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Article: Combination of maintenance hemodialysis with hemoperfusion: A safe and effective model of artificial kidney

TitleCombination of maintenance hemodialysis with hemoperfusion: A safe and effective model of artificial kidney
Authors
KeywordsArtificial kidney
Hemoperfusion
Maintenance hemodialysis
Middle and large molecule uremic toxins
Issue Date2011
PublisherWichtig Editore srl. The Journal's web site is located at http://www.artificial-organs.com
Citation
International Journal Of Artificial Organs, 2011, v. 34 n. 4, p. 339-347 How to Cite?
AbstractObjective: To investigate whether the combination of maintenance hemodialysis (MHD) with hemoperfusion (HP) could improve the clearance rate of middle and large molecule uremic toxins so as toimprove the quality of life of MHD patients and reduce their mortality rate. Methods: This study was a prospective, randomized, controlled clinical trial. 100 MHD patients were selected and then randomly divided into two groups after four weeks of run-in period. Group 1 received HD alone 2 times a week and the combined treatment of HD with HP (HD+HP) once a week, whereas Group 2 was given HD alone 3 times a week. This study was followed up for a mean of 2 years. The primary outcome was the death of patients. Secondary end points included normal clinical data, leptin, high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), β2 microglobulin (β2-MG), immunoreactive parathyroid hormone (iPTH), tumor necrosis factor-α (TNF-α) and the index of dimensions of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 Chinese Edition). Results: At the end of the two-year observation, the serum concentration of leptin, hsCRP, iPTH, IL-6, β2-MG and TNF-α, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cardiothoracic ratio, left ventricular mass index (LVMI), the EPO doses and the types of antihypertensive drugs used were lower with Group 1 than with Group 2 (p<0.05); Group 1 had higher hemoglobin (Hb), ejection fraction (EF), and body mass index (BMI) (p<0.05). No statistical difference between the two groups was observed in terms of serum albumin, serum iron (SI), total iron binding capacity (TIBC), cardiac output (CO), Kt/V, early/atrial mitral inflow velocities (E/A) (p>0.05). Besides, the SF-36 indicated that the total score of overall dimentions of Group 1 was higher than Group 2 (p<0.05) and the quality of life of Group 1 was evidently better than Group 2. The Kaplan-Meier Survival Curves for the 2-year observation period showed that patients in Group 1 had obvious survival advantage while Log-rank test results showed p<0.05. No serious adverse incidents occurred during the HD+HP treatment. Conclusions: HD+HP was superior to HD in regularly eliminating middle and large molecule uremic toxins accumulated in the body. These findings suggest a potential role for HD+HP in the treatment to improve the quality of life and survival rate of MHD patients. © 2011 Wichtig Editore.
Persistent Identifierhttp://hdl.handle.net/10722/168526
ISSN
2023 Impact Factor: 1.4
2023 SCImago Journal Rankings: 0.430
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChen, SJen_US
dc.contributor.authorJiang, GRen_US
dc.contributor.authorShan, JPen_US
dc.contributor.authorLu, Wen_US
dc.contributor.authorHuang, HDen_US
dc.contributor.authorJi, Gen_US
dc.contributor.authorWu, Pen_US
dc.contributor.authorWu, GFen_US
dc.contributor.authorWang, Wen_US
dc.contributor.authorZhu, Cen_US
dc.contributor.authorBian, Fen_US
dc.date.accessioned2012-10-08T03:20:04Z-
dc.date.available2012-10-08T03:20:04Z-
dc.date.issued2011en_US
dc.identifier.citationInternational Journal Of Artificial Organs, 2011, v. 34 n. 4, p. 339-347en_US
dc.identifier.issn0391-3988en_US
dc.identifier.urihttp://hdl.handle.net/10722/168526-
dc.description.abstractObjective: To investigate whether the combination of maintenance hemodialysis (MHD) with hemoperfusion (HP) could improve the clearance rate of middle and large molecule uremic toxins so as toimprove the quality of life of MHD patients and reduce their mortality rate. Methods: This study was a prospective, randomized, controlled clinical trial. 100 MHD patients were selected and then randomly divided into two groups after four weeks of run-in period. Group 1 received HD alone 2 times a week and the combined treatment of HD with HP (HD+HP) once a week, whereas Group 2 was given HD alone 3 times a week. This study was followed up for a mean of 2 years. The primary outcome was the death of patients. Secondary end points included normal clinical data, leptin, high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), β2 microglobulin (β2-MG), immunoreactive parathyroid hormone (iPTH), tumor necrosis factor-α (TNF-α) and the index of dimensions of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 Chinese Edition). Results: At the end of the two-year observation, the serum concentration of leptin, hsCRP, iPTH, IL-6, β2-MG and TNF-α, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cardiothoracic ratio, left ventricular mass index (LVMI), the EPO doses and the types of antihypertensive drugs used were lower with Group 1 than with Group 2 (p<0.05); Group 1 had higher hemoglobin (Hb), ejection fraction (EF), and body mass index (BMI) (p<0.05). No statistical difference between the two groups was observed in terms of serum albumin, serum iron (SI), total iron binding capacity (TIBC), cardiac output (CO), Kt/V, early/atrial mitral inflow velocities (E/A) (p>0.05). Besides, the SF-36 indicated that the total score of overall dimentions of Group 1 was higher than Group 2 (p<0.05) and the quality of life of Group 1 was evidently better than Group 2. The Kaplan-Meier Survival Curves for the 2-year observation period showed that patients in Group 1 had obvious survival advantage while Log-rank test results showed p<0.05. No serious adverse incidents occurred during the HD+HP treatment. Conclusions: HD+HP was superior to HD in regularly eliminating middle and large molecule uremic toxins accumulated in the body. These findings suggest a potential role for HD+HP in the treatment to improve the quality of life and survival rate of MHD patients. © 2011 Wichtig Editore.en_US
dc.languageengen_US
dc.publisherWichtig Editore srl. The Journal's web site is located at http://www.artificial-organs.comen_US
dc.relation.ispartofInternational Journal of Artificial Organsen_US
dc.subjectArtificial kidney-
dc.subjectHemoperfusion-
dc.subjectMaintenance hemodialysis-
dc.subjectMiddle and large molecule uremic toxins-
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnemia - Blood - Drug Therapyen_US
dc.subject.meshAntihypertensive Agents - Therapeutic Useen_US
dc.subject.meshBiological Markers - Blooden_US
dc.subject.meshBlood Pressureen_US
dc.subject.meshCardiovascular Diseases - Blood - Physiopathology - Therapyen_US
dc.subject.meshChinaen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rateen_US
dc.subject.meshHematinics - Therapeutic Useen_US
dc.subject.meshHemoperfusion - Adverse Effects - Instrumentation - Mortalityen_US
dc.subject.meshHumansen_US
dc.subject.meshKaplan-Meier Estimateen_US
dc.subject.meshKidney Diseases - Blood - Mortality - Physiopathology - Psychology - Therapyen_US
dc.subject.meshKidney, Artificialen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshQuality Of Lifeen_US
dc.subject.meshQuestionnairesen_US
dc.subject.meshRenal Dialysis - Adverse Effects - Instrumentation - Mortalityen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshUremia - Blood - Mortality - Physiopathology - Psychology - Therapyen_US
dc.titleCombination of maintenance hemodialysis with hemoperfusion: A safe and effective model of artificial kidneyen_US
dc.typeArticleen_US
dc.identifier.emailLu, W:luwei@hku.hken_US
dc.identifier.authorityLu, W=rp00754en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.5301/IJAO.2011.7748en_US
dc.identifier.pmid21534244-
dc.identifier.scopuseid_2-s2.0-79955664965en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79955664965&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume34en_US
dc.identifier.issue4en_US
dc.identifier.spage339en_US
dc.identifier.epage347en_US
dc.identifier.isiWOS:000290353000002-
dc.publisher.placeItalyen_US
dc.identifier.scopusauthoridChen, SJ=36630032200en_US
dc.identifier.scopusauthoridJiang, GR=21742340700en_US
dc.identifier.scopusauthoridShan, JP=49864615900en_US
dc.identifier.scopusauthoridLu, W=27868087600en_US
dc.identifier.scopusauthoridHuang, HD=49863289100en_US
dc.identifier.scopusauthoridJi, G=36056359400en_US
dc.identifier.scopusauthoridWu, P=49864863100en_US
dc.identifier.scopusauthoridWu, GF=7404974756en_US
dc.identifier.scopusauthoridWang, W=36072896000en_US
dc.identifier.scopusauthoridZhu, C=35091707900en_US
dc.identifier.scopusauthoridBian, F=38461062100en_US
dc.identifier.issnl0391-3988-

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