大剂量血液渗滤对脂肪生成素和补体因子 D 清除率的影响

The Egyptian Journal of Hospital Medicine Pub Date : 2024-07-01 DOI:10.21608/ejhm.2024.363728

H. ElSayed, Magdy ElSharkawy, Saeed Abd ElWahab, Ahmed Tawfik, Mahmoud Fayez, Lamis Khedr

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引用次数: 0

摘要

背景：脂联素和补体因子 D 是有害的中间大分子，会在终末期肾病患者体内蓄积。大剂量血液滤过（HDF）最近显示出明显的生存益处。研究目的在这项研究中，我们旨在比较使用两种不同的高通量透析器进行 HDF 和高通量血液透析（HD）的患者对脂肪连蛋白和补体因子 D 的清除情况。患者和方法：这是一项交叉临床试验。20 名血液透析患者参加了试验。在周中的一次透析过程中对透析器和治疗效果进行了检查，采用的治疗方法包括 HD FX 80、HD H4、HDF FX80 和 HDF H4。治疗效果通过计算每次治疗前后的脂肪连蛋白和补体因子 D 的降低率 (RR) 进行评估。结果20名透析患者，年龄（50.5±10.4）岁。HDF 期间的尿素还原率 (URR) 为 70.4 ± 6.8，而 HD 期间为 65.1 ± 7。使用 HDF FX80 的脂肪直链肽还原率为 48.1 ± 9.3，而使用 HD FX80 的还原率为 32.2 ± 9，P <0.001。使用 HDF H4 的脂肪直链肽 RR 为 46.7 ± 12.2，而使用 HD H4 时为 31.1±9.4，P<0.001。使用 HDF FX80 的补体因子 D RR 为 48.1 ± 13，而使用 HD FX80 的 RR 为 29.8±9.6，P<0.001。使用HDF H4的补体因子D RR为46.7±12.2，而使用HD H4的补体因子D RR为26.6±7.5，P<0.001。结论：与高通量 HD 相比，高剂量 HDF 能更好地清除脂肪连蛋白和补体因子 D。所使用的两种高通量透析器之间没有差异。

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Effect of High Dose Hemodiafiltration on Adiponectin and Complement Factor D Removal

Background: Adiponectin and complement factor D are harmful large middle molecules that accumulate in patients with end stage renal disease. High-dose hemodiafiltration (HDF) has recently shown a clear survival benefit. Objective: In this study we aimed to compare the removal of adiponectin and complement factor D in patients on HDF versus high flux hemodialysis (HD) using two different high flux dialysers. Patients and Method: This is a cross over clinical trial. Twenty hemodialysis patients were enrolled. Dialyser and treatment efficacies were examined during a mid-week session with the following treatments HD FX 80, HD H4, HDF FX80, HDF H4. Treatment efficacy was assessed by calculating the reduction ratio (RR) of adiponectin and complement factor D before and after each session. Results: Twenty dialysis patients aged 50.5 ± 10.4 years. During HDF urea reduction ratio (URR) was 70.4 ± 6.8 compared to 65.1 ± 7 during HD. Adiponectin RR using HDF FX80 was 48.1 ± 9.3 compared to 32.2± 9 with HD FX80, p <0. 001. Adiponectin RR using HDF H4 was 46.7 ±12.2 compared to 31.1± 9.4 with HD H4, p<0. 001. Complement factor D RR using HDF FX80 was 48.1 ± 13 compared to 29.8±9.6 with HD FX80, p<0.001. Complement factor D RR using HDF H4 was 46.7±12.2 compared to 26.6 ± 7.5 using HD H4, p<0.001. Conclusion: High-dose HDF offered better removal of adiponectin and complement factor D compared to high flux HD. No difference was observed between the two high flux dialysers used.

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The Egyptian Journal of Hospital Medicine

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