Abstract:
Objective To explore the value of high-flux hemodialysis in improving left ventricular function in patients with uremia evaluated by ultrasound.
Methods Sixty-seven patients with uremia who had been treated by maintenance hemodialysis were selected and divided into two groups according to the dialysis modality: conventional hemodialysis(HD)group(forty-four cases) and HFHD group(twenty-three cases). Urea nitrogen (BUN), creatinine(SCr), serum calcium(Ca), serum phosphorus(P), uric acid(UA), albumin(ALB), parathyroid hormone(PTH), tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6), endothelin-1(ET-1) were detected in the two groups before treatment and six months after treatment, and left ventricular end-diastolic posterior wall thickness(LVPW), left ventricular ejection fraction (LVEF), mitral E/A value, left ventricular peak systolic mitral annular displacement (MAPSE) were measured by ultrasonography.The statistical method unpaired t test was used to analyse the data.
Result There were no significant differences in the decreasing rates of BUN, SCr, UA, IL-6 between the HD group[(6.50±2.51)%, (-16.94±8.13)%, (-2.50±0.98)%, (-0.31±0.12)%, respectively)] and the HFHD group[(-7.81±2.07)%, (-15.33±6.21)%, (-3.16±0.53)%, (-0.33±0.18)%, respectively](t=-1.984, -0.830, 1.684, 0.543; P>0.05) after treatment, there was significant difference in the decreasing rate of serum P between the two groups [(-5.23±2.12)%, (-11.53±4.43)%, t=-7.896, P<0.05]. The decline rates of PTH, TNF-α, ET-1 of the HD group[(9.62±3.55)%, (16.31±6.83)%, (21.21±8.13)%, respectively)]were lower than those of the HFHD group [(-22.13±7.33)%, (-19.73±7.25)%, (-31.32±12.13)%, respectively)](t=-23.960, -20.081, -21.110; P<0.05). The thickening rate of LVPW of the HD group[(0.98±2.31)%] had no significant difference with the HFHD group[(0.43±0.17) %] (t=1.136, P>0.05). The increasing rates of E/A, LVEF, MAPSE of the HD group[(1.42±1.16)%, (2.75±0.97)%, (2.17±0.67)%, respectively)] were lower than those of the HFHD group[(9.02±2.74)%, (11.23±3.45)%, (17.6±4.44)%, respectively) ](t=-15.946, -15.282, -22.716; P<0.05).
Conclusion Compared with HD, HFHD can improve the left ventricular function of patients with uremia.
Key words:
Uremia,
Renal dialysis,
Ventricular function, left,
Ultrasonography
Wenyuan Liu, Min Wang, Yudong Liu, Hanhui Zhao, Yu Qin, Lei Dong. The value of high-flux hemodialysis in improving left ventricular function in patients with uremia evaluated by ultrasound[J]. Chinese Journal of Diagnostics(Electronic Edition), 2015, 03(01): 32-35.