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首页> 外文期刊>Blood purification >No benefit of hemodiafiltration over hemodialysis in lowering elevated levels of asymmetric dimethylarginine in ESRD patients.
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No benefit of hemodiafiltration over hemodialysis in lowering elevated levels of asymmetric dimethylarginine in ESRD patients.

机译：在降低ESRD患者中不对称二甲基精氨酸水平升高方面，血液透析滤过不优于血液透析。

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BACKGROUND: It has been suggested that hemodiafiltration (HDF) is more efficient than hemodialysis (HD) in lowering plasma levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA), which is a strong and independent predictor of overall mortality in ESRD patients. METHODS/PATIENTS: Twenty ESRD patients (11 women) were studied during both a single online HDF session and a single HD session. In each patient, ADMA, L-arginine, SDMA, beta(2)-microglobulin and urea were measured at several time points. RESULTS: Although HDF was clearly superior to HD in decreasing plasma beta(2)-microglobulin, there was no difference in the elimination characteristics of ADMA. However, HDF but not HD eliminated the nitric oxide synthase substrate L-arginine, making HD superior in increasing the L-arginine/ADMA ratio. CONCLUSION: Neither HD nor HDF sufficiently removes the putative uremic toxin ADMA. The clinical significance of HD better improving the L-arginine/ADMA ratio (parameter of NO production) as compared to HDF needs to be determined.
机译：背景：已提出血液透析滤过（HDF）在降低内源性一氧化氮合酶抑制剂不对称二甲基精氨酸（ADMA）的血浆水平方面比血液透析（HD）更有效，这是ESRD患者总体死亡率的有力且独立的预测指标。方法/患者：在一次在线HDF会话和一次HD会话中对20例ESRD患者（11名女性）进行了研究。在每个患者中，在几个时间点测量ADMA，L-精氨酸，SDMA，β（2）-微球蛋白和尿素。结果：尽管HDF在降低血浆β（2）-微球蛋白方面明显优于HDF，但在ADMA的消除特性方面没有差异。然而，HDF而不是HD消除了一氧化氮合酶底物L-精氨酸，从而使HD在增加L-精氨酸/ ADMA比方面具有优势。结论：HD和HDF都不能充分去除假定的尿毒症毒素ADMA。需要确定与HDF相比，HD更好地改善L-精氨酸/ ADMA比（NO产生的参数）的临床意义。

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