| Objectives To explore the effects of the combination of high flux hemodialysis and levocarnitine,on renal anemia in end-stage renal disease(ESRD)patients,who were in hemodialysis therapy.Methods From September1 2015 to August 31 2016,153 patients were selected in hemodialysis room of the First Hospital of Qinhuangdao,who were in maintenance hemodialysis with CKD-5.Patients were choosed who met the inclusion criteria were coded randomly and divided into 4 groups:(1)group A(low flux)36 cases,with low flux hemodialysis treatment,dialysate flow rate was 500 ml/min,Blood flow rate: low-pass dialysis 200ml-250ml/min,;(2)group B(high flux)39 cases,dialysate flow rate was 800ml/min,Blood flow rate: low-pass dialysis 250ml-300ml/min;(3)group C(low flux combined with levocarnitine)37 patients,the dialysis parameters were same to group A,combiend with the administration of levocarnitine;(4)group D(high flux combined with levocarnitine)41 patients,the dialysis parameters were same to group B,combiend with the administration of levocarnitine.All patients above were designed to perform hemodialysis treatment 3 times per week and 4 hours every time,with ultra pure water and bicarbonate dialysate,low molecular weight heparin calcium anticoagulant,dialyzer disposable,and L-carnitine was injected from the venous at the end of dialysis.153 patients were treated with subcutaneous injection of recombinant human erythropoietin(rHuEP0)to correct anemia.In September 2015 the baseline specimens were obtained immediately before dialysis and after 12 months treatment the specimens were obtained again in September 2016.Test items include height,weight and hemoglobin(Hb),serum albumin(Alb),triglyceride(TG),cholesterol(CHOL),parathyroid hormone(PTH),serum ferritin(FER),serum C-reactive protein(CRP),?2 microglobulin(?2-MG),serum C reactive protein(CRP),B natriuretic peptide(BNP),body mass index(BMI),etc.Various discomfort symptoms and adverse events were tightly observed.Statistical software SPSS19.0 was used for data analysis.Results There were no significant differences in the first dialysis test between the four groups of patients.The levels of hemoglobin of D group had the highest increase after one year of treatment,and there was a significant difference between the groups(P<0.05).The number of people with high doses of rHuEO in group B and D was significantlyreduced,the D group was more significant,and there was a significant difference between the groups(P<0.05).The levels of UUR,KT/V,albumin,blood phosphorus and other indicators in the four groups were significantly increased in groups B and D than in groups A and C.The increase was the largest in group D.The difference between groups was statistically significant.There were no significant differences in blood calcium,ferritin,BMI and cholesterol levels between the four groups after treatment(P>0.05).The levels of ?2 microglobulin,CRP and BNP of group A and C increased after treatment.The reduction of group B and group D was greater than that of group A.the difference between groups was statistically significant.(P<0.05).The levels of triglyceride of the four groups decreased after treatment,The group D was more obvious than the other three groups.the difference between groups was statistically significant.The quality of life scores of the four groups improved after treatment.There was no significant difference between group A and group C before treatment.Group B and group D were higher before treatment.Obviously,and group D was larger than the other three,the difference between groups was statistically significant(P<0.05)..Conclusion High-flux hemodialysis(HFHD)combined with L-carnitine treatment for MHD patients can significantly improve renal anemia,and the dosage of rHuEP0 is also significantly reduced compared with before.Meanwhile,the nutritional status of patients,removal of uremic toxins,cardiac function status and other aspects are also significantly improved.All of this will significantly improve the quality of life,which is extremely suitable for clinical promotion.Table12;Reference 76... |
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