中截止透析器、高通量透析器和血液透析患者身体功能的比较。

IF 1.8 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2025-07-14 DOI:10.1159/000546941

Gizem Kumru, Busra Haktaniyan, Kenan Ates, Sehsuvar Erturk, Gokhan Nergizoglu, Kenan Keven, Sule Sengul, Sim Kutlay

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引用次数: 0

摘要

所有的透析方式都可以潜在地改善身体活动水平和患者的健康，主要是通过更好的毒素清除。我们试图评估中截止血液透析（MCO-HD）、高通量血液透析（HF-HD）和高通量血液透析（HF-HDF）对定量身体表现指标的影响，这些指标是生活质量和死亡风险的预后指标。方法：10例维持性血液透析患者分别接受MCO-HD、HF-HD和HF-HDF治疗，疗程均为6个月。结果包括身体活动水平的改变，通过国际身体活动问卷进行评估，身体表现通过5次坐立、4米步态速度、握力测试和生物电阻抗分析进行评估。结果：该队列包括7名男性和3名女性，中位透析时间为96个月（IQR:36）。透析充分性（单池KtV≥1.2）在所有模式下均达到18个月，营养和炎症标志物（包括血清白蛋白）无明显改变。自我报告的身体活动在MCO-HD期间得到改善[总MET分钟/周234.5(IQR:1188) vs 1229.5(IQR:1683), p=0.019]。两组在握力、步态速度或肌肉质量方面没有显著变化，两组之间也没有显著差异。5次坐立测试显示MCO-HD组的稳定性，而HF-HDF组在6个月后观察到显著增强[12.34(IQR:3.88) vs 10.18（IQR:3.14）秒，p=0.022]。结论：MCO-HD组报告了身体活动水平的提高，而HF-HDF组显示了下肢力量的显著增强。以患者为中心选择透析方式，包括实施锻炼和营养干预，可以改善身体表现和患者预后。

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Comparison of Physical Function in Hemodialysis Patients Treated with Medium Cut-Off Dialyzers, High-Flux Dialyzers, and Hemodiafiltration.

Introduction: All dialysis modalities can potentially improve physical activity levels and patient well-being, primarily through better toxin clearance. We sought to assess the impact of medium cut-off hemodialysis (MCO-HD), high-flux hemodialysis (HF-HD), and high-flux hemodiafiltration (HF-HDF) on quantitative physical performance measures, which are prognostic for quality of life and mortality risk.

Methods: Ten maintenance hemodialysis patients received MCO-HD, HF-HD, and HF-HDF, each for a duration of 6 months. Outcomes encompassed alterations in physical activity levels, assessed with the International Physical Activity Questionnaire, and physical performance, evaluated through the 5-times sit-to-stand, 4-meter gait speed, grip strength tests, and bioelectrical impedance analysis.

Results: The cohort comprised 7 men and 3 women with a median dialysis vintage of 96 months (IQR: 36). Dialysis adequacy (single-pool KtV ≥1.2) was attained across all modalities for 18 months, with no notable alterations in nutritional and inflammation markers, including serum albumin. Self-reported physical activity improved during MCO-HD (total MET min/week 234.5 [IQR: 1,188] vs. 1,229.5 [IQR: 1,683], p = 0.019). There were no significant changes in handgrip strength, gait speed, or muscle mass in either group, nor were there any notable differences between the groups. The 5-times sit-to-stand test has shown stability in the MCO-HD group, whereas a substantial enhancement over 6 months observed with the HF-HDF (12.34 [IQR: 3.88] vs. 10.18 [IQR: 3.14] seconds, p = 0.022]).

Conclusion: The MCO-HD group reported elevated physical activity levels, while the HF-HDF group demonstrated considerable enhancement in low extremity strength. The patient-centered selection of dialysis modality, including the implementation of exercises and nutritional interventions, may improve physical performance and patient outcomes.

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.