50 cases in each group. The combined group used hemodialysis combined with hemoperfusion, and the control group used conventional hemodialysis. The changes of plasma albumin, prealbumin, hemoglobin and transferrin were compared between the two groups after intervention. And the blood phosphorus (P), calcium (Ca), calcium phosphorus product, and serum thyroid status of the two groups.Bone metabolism and iron metabolism indexes were compared between the two groups, including bone markers type Ⅰ procollagen amino terminal extension peptide (P1NP), β-collagen degradation product (β-CTX), osteocalcin (BGP), serum iron, ferritin (Fer), transferrin (TRF), total iron binding capacity (TIBC), transferrin saturation (TSAT).

Results

There was no significant difference in the levels of plasma albumin, prealbumin, hemoglobin, transferrin, average P, Ca, calcium-phosphorus product and iPTH before treatment(P>0.05). After 6 months of treatment, the levels of plasma albumin, prealbumin, hemoglobin, transferrin and calcium in the combined group were significantly higher than those in the control group, while the levels of P, calcium and phosphorus products and iPTH in the combined group were significantly lower than those in the control group (P<0.05). Also, there was no statistically significant difference in the levels of P1NP, β-CTX and BGP between the two groups before treatment. The levels of P1NP, β-CTX and BGP in the combination group were significantly lower than those in the control group (P<0.05). Moreover, the levels of serum iron, TIBC and TSAT in the two groups were increased compared with those before treatment, and the levels of serum iron, TIBC and TSAT in the combined group were significantly higher than those in the control group (P<0.05).

Conclusions

Hemodialysis combined with hemoperfusion can improve the nutritional status of patients with uremia, correct the disorder of calcium and phosphorus metabolism, and significantly improve the transformation of bone metabolism and iron metabolism.

Key words: Hemodialysis, Hemoperfusion, Uremia, Nutrition, Calcium and phosphorus metabolism

Huang Zhaohui, Liu Renhua, Yang Liwen. Effects of hemodialysis combined with hemoperfusion on nutrition and calcium and phosphorus metabolism disorders in patients with uremia[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(03): 169-173.

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References 19

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组别	n（例）	性别		年龄（岁）	BMI（kg/m²）	平均透析时间（月）	高血压（%）	糖尿病（%）
组别	n（例）	男	女	年龄（岁）	BMI（kg/m²）	平均透析时间（月）	高血压（%）	糖尿病（%）
联合组	48	25	23	53.3±4.1	23.1±2.2	11.7±4.1	25（52.1）	18（37.5）
对照组	48	21	27	54.2±3.8	22.9±2.5	12.6±3.7	31（70.8）	21（43.8）
t/χ²值		0.668		1.115	0.416	1.129	1.543	0.389
P值		>0.05		>0.05	>0.05	>0.05	>0.05	>0.05

组别	n（例）	性别		年龄（岁）	BMI（kg/m²）	平均透析时间（月）	高血压（%）	糖尿病（%）
组别	n（例）	男	女	年龄（岁）	BMI（kg/m²）	平均透析时间（月）	高血压（%）	糖尿病（%）
联合组	48	25	23	53.3±4.1	23.1±2.2	11.7±4.1	25（52.1）	18（37.5）
对照组	48	21	27	54.2±3.8	22.9±2.5	12.6±3.7	31（70.8）	21（43.8）
t/χ²值		0.668		1.115	0.416	1.129	1.543	0.389
P值		>0.05		>0.05	>0.05	>0.05	>0.05	>0.05

组别	n（例）	血浆白蛋白		前白蛋白		血红蛋白
组别	n（例）	治疗前	6个月	治疗前	6个月	治疗前	6个月
联合组	48	32.3±2.5	38.2±2.6*	0.26±0.04	0.35±0.03*	98.2±4.5	106.3±4.9*
对照组	48	32.6±2.3	35.3±2.4*	0.27±0.05	0.30±0.04*	99.4±5.1	103.1±3.7*
t值		0.612	5.678	1.082	6.928	1.222	3.661
P值		>0.05	<0.001	>0.05	<0.001	>0.05	<0.001

组别	n（例）	血浆白蛋白		前白蛋白		血红蛋白
组别	n（例）	治疗前	6个月	治疗前	6个月	治疗前	6个月
联合组	48	32.3±2.5	38.2±2.6*	0.26±0.04	0.35±0.03*	98.2±4.5	106.3±4.9*
对照组	48	32.6±2.3	35.3±2.4*	0.27±0.05	0.30±0.04*	99.4±5.1	103.1±3.7*
t值		0.612	5.678	1.082	6.928	1.222	3.661
P值		>0.05	<0.001	>0.05	<0.001	>0.05	<0.001

组别	n（例）	P（mmol/L）		Ca（mmol/L）		钙磷乘积（mmol²/L²）		iPTH（pg/mL）
组别	n（例）	治疗前	6个月	治疗前	6个月	治疗前	6个月	治疗前	6个月
联合组	48	2.76±0.45	2.07±0.33*	1.96±0.25	2.32±0.41*	5.41±0.54	4.76±0.45*	554±31	478±41*
对照组	48	2.73±0.36	2.34±0.31*	1.97±0.33	2.11±0.24*	5.38±0.61	4.96±0.37*	558±46	532±39*
t值		0.719	4.131	0.868	3.062	0.258	2.378	0.619	6.612
P值		>0.05	<0.001	>0.05	<0.05	>0.05	<0.05	>0.05	<0.001

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