Abstract：Objective To investigate the effects of high flux hemodialysis on cardiac structure and function in maintenance hemodialysis patients, and to study the possible mechanism. Methods The study was prospective and self-controlled.A totol of 88 patients on maintainance low flux hemodialysis were recruited, after changing to a high flux hemodialysis treatment for 24 months. Their cardiac structure and function were compared by echocardiography respectively. Serum creatinine(SCr), blood urea nitrogen(BUN), serum phosphorus(P), calcium(Ca), intact parathyroid hormone(iPTH), β2- microglobulin(β2-MG),high sensitivity C-reactive protein(hs-CRP), albumin(ALB),and hemoglobin(Hb) levels were determined after the switch for 0, 12 and 24 months. Results There was no significant atteration of the cardiac function indexes of LAD, LVPWT, IVST, LVEF, E/A, compared with before after 12 months’ treatment of HFHD.But patients with HDHF on treatment for 24 months, had significant alteration of the cardiac function indexes of LAD, LVDd, LVPWT, IVST, LVEF compared with before (P＜0.05). In patients with HDHF on the treatment for 24 months, the clinical indicators of serum ALB, CH, TG, HDL, LDL, Scr, BUN, hs-CRP, DBP, MAP had no differences before and after changing to HFHD, serum Hb and Ca significantly increased after changing to HFHD(P＜0.05),serum P, iPTH、β2-MG have significantly decreased after changing to HFHD(P＜0.05). Conclusions In MHD patients universally exists left ventricular hypertrophy. Although HFHD may remove plasma medium molecule and macromolecule toxins such as β2-MG, inflammation substance and improve uremia in the body, it can not improve left ventricular diastolic function.
涂晓文,王欢,赵雯雯,王彦珺. 高通量血液透析对维持性血液透析患者左心室结构和功能的影响[J]. , 2014, 25(8): 793-796.
TU Xiaowen,WANG Huan,ZHAO Wenwen,WANG Yanjun. Effects of high flux hemodialysis on left ventricular structure and function in maintenance hemodialysis patients. , 2014, 25(8): 793-796.
US Renal Data System. Overall hospitalization and mortality[J]. Am J Kidney Dis, 2003, 42(6 Suppl 5):S1-1S230.
[1]
Dhar S, Pressman G S, Subramanian S, et al. Natriuretic peptides and heart failure in the patient with chronic kidney disease: a review of current evidence[J]. Postgrad Med J, 2009, 85(1004):299-302.
[3]
Asci G, Tz H, Ozkahya M, et al. The impact of membrane permeability and dialysate purity on cardiovascular outcomes[J]. J Am Soc Nephrol, 2013,24(6):1014-1023.
[4]
Boure T, Vanholder R. Biochemical and clinical evidence for uremic toxicity[J]. Artif Organs, 2004,28(3):248-253.
[2]
US Renal Data System. Overall hospitalization and mortality[J]. Am J Kidney Dis, 2003, 42(6 Suppl 5):S1-1S230.
[5]
Patel R K, Oliver S, Mark P B, et al. Determinants of left ventricular mass and hypertrophy in hemodialysis patients assessed by cardiac magnetic resonance imaging[J]. Clin J Am Soc Nephrol, 2009,4(9):1477-1483.
[3]
Asci G, Tz H, Ozkahya M, et al. The impact of membrane permeability and dialysate purity on cardiovascular outcomes[J]. J Am Soc Nephrol, 2013,24(6):1014-1023.
[6]
Ok E, Asci G, Toz H, et al. Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study[J]. Nephrol Dial Transplant, 2013,28(1):192-202.
[4]
Boure T, Vanholder R. Biochemical and clinical evidence for uremic toxicity[J]. Artif Organs, 2004,28(3):248-253.
[7]
Traut M, Haufe C C, Eismann U, et al. Increased binding of beta-2-microglobulin to blood cells in dialysis patients treated with high-flux dialyzers compared with low-flux membranes contributed to reduced beta-2-microglobulin concentrations(Results of a cross-over study)[J]. Blood Purif, 2007,25(5-6):432-440.
[5]
Patel R K, Oliver S, Mark P B, et al. Determinants of left ventricular mass and hypertrophy in hemodialysis patients assessed by cardiac magnetic resonance imaging[J]. Clin J Am Soc Nephrol, 2009,4(9):1477-1483.
[8]
Duran M, Unal A, Inanc M T, et al. Hemodialysis does not impair ventricular functions over 2 years[J]. Hemodial Int, 2011,15(3):334-340.
[6]
Ok E, Asci G, Toz H, et al. Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study[J]. Nephrol Dial Transplant, 2013,28(1):192-202.
[9]
Zumrutdal A, Sezer S, Demircan S, et al. Cardiac troponin I and beta 2 microglobulin as risk factors for early-onset atherosclerosis in patients on haemodialysis[J]. Nephrology (Carlton), 2005,10(5):453-458.
[7]
Traut M, Haufe C C, Eismann U, et al. Increased binding of beta-2-microglobulin to blood cells in dialysis patients treated with high-flux dialyzers compared with low-flux membranes contributed to reduced beta-2-microglobulin concentrations(Results of a cross-over study)[J]. Blood Purif, 2007,25(5-6):432-440.
[10]
Cheung A K, Rocco M V, Yan G, et al. Serum beta-2 microglobulin levels predict mortality in dialysis patients: results of the HEMO study[J]. J Am Soc Nephrol, 2006,17(2):546-555.
[8]
Duran M, Unal A, Inanc M T, et al. Hemodialysis does not impair ventricular functions over 2 years[J]. Hemodial Int, 2011,15(3):334-340.
Zumrutdal A, Sezer S, Demircan S, et al. Cardiac troponin I and beta 2 microglobulin as risk factors for early-onset atherosclerosis in patients on haemodialysis[J]. Nephrology (Carlton), 2005,10(5):453-458.
Cheung A K, Rocco M V, Yan G, et al. Serum beta-2 microglobulin levels predict mortality in dialysis patients: results of the HEMO study[J]. J Am Soc Nephrol, 2006,17(2):546-555.
2014, Vol. 25 
