血液透析与血液透析滤过对糖尿病肾病尿毒症毒素MMS和PENT的清除观察

Clearance Effects of Hemodialysis and Hemodiafiltration on Uremic Toxins MMS and PENT in DKD-caused Uremia Patients

目的观察糖尿病肾病尿毒症患者接受血液透析(HD)和血液透析滤过(HDF)治疗对中分子毒素(MMS)、晚期糖基化终产物戊糖素(PENT)的清除效果。方法选择符合入选标准的36例维持性血液透析DKD尿毒症患者,分为HD组(n=24)、HDF组(n=12),于单次治疗前后取血,测定血清尿素氮(BUN)、MMS、PENT,应用Daugirdas公式计算单次透析充分性(KT/V)。结果各组患者治疗后血清BUN水平均显著下降(P<0.01),KT/V均超过1.3,但各组间BUN下降率及KT/V差异无统计学意义。各组均能部分降低血清MMS、PENT水平,HDF对MMS、PENT的清除率优于常规HD清除(P<0.05)。结论血液透析滤过对糖尿病肾病尿毒症患者MMS、PENT清除明显优于常规血液透析。

Objective To investigate the effects of hemodialysis （HD）and hemodiafiltration（HDF） on pentosidine（PENT） and middle molecular substances （MMS ）in diabetic kidney disease （DKD ） uremic patients.Methods 36 cases of DKD uremic hemodialysis pa-tients met the inclusion criteria were divided into 2 groups：HD group （n=24 ） ,HDF group （n=12 ）.Before and after each conven-tional therapy ,blood was sampled for BUN ,MMS ,PENT.Each dialysis adequacy （KT/V） was calculated by the Daugirdas formu-la .Results The BUN in each group was significantly decreased （ P〈0.01） ,KT/V was more than 1.3 ,and there were no significant differences among the rates of BUN and KT/V descending among groups.Each group could partially reduce the levels of serum MMS , PENT ,but HDF did better than HD （ P〈0.05 ）.Conclusions In terms of clearing MMS ,PENT for DKD-caused patients ,HDF is better than conventional HD.