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Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus

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收录情况： ◇ SCIE

作者：
Zhao Delong[1] * ; Wang Yuanda[2] ; Wang Yong[2] ; Jiang Aili[3] ; Cao Ning[4] ; He Yani[5] ; Wang Junxia[6] ; Guo Zhiyong[7] ; Liu Wenhu[8] ; Shi Wei[9] ; Hao Lirong[10] ; Li Jinyu[11] ; Li Wenge[12] ; Wang Caili[13] ; Wang Jianqin[14] ; Lin Hongli[15] ; Shi Wei[16] ; Wang Lihua[17] ; Jiang Hongli[18] ; Ding Guohua[19] ; Li Yun[20] ; Hu Wenbo[21] ; Yue Hua[22] ; Liu Jian[23] ; Yang Xiaoping[24] ; Yang Yibin[25] ; Liu Guohui[26] ; Li Hong[27] ; Xiao Yuefei[28] ; Wang Niansong[29] ; Jiang Gengru[30] ; Ma Guoying[31] ; Wang Jie[32] ; Li Ying[33] ; Li Rongshan[34] ; Li Qian[35] ; Sun Shiren[36] ; Jiao Jundong[37] ; Xi Chunsheng[38] ; Cai Guangyan[2] ; Sun Xuefeng[2] ; Chen Xiangmei[2] ;
单位： [1]Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China, zhaodelong@301hospital.com.cn. [2]Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China. [3]Blood Purification Center, The Second Hospital of Tianjin Medical University, Tiangjing, China. [4]Blood Purification Center, Northern Theater General Hospital, Shenyang, China. [5]Department of Nephrology, Daping Hospital of Army Medical University, Chongqing, China. [6]Blood Purification Center, The First Affiliated Hospital of Henan University of Science and Technology, Henan, China. [7]Department of Nephrology, Changhai Hospital Affiliated to Naval Medical University, Shanghai, China. [8]Department of Nephrology, Beijing Friendship Hospital, Beijing, China. [9]Department of Nephrology, Guangdong Provincial People's Hospital, Guangzhou, China. [10]Department of Nephrology, The First Affiliated Hospital of Harbin Medical University, Harbin, China. [11]Department of Nephrology, Heilongjiang Provincial People's Hospital, Harbin, China. [12]Department of Nephrology, China-Japan Friendship Hospital, Beijing, China. [13]Department of Nephrology, The First Affiliated Hospital of Baotou Medical College, Baotou, China. [14]Department of Nephrology, The Second Affiliated Hospital of Lanzhou University, Lanzhou, China. [15]Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Dalian, China. [16]Department of Nephrology, The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, China. [17]Department of Nephrology, The Second Affiliated Hospital of Shanxi Medical University, Taiyuan, China. [18]Department of Nephrology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. [19]Department of Nephrology, People's Hospital of Wuhan University, Wuhan, China. [20]Department of Nephrology, Jiangxi Provincial People's Hospital, Nanchang, China. [21]Department of Nephrology, Qinghai Provincial People's Hospital, Xining, China. [22]Department of Nephrology, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, China. [23]Department of Nephrology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. [24]Department of Nephrology, The First Affiliated Hospital of Xinjiang Shihezi University, Xinjiang, China. [25]Department of Nephrology, Affiliated Hospital of Guizhou Zunyi Medical College, Zunyi, China. [26]Department of Nephrology, Dongguan People's Hospital, Dongguan, China. [27]Blood Purification Center, Hainan People's Hospital, Hainan, China. [28]Department of Nephrology, Aerospace Center Hospital, Beijing, China. [29]Department of Nephrology, Shanghai Sixth People's Hospital, Shanghai, China. [30]Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China. [31]Department of Nephrology, Qiandongnan People's Hospital, Guizhou, China. [32]Department of Nephrology, Affiliated Hospital of Youjiang Ethnic Medical College, Guangxi, China. [33]Department of Nephrology, The Third Hospital of Hebei Medical University, Shijiazhuang, China. [34]Department of Nephrology, Shanxi Provincial People's Hospital, Taiyuan, China. [35]Department of Nephrology, Changsha Central Hospital, Changsha, China. [36]Department of Nephrology, Xijing Hospital of Air Force Medical University, Xi'an, China. [37]Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. [38]Department of Nephrology, Joint Logistic Support Unit 940 Hospital, Gansu, China.
出处：
DOI： 10.1159/000525225
ISSN：

关键词： Hemoperfusion Hemodialysis Uremic toxins Uremic pruritus Adsorption

摘要：
Classic hemodialysis schedules present inadequate middle-molecular-weight toxin clearance due to limitations of membrane-based separation processes. Accumulation of uremic retention solutes may result in specific symptoms (e.g., pruritus) and may affect clinical outcome and patient's quality of life. Hemoperfusion (HP) is a blood purification modality based on adsorption that can overcome such limitations, and thus, it may be interesting to test the efficacy of at least one session per week of HP combined with hemodialysis. This is a randomized, open-label trial, controlled, multicenter clinical study to investigate the effect of long-term HP combined with hemodialysis on middle-molecular-weight toxins and uremic pruritus in maintenance hemodialysis (MHD) patients.438 MHD patients from 37 HD centers in China with end-stage kidney disease (63.9% males, mean age 51 years) suffering from chronic intractable pruritus were enrolled in the study. Eligible patients were randomized into four groups: low-flux hemodialysis (LFHD), high-flux hemodialysis (HFHD), HP + LFHD, and HP + HFHD at a 1:1:1:1 ratio. Beta-2 microglobulin (β2M) and parathyroid hormone (PTH) were measured at baseline, 3-6, and 12 months. At the same time points, the pruritus score was evaluated. The primary outcome was the reduction of β2M and PTH, while the secondary outcome was the reduction of the pruritus score.In the two groups HP + LFHD and HP + HFHD, there was a significant decrease of β2M and PTH levels after 12 months compared to the control groups. No significant differences were noted between HP + LFHD and HP + HFHD. Pruritus score reduction was 63% in the HP + LFHD group and 51% in the HP + HFHD group, respectively.The long-term HP + HD can reduce β2M and PTH levels and improve pruritus in MHD patients independently on the use of high- or low-flux dialyzers, showing that the results are linked to the effect of adsorption.© 2022 S. Karger AG, Basel.

基金：
This work was supported by the grants from the National Natural Science Foundation of China (32141005, 81830019, 82030025), National Key Technology R&D Program (2018YFA0108803).
语种：
外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类 | 4 区 医学
小类 | 4 区 血液学 4 区 泌尿学与肾脏学
最新[2025]版：
大类 | 4 区 医学
小类 | 4 区 血液学 4 区 泌尿学与肾脏学
JCR分区：
出版当年[2020]版：
Q3 HEMATOLOGY Q3 UROLOGY & NEPHROLOGY
最新[2023]版：
Q2 UROLOGY & NEPHROLOGY Q3 HEMATOLOGY

影响因子： 最新[2023版] 最新五年平均[2021-2025] 出版当年[2020版] 出版当年五年平均[2016-2020] 出版前一年[2019版] 出版后一年[2021版]

第一作者：
第一作者单位： [1]Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China, zhaodelong@301hospital.com.cn.
通讯作者：
推荐引用方式(GB/T 7714)：
Zhao Delong,Wang Yuanda,Wang Yong,et al.Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus[J].Blood Purification.2022,1-11.doi:10.1159/000525225.
APA：
Zhao Delong,Wang Yuanda,Wang Yong,Jiang Aili,Cao Ning...&Chen Xiangmei.(2022).Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus.Blood Purification,,
MLA：
Zhao Delong,et al."Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus".Blood Purification .(2022):1-11

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