Effect of hemodialysis combined hemofiltration on the level of serum fibroblast growth factor 23 in uremic patients

Abstract

Objective To compare the clear effect of serum FGF23 between traditional hemodialysis(HD)and hemodialysis combined hemofiltration(HF)in uremic patients.Methods A total of 212 patients with chronic kidney disease(CKD)at stage 5 treated with maintenance HD were enrolled in the study,and the study last for 8 weeks.Patients were divided into HD group and HD combined HF group randomly.Prescription for HD group:HD,3 times/week,4 h/time.Prescription for HD combined HF group:HF,1 time/week,6 h/time.HD,2 times/week,4 h/time.Serum phosphorus(P),calcium(Ca),urea nitrogen(BUN),creatinine(Scr),intact parathyroid hormone(iPTH),FGF23 and 1,25(OH)2D3 levels were determined before and after the study.Results There were no significantly difference of P,Ca,BUN,Scr,iPTH,FGF23 and 1,25(OH)2D3 between HD group and HD combined HF group at the beginning of the study(P0.05).No distinctly difference of P,Ca,iPTH,FGF23 and 1,25(OH)2D3 was found in HD group at the end of the study compared with those at the beginning of the study(P0.05),but BUN and Scr decreased obviously(P0.001).In HD combined HF group,no significantly difference of Ca and 1,25(OH)2D3 was found at the end of the study compared with those at the beginning of the study(P0.05),but BUN,Scr,P,iPTH and FGF23 decreased distinctly(P0.001).At the end of the study,P,iPTH and FGF23 decreased significantly in HD combined HF group compared with those in HD group(P0.001).Conclusions Compared with HD,HD combined HF treatment modalities can significantly reduce the phosphorus,iPTH and FGF23 levels in circulating blood of patients with end-stage uremia,indicating that HD combined HF treatment model has a good effect to remove the macromolecule substance,HD combined HF is an ideal combination of treatment modalities.