| Hemodialysis(HD) is an important means to maintain the life of uremia patients with advanced chronic kidney failure, but with the prolonged survival time of patients dialysis-related complications have emerged one after another. Renal anemia in long-period hemodialysis patients with uremia is one of the common complications, which seriously result in lower living quality of patients and discompleted recovery, directly associated with high mortality. Therefore, how to ameliorate and correct anemia in patients should be a major question to the clinical medical workers in particular nephritic physicians. Therapy with recombinant human erythropoietin(r-HuEPO) help to improve anemia in some of the patients, but low response to r-HuEPO in patients repressed its effect to anemia treatment is not satisfactory. Clinical application of high-flux hemodialysis and levocarnitine obtained nice results for renal anemia amelioration.In order to evaluate the therapeutic effect of high-flux hemodialysis (HFHD) combined with levocarnitine(L-CN) on the application of long-term maintenance hemodialysis patients with renal anemia, we selected 80 patients performing hemodialysis for the object of study and observation in the period of December 2006 to February 2008 at department of the Second Hospital of Jilin University Medical kidney blood purification treatment room. They were divided into 4 groups in accordance with the use of dialyzers types and the use of levocarnitine: Group A (control group: LFHD group ),group B(observation groupâ… : LFHD+L-CN group),group C(observation groupâ…¡: HFHD group),group D(observation Groupâ…¢: HFHD + L-CN group).The results showed that: (1).For the four groups of dialysis patients blood urine nitrogen (BUN) and serum creatinine(Scr) clearance were obviously reduced compared with pre-dialysis (P<0.001).No clear difference about BUN and Scr clearance was seen among 4 groups after 6 months'therapy (P>0.05). (2). There aren't significant differences of serum phosphorus and parathyroid hormone levels among the 4 groups (P>0.05). The difference was not significant in group A and group B after 6 months'therapy compared with pre-therapy(P>0.05),but obvious decreasement were seen in group C and group D after 6 months'therapy compared with pre-therapy(P<0.001) and the inter-group difference was not significant in group C and group D (P>0.05). (3). Hemoglobin and hematocrit were increased significantly in all patients after 6 months'therapy (P<0.01).After therapy, hemoglobin and hematocrit were improved significantly in group D compared with group B and group C (P<0.01). The results showed that the same trend in group B and group C compared with group A (P<0.01). There was markly significant difference between group D and group A(P<0.001). (4).Serum albumin was increased in group B,group C and group D after therapy compared with pre-therapy. In the post-treatment groups, serum albumin was increased significantly in group D compared with group B and group C (P<0.01). There was markly significant difference between group D and group A(P<0.001). The inter-group difference was not significant between B and C(P>0.05). (5)The complications were improved to various degrees in group B,group C and group D of patients with different therapy for 6 months.There was markly significant difference between group D and group A .The current study showed that both high-flux hemodialysis and levocarnitine could increase hemoglobin, hematocrit, serum albumin levels and ameliorated anemia condition.The combined application for high-flux hemodialysis combined levocarnitine received better effect.Furthermore, for the improvement of appetite, arrhythmia, pleural effusion, wrist ache and intractable itching, myalgia,dialysis-related hypotension and spasm, high-flux hemodialysis and levocarnitine treatment showed cleanly exact therapeutic effect. They should be widespread recommended for high-flux hemodialysis model to carry out as well as the use of levocarnitine. |
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