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Effects of different frequencies of hemodiafiltration combined with high⁃flux hemodialysis on renal function, micro⁃inflammatory state and left ventricular function in patients with diabetic nephropathy after maintenance hemodialysis
Received date: 2025-08-13
Online published: 2025-11-13
Objective To investigate the effects of different hemodiafiltration (HDF) frequencies combined with high-flux hemodialysis (HFHD) on renal function, micro-inflammatory status, and left ventricular function in patients with diabetic nephropathy who have undergone maintenance hemodialysis (MHD). Methods A total of 120 patients with diabetic nephropathy undergoing MHD between January 2022 and December 2024 were enrolled in the study and randomly divided into a study group and a control group using a random number table method, with 60 patients in each group. Both groups received HFHD. The control group received hemodiafiltration (HDF) once a month, whereas the study group received HDF once a week. The study evaluated the two groups in terms of therapeutic efficacy, renal function indices, calcium-phosphorus metabolism indices, micro-inflammatory status, left ventricular function indices, and the incidence of adverse reactions. Results The total response rate in the study group was significantly higher than that in the control group (P < 0.05). Following treatment, the levels of serum creatinine (Scr), cystatin C (Cys C), and 24-hour urine protein quantification (24hUP) in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the blood calcium level in the study group was higher, whereas the blood phosphorus level was lower compared to the control group (P < 0.05). Additionally, post-treatment levels of interleukin-8 (IL-8), IL-6, and tumor necrosis factor-α (TNF-α) in the study group were significantly reduced in comparison to the control group (P < 0.05). The study group also exhibited improved cardiac function after treatment, as evidenced by a higher left ventricular ejection fraction (LVEF), and reduced left ventricular end-diastolic diameter (LVDD) and left ventricular end-systolic diameter (LVSD) compared to the control group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups [8.33% (5/60) vs. 11.67% (7/60), P > 0.05]. Conclusion Combining once-weekly HDF with HFHD can enhance therapeutic outcomes and renal function, promote the recovery of calcium-phosphorus metabolism, alleviate the micro-inflammatory state, and improve left ventricular function in MHD patients with diabetic nephropathy.
Jing GAO , Jin ZHAO , Fan WANG , Kang. LIU . Effects of different frequencies of hemodiafiltration combined with high⁃flux hemodialysis on renal function, micro⁃inflammatory state and left ventricular function in patients with diabetic nephropathy after maintenance hemodialysis[J]. The Journal of Practical Medicine, 2025 , 41(21) : 3398 -3404 . DOI: 10.3969/j.issn.1006-5725.2025.21.015
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