Effect of Hemodialysis Combined With Hemodiafiltration on Cardiac Structure, Function, and Metabolic Indicators in Uremic Patients.

Aims/Background Uremia is a severe manifestation of end-stage renal failure, with high cardiovascular risk, and current dialysis treatments like hemodialysis (HD) face limitations in toxin clearance, necessitating more effective therapeutic strategies. This study aims to evaluate the clinical efficacy of HD combined with hemodiafiltration (HDF) in treating uremia and its influence on cardiac ultrasound indices. Methods This study retrospectively analyzed clinical data from 80 uremic patients treated at the Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University between April 2019 and April 2023. Based on different therapeutic regimens, patients were divided into a control group (n = 41) and an observation group (n = 39). The control group received HD, while the observation group underwent HD combined with HDF. The cardiac structure, cardiac function, lipid metabolism, and other biochemical indicators were comparatively assessed between the two groups. Results There were no significant differences in baseline characteristics between the two groups (p > 0.05). Before treatment, both groups demonstrated no significant difference in left atrial diameter (LAD), left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDD), brain natriuretic peptide (BNP), and troponin T (TnT) (p > 0.05). However, after 6 months of treatment, these indices were significantly declined in the observation group (p < 0.05). Similarly, no significant differences were observed in left ventricular ejection fraction (LVEF), fractional shortening (FS), cardiac output (CO), stroke volume (SV), and peak mitral E-wave velocity/peak mitral A-wave velocity (E/A) before treatment (p > 0.05). However, a significant improvement was observed in the observation group following 6 months of treatment (p < 0.05). Before treatment, there were no significant differences in serum creatinine (Scr), blood urea nitrogen (BUN), β2-microglobulin (β2-MG), and parathyroid hormone (PTH) between the two groups (p > 0.05). However, the observation group showed significant improvements in Scr, BUN, β2-MG, and PTH after treatment (p < 0.001). Additionally, the two study groups had no significant differences in total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) before treatment (p > 0.05). However, their levels decreased significantly in the observation group after treatment (p < 0.05). Hypertension and hypotension occurred less frequently in the observation group (p < 0.05), with no significant differences observed in the incidence of arrhythmia and infection between the two groups (p > 0.05). Conclusion HD combined with HDF effectively improves cardiac structure and function, reduces metabolic wastes such as Scr, BUN and β2-MG, and decreases blood lipid levels in uremic patients. This study further confirmed the clinical efficacy of this combined approach in treating uremia, which is of positive significance for the prevention and treatment of cardiovascular diseases in uremic patients.