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首页> 外文期刊>Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy >Cardiovascular Protective Effects of On-Line Hemodiafiltration: Comparison With Conventional Hemodialysis
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Cardiovascular Protective Effects of On-Line Hemodiafiltration: Comparison With Conventional Hemodialysis

机译：在线血液透析滤过对心血管的保护作用：与常规血液透析的比较

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摘要

Atherosclerotic complications have a significant effect on mortality in patients undergoing hemodialysis (HD) therapy. However, anti-atherosclerotic and cardioprotective effects of on-line hemodiafiltration (HDF) remain to be elucidated. We prospectively compared the anti-atherosclerotic and cardioprotective effects in two randomly divided groups, i.e. on-line HDF group (n=13) and conventional HD group (n=9) for 1year. Surrogate markers were brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT) of carotid artery as an atherosclerosis marker, and cardiac functional surrogate markers included left ventricular mass index (LVMI), ejection fraction (EF), and LV diastolic capacity represented as E/A and deceleration time (DT). LVMI in on-line HDF patients showed significant regression after 1year of treatment (131.9±25.8 to 116.5±24.7g/m 2, P=0.03), while LVMI in HD patients did not show any significant change (148.0±47.1 to 142.3±35.5g/m 2). Levels of baPWV in HD patients showed a significant increase (11.4%) from basal levels, while on-line HDF groups showed no significant increase. Furthermore, HD patients showed significant worsening of LV diastolic capacity (E/A: from 0.87±0.12 to 0.79±0.08, P=0.03), while it was not shown in on-line HDF patients. Ejection fraction and IMT did not show any significant change in both groups. Serum albumin, C-reactive protein, β2 microglobulin, blood pressure, and anti-hypertensive drug use did not change in both groups. On-line HDF showed a significant improvement in LVMI and prevented a significant worsening of baPWV or LV diastolic capacity compared with patients on conventional HD therapy.
机译：动脉粥样硬化并发症对接受血液透析（HD）治疗的患者的死亡率有重大影响。但是，在线血液透析滤过（HDF）的抗动脉粥样硬化和心脏保护作用仍有待阐明。我们前瞻性比较了随机分为两组的抗动脉粥样硬化和心脏保护作用，即在线HDF组（n = 13）和常规HD组（n = 9）1年。替代指标包括臂踝脉搏波速度（baPWV），作为动脉粥样硬化指标的颈动脉内膜中膜厚度（IMT），心脏功能替代指标包括左心室质量指数（LVMI），射血分数（EF）和LV舒张容量表示为E / A和减速时间（DT）。 HDF在线患者治疗1年后LVMI显着下降（131.9±25.8至116.5±24.7g / m 2，P = 0.03），而HD患者中LVMI无明显变化（148.0±47.1至142.3±） 35.5g / m 2）。 HD患者的baPWV水平较基础水平显着升高（11.4％），而在线HDF组未见明显升高。此外，HD患者表现出左室舒张能力显着恶化（E / A：从0.87±0.12降至0.79±0.08，P = 0.03），而在线HDF患者中未显示。两组的射血分数和IMT均未显示任何显着变化。两组的血清白蛋白，C反应蛋白，β2微球蛋白，血压和抗高血压药物的使用均未改变。与接受常规HD治疗的患者相比，在线HDF表现出LVMI的显着改善，并防止了baPWV或LV舒张能力的显着恶化。

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