Clearance of serum hypersensitive C-reactive protein, interleukin-6, interleukin-12, and tumor necrosis factor-α in maintenance hemodialytic patients by high cut-off hemodialysis

doi:10.3877/cma.j.issn.1674-0785.2020.09.008

Abstract

Abstract:

Objective

To investigate the clearance effect of high cut-off hemodialysis (HCO-HD) on serum hypersensitive C-reactive protein (H-CRP), interleukin 6 (IL-6), interleukin 12 (IL-12), and tumor necrosis factor-α (TNF-α) in maintenance hemodialytic patients.

Methods

Ten patients who underwent maintenance hemodialysis in the Blood Purification Center of Subei People's Hospital of Jiangsu Province from August 2018 to January 2019 who met the inclusion criteria were selected. All the patients were changed from ordinary hemodialysis to high cut-off hemodialysis. A prospective self-control study was conducted. The ten patients underwent single hemodialysis (HD group), hemodiafiltration (HDF group), or high cut-off hemodialysis (HCO-HD group), all of which were performed for 4 h each time. The clearance effects of the three dialysis methods on serum H-CRP, IL-6, IL-12, TNF-α, and albumin were compared. In addition, the changes of urea nitrogen, creatinine, calcium, and phosphorus in serum before and after dialysis were compared.

Results

The clearance rate of serum inflammatory factors was the highest in the HCO-HD group, suggesting that HCO-HD increased the clearance of inflammatory factors. There was no significant difference in the clearance of inflammatory factors and albumin between HCO-HD and HDF (P>0.05). The clearance rates of inflammatory factors and albumin in the HCO-HD group were significantly higher than those in the HD group [IL-6: 67 (20-79) vs 17 (-5-60); IL-12: 15 (11.5-22) vs -6 (-19.5-19.5); H-CRP: 30 (22-52) vs 17 (4-36); TNF-α: 11 (5-16.5) vs -16 (-19-10.5); albumin: 31 (28-69) vs 11 (-2-24); P<0.05], but there was no significant difference between HDF and HD (P>0.05). The levels of serum inflammatory factors, albumin, urea nitrogen, serum creatinine, and calcium in the HCO-HD group after dialysis were significantly lower than those before dialysis (IL-6: 9.0±3.3 vs 4.6±3.9; IL-12: 38.8±22.0 vs 31.3±21.0; TNF-α: 66.0±46.7 vs 59.9±46.0; H-CRP: 20.9±8.0 vs 15.5±6.6; albumin: 46.4±4.4 vs 38.6±2.2; urea nitrogen: 27.7±6.1 vs 7.7±3.4; serum creatinine: 740.5±219.5 vs 236.2±93.3; calcium: 2.2±0.2 vs 2.0±0.3; P<0.05).

Conclusion

Compared with the traditional dialysis methods, HCO-HD can significantly increase the clearance of serum inflammatory factors in maintenance hemodialytic patients, and clear small molecules of uremic toxin, but the albumin loss is greater when using HCO-HD.

Key words: Uremia, High cut-off hemodialysis, Serum inflammatory factor, Serum albumin

Dongdong Hao, Ping Li, Ying Zhang, Chengtong Liang, Changhua Liu, Daoliang Xu. Clearance of serum hypersensitive C-reactive protein, interleukin-6, interleukin-12, and tumor necrosis factor-α in maintenance hemodialytic patients by high cut-off hemodialysis[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(09): 704-708.

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Figures/Tables 5

References 14

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炎性因子及毒素	分子量（Da）
白介素6（ng/L）	24 500
白介素12（ng/L）	75 000
肿瘤坏死因子α（ng/L）	17 000
超敏C反应蛋白（μg/L）	25 106
白蛋白（g/L）	66 400
尿素氮（mmol/L）	60
血肌酐（μmol/L）	113
血钙（mmol/L）	40
血磷（mmol/L）	31

炎性因子及毒素	分子量（Da）
白介素6（ng/L）	24 500
白介素12（ng/L）	75 000
肿瘤坏死因子α（ng/L）	17 000
超敏C反应蛋白（μg/L）	25 106
白蛋白（g/L）	66 400
尿素氮（mmol/L）	60
血肌酐（μmol/L）	113
血钙（mmol/L）	40
血磷（mmol/L）	31

组别	例数	白介素6（ng/L）	白介素12（ng/L）	肿瘤坏死因子α（ng/L）	超敏C反应蛋白（μg/L）
HD组	10
透析前		8.0±3.3	29.3±18.0	153.0±93.3	18.4±9.0
透析后		5.9±5.2	32.0±21.9	167.0±99.0	15.3±8.2
t值		1.45	-1.191	-1.574	2.237
P值		0.185	0.268	0.154	0.056
HDF组	6
透析前		11.1±6.0	34.6±19.0	182.0±105.0	19.4±11.0
透析后		4.2±4.3	35.0±17.8	155.0±81.6	14.1±10.0
t值		3.727	-0.359	0.997	3.560
P值		0.034	0.743	0.392	0.038
HCO-HD组	10
透析前		9.0±3.3	38.8±22.0	66.0±46.7	20.9±8.0
透析后		4.6±3.9	31.3±21.0	59.9±46.0	15.5±6.6
t值		4.270	2.840	4.404	3.800
P值		0.03	0.022	0.002	0.005

组别	例数	白介素6（ng/L）	白介素12（ng/L）	肿瘤坏死因子α（ng/L）	超敏C反应蛋白（μg/L）
HD组	10
透析前		8.0±3.3	29.3±18.0	153.0±93.3	18.4±9.0
透析后		5.9±5.2	32.0±21.9	167.0±99.0	15.3±8.2
t值		1.45	-1.191	-1.574	2.237
P值		0.185	0.268	0.154	0.056
HDF组	6
透析前		11.1±6.0	34.6±19.0	182.0±105.0	19.4±11.0
透析后		4.2±4.3	35.0±17.8	155.0±81.6	14.1±10.0
t值		3.727	-0.359	0.997	3.560
P值		0.034	0.743	0.392	0.038
HCO-HD组	10
透析前		9.0±3.3	38.8±22.0	66.0±46.7	20.9±8.0
透析后		4.6±3.9	31.3±21.0	59.9±46.0	15.5±6.6
t值		4.270	2.840	4.404	3.800
P值		0.03	0.022	0.002	0.005

组别	例数	尿素氮（mmol/L）	血肌酐（μmol/L）	血钙（mmol/L）	血磷（mmol/L）
HD组	10
透析前		28.8±7.0	364.0±75.7	2.3±0.2	2.3±0.5
透析后		7.9±4.3	242.3±95.7	1.6±0.9	2.3±0.6
t值		4.051	3.442	1.812	0.59
P值		0.015	0.026	0.144	0.587
HDF组	6
透析前		26.6±6.0	592.3±259.3	2.2±0.1	2.3±0.7
透析后		7.2±4.3	184.1±30.2	2.2±0.5	2.2±0.4
t值		4.927	3.051	-0.065	2.25
P值		0.039	0.048	0.954	0.843
HCO-HD组	10
透析前		27.7±6.1	740.5±219.5	2.2±0.2	2.3±0.8
透析后		7.7±3.4	236.2±93.3	2.0±0.3	2.2±0.5
t值		7.236	7.645	3.075	1.763
P值		0.002	0.002	0.037	0.153

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