Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2144-2149
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2144
High flux hemodialysis in elderly patients with chronic kidney failure
Hai-Yan Xue, Bin Duan, Zhen-Jiang Li, Peng Du
Hai-Yan Xue, Dialysis Center, The Fourth People’s Hospital of Shaanxi, Xi’an 710043, Shaanxi Province, China
Bin Duan, Zhen-Jiang Li, Peng Du, Department of Kidney Diseases, Dialysis Center, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Author contributions: Du P reviewed and edited the manuscript; Xue HY and Li ZJ contributed equally to this manuscript and should be considered as co-first authors; Xue HY, Li ZJ, Duan B, and Du P contributed to study conceptualization, methodology, data collection, data analysis, and article writing; all authors approved the submitted manuscript.
Institutional review board statement: The study was approved by Ethics Committee of The Fourth People’s Hospital of Shaanxi.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data available.
STROBE statement: The manuscript has been prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Peng Du, MD, Chief Physician, Department of Kidney Disease, Dialysis Center, Shaanxi Provincial People’s Hospital, No. 256, Youyi West Road, Beilin District, Xi’an 710068, Shaanxi Province, China. seasonn@163.com
Received: March 22, 2020
Peer-review started: March 22, 2020
First decision: April 14, 2020
Revised: April 29, 2020
Accepted: May 1, 2020
Article in press: May 1, 2020
Published online: June 6, 2020
Processing time: 77 Days and 23.8 Hours
ARTICLE HIGHLIGHTS
Research background

Hemodialysis is an advanced blood purification technique to manage kidney failure. However, conventional hemodialysis may cause cardiovascular diseases and an increase mortality because of the high prevalence of dyslipidemia. Moreover, toxins accumulating in the body over time may induce some complications. High flux hemodialysis has been reported to effectively improve disease indexes and clinical symptoms. Little data is available on the effectiveness of high flux hemodialysis in the real clinical world. The present study researched the effect of high flux hemodialysis on kidney function, incidence of complications, and serum toxins in elderly patients with chronic kidney failure (CKF).

Research motivation

This study explored the effectiveness of high flux hemodialysis in the real clinical world to find ways to improve kidney function and reduce the incidence of complications in patients with CKF.

Research objectives

The study aimed to identify the efficacy of high flux hemodialysis in elderly patients with CKF.

Research methods

Sixty-six patients with CKF who received treatment at our hospital were enrolled and observed between October 2017 and October 2018. They were divided into a study group and a control group according to the treatment they received. Patients in the study group received high flux hemodialysis with a coefficient of ultrafiltration of 56 mL/h per mmHg and blood flow rate of 220 to 250 mL/min (3 times a week, 4 h per session). Patients in the control group underwent hemodialysis using a 4008B dialysis machine with a KUF of 10 mL/h per mmHg and blood flow rate of 220 to 250 mL/min (3 times a week, 4 h per session). Kidney function, serum creatinine, blood urea nitrogen concentration, toxin levels, and overall incidence of complications were compared between the two groups.

Research results

Before the treatment, there was no significant difference in kidney function, β2-microglobulin, or blood urea nitrogen between the two groups. In contrast, kidney function was better in the study group than in the control group after the treatment. In addition, the study group had significantly lower parathyroid hormone and serum cystatin C than the control group. The incidence of complications was 8.57% in the study group, which was lower than that of the control group (20.00%).

Research conclusions

After the treatment, kidney function was improved in patients receiving high flux hemodialysis compared with patients receiving conventional hemodialysis. High flux hemodialysis can effectively remove toxins from the blood and regulate lipids in the blood. It also helps reduce dialysis membrane reactions, inflammatory stress, and the incidence of compilations. What’s more, the healthcare expense is comparatively low for high flux hemodialysis.

Research perspectives

High flux hemodialysis is worthy of clinical promotion in elderly patients with CKF.