递增式血液透析对终末期肾病患者肾功能、微炎症及死亡率的影响

目的研究递增式血液透析(IHD)对终末期肾病(ESRD)患者肾功能、微炎症及死亡率的影响。 方法选取2017年7月至2021年6月于我院行血液透析(HD)治疗的ESRD患者84例，按照随机数字表法将84例ESRD患者分为递增组(n＝42)与常规组(n＝42)。治疗前及治疗6个月后，观察两组透析充分及生存情况、血尿素氮(BUN)、胱抑素C(CysC)、血清肌酐(Scr)、残余尿量(RUV)、尿素氮下降率(URR)、Kt/V等肾功能指标，血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和β2微球蛋白(β2-MG)等微炎症指标，以及透析期间不良反应。 结果与常规组相比，递增组透析充分率增高，死亡率降低(P<0.05)。治疗6个月后，与常规组相比，递增组的BUN、CysC、Scr、RUV降低；URR、Kt/V增高(P<0.05)；血清CRP、IL-6、TNF-α及β2-MG水平降低(P<0.05)；不良反应发生率降低(P<0.05)。 结论IHD可以保护ESRD患者的残余肾功能，抑制机体微炎症，降低不良反应率和死亡率。

Effect of incremental hemodialysis on renal function,microinflammation and mortality in end-stage renal disease patients

ObjectiveTo investigate the effect of incremental hemodialysis (IHD) on renal function, microinflammation, and mortality in end-stage renal disease (ESRD) patients. MethodsA total of 84 ESRD patients who received HD treatment in our hospital from July 2017 to June 2021 were selected. By means of the random number table method, the patients were divided into the incremental group (n=42) and the routine group (n=42). Before and 6 months after the treatment, the following indexes were observed, including dialysis adequacy, survival, BUN, cystatin C (CysC), serum creatinine (Scr), residual urine volume (RUV), urea nitrogen reduction rate (URR), Kt/V, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and β2 microglobulin (β2-MG), as well as adverse reactions during dialysis. ResultsCompared with the routine group, the incremental group showed higher dialysis adequacy rate and lower mortality rate (P<0.05). After 6 months of the treatment, compared with the routine group, the incremental group displayed lower levels of BUN, CysC, Scr, and RUV (P<0.05), higher levels of URR and Kt/V (P<0.05), and lower levels of serum CRP, IL-6, TNF-α and β2-MG (P<0.05), as well as lower rate of adverse reactions (P<0.05). ConclusionIHD could protect the residual kidney function of ESRD patients, inhibit the body′s microinflammation, and reduce both the adverse reaction rate and mortality rate.