Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus
| العنوان: | Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus |
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| المؤلفون: | Delong Zhao, Yuanda Wang, Yong Wang, Aili Jiang, Ning Cao, Yani He, Junxia Wang, Zhiyong Guo, Wenhu Liu, Wei Shi, Lirong Hao, Jinyu Li, Wenge Li, Caili Wang, Jianqin Wang, Hongli Lin, Lihua Wang, Hongli Jiang, Guohua Ding, Yun Li, Wenbo Hu, Hua Yue, Jian Liu, Xiaoping Yang, Yibin Yang, Guohui Liu, Hong Li, Yuefei Xiao, Niansong Wang, Gengru Jiang, Guoying Ma, Jie Wang, Ying Li, Rongshan Li, Qian Li, Shiren Sun, Jundong Jiao, Chunsheng Xi, Guangyan Cai, Xuefeng Sun, Xiangmei Chen |
| المصدر: | Blood Purification. 51:812-822 |
| بيانات النشر: | S. Karger AG, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Nephrology, Hematology, General Medicine |
| الوصف: | Introduction: Classic hemodialysis schedules present inadequate middle-molecular-weight toxin clearance due to limitations of membrane-based separation processes. Accumulation of uremic retention solutes may result in specific symptoms (e.g., pruritus) and may affect clinical outcome and patient’s quality of life. Hemoperfusion (HP) is a blood purification modality based on adsorption that can overcome such limitations, and thus, it may be interesting to test the efficacy of at least one session per week of HP combined with hemodialysis. This is a randomized, open-label trial, controlled, multicenter clinical study to investigate the effect of long-term HP combined with hemodialysis on middle-molecular-weight toxins and uremic pruritus in maintenance hemodialysis (MHD) patients. Methods: 438 MHD patients from 37 HD centers in China with end-stage kidney disease (63.9% males, mean age 51 years) suffering from chronic intractable pruritus were enrolled in the study. Eligible patients were randomized into four groups: low-flux hemodialysis (LFHD), high-flux hemodialysis (HFHD), HP + LFHD, and HP + HFHD at a 1:1:1:1 ratio. Beta-2 microglobulin (β2M) and parathyroid hormone (PTH) were measured at baseline, 3–6, and 12 months. At the same time points, the pruritus score was evaluated. The primary outcome was the reduction of β2M and PTH, while the secondary outcome was the reduction of the pruritus score. Results: In the two groups HP + LFHD and HP + HFHD, there was a significant decrease of β2M and PTH levels after 12 months compared to the control groups. No significant differences were noted between HP + LFHD and HP + HFHD. Pruritus score reduction was 63% in the HP + LFHD group and 51% in the HP + HFHD group, respectively. Conclusion: The long-term HP + HD can reduce β2M and PTH levels and improve pruritus in MHD patients independently on the use of high- or low-flux dialyzers, showing that the results are linked to the effect of adsorption. |
| تدمد: | 1421-9735 0253-5068 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cf62a6b9bf1c0fabf5ae0c0b02349eb2 https://doi.org/10.1159/000525225 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....cf62a6b9bf1c0fabf5ae0c0b02349eb2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14219735 02535068 |
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