Clinical Efficacy of High-flux Hemodialysis for Treating Uremia and its Effect on Microinflammation and Nutritional Status

Authors

  • Fei Guo Department of Nephrology, Qinhuangdao Haigang Hospital, Qinhuangdao 066000, Hebei China. Author
  • Jiakang Sun Department of Nephrology, Qinhuangdao Haigang Hospital, Qinhuangdao 066000, Hebei China. Author
  • Deheng Wan Department of Nephrology, Qinhuangdao Haigang Hospital, Qinhuangdao 066000, Hebei China. Author
  • Yan Wang Department of Nephrology, Qinhuangdao Haigang Hospital, Qinhuangdao 066000, Hebei China Author

DOI:

https://doi.org/10.61882/ijkd.19.3.165

Keywords:

High-flux hemodialysis, Uremia, Clinical efficacy, Microinflammation, Nutritional status

Abstract

Introduction. The objective of this study was to evaluate the clinical efficacy of high-flux hemodialysis for treating uremia and its effect on microinflammation and nutritional status.
Methods. This was a case-control study. One hundred and twenty patients under chronic hemodialysis in Qinhuangdao Haigang Hospital from June 2021 to June 2023 were randomly divided into experiment group and control groups, with 60 patients in each group. Patients in the experiment group received high-flux hemodialysis (HFHD), while those in the control group underwent conventional hemodialysis. The differences between the two groups regarding clinical efficacy, inflammatory factors including 
IL-6, CRP and TNF-a, and macromolecular toxins including β2-microglobulin, parathyroid hormone, and cysteine protease inhibitor were compared. The levels of nutritional indices including serum transferrin, albumin, and hemoglobin were compared between the two groups after 6 months of therapy. All patients were followed- up for 1.5 to 2 years, and the incidence of their cardiovascular and cerebrovascular events after treatment was analyzed.
Results. The response rate (markedly effective + effective)/total number of cases × 100%.) was 93% in the experiment vs. 80% in the control group (P = .03). After treatment, IL-6, CRP, TNF-a, 
β2-microglobulin, parathyroid hormone, and cysteine protease inhibitor significantly reduced and serum transferrin, albumin and hemoglobin significantly improved in the experiment vs. control group (P = .00). At the end of the follow-up period the incidence of cardiovascular and cerebrovascular diseases was 7% in the experiment group, which was markedly lower than that of 22% in the control group (P = .02).
Conclusion. High-flux hemodialysis is a safe and effective treatment for uremia with remarkable clinical efficacy, offering various benefits such as significant reduction of inflammatory biomarkers and macromolecular toxins, improvement of patients’ nutritional status, and reduction of the incidence of cardiovascular and cerebrovascular diseases.

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References

REFERENCE

1. Imamah NF, Lin HR. Palliative Care in Patients with End-Stage Renal Disease: A Meta Synthesis. Int J Environ Res Public Health. 2021;18(20):10651.

2. Nagaraju SP, Shenoy SV, Gupta A. Frailty in end stage renal disease: Current perspectives. Nefrologia (Engl Ed). 2022;42(5):531-539.

3. Wark DM. Hypnosis and end-stage renal disease: Review and treatment. Am J Clin Hypn. 2020;63(1):36-48.

4. Kalantar-Zadeh K, Lockwood MB, Rhee CM, et al. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nat Rev Nephrol. 2022;18(3):185-198.

5. Maduell F, Rodas L, Broseta JJ, et al. High-permeability alternatives to current dialyzers performing both high-flux hemodialysis and postdilution online hemodiafiltration. Artif Organs. 2019;43(10):1014-1021.

6. Olsen E, van Galen G. Chronic Renal Failure-Causes, Clinical Findings, Treatments and Prognosis. Vet Clin North Am Equine Pract. 2022;38(1):25-46.

7. Blankestijn PJ, Vernooij RWM, Hockham C, et al. Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure. N Engl J Med. 2023;389(8):700-709.

8. Guerrero Riscos MA, Toro Prieto FJ, Batalha Caetano P, et al. Advanced chronic renal failure (ACRF) study. Baseline characteristics, evaluation of the application of the structured information for the election of renal replacement therapy and one-year evolution of the incident patients in the ACRF medical office. Estudio ERCA. Características basales, evaluación de la aplicación de la información estructurada para la elección de tratamiento renal sustitutivo y evolución a un año de los pacientes incidentes en la consulta ERCA. Nefrologia (Engl Ed). 2019;39(6):629-637.

9. Jiang X, Sun F, Huang H. Clinical Efficacy and Long-term Prognosis of High Flux Hemodialysis Combined with Different Frequency Hemodiafiltration in the Treatment of Middle-Aged and Elderly Patients with Uremia. Iran J Kidney Dis. 2024;1(1):36-44.

10. Mitchell CR, Hornig C, Canaud B. Systematic review to compare the outcomes associated with the modalities of expanded hemodialysis (HDx) versus high-flux hemodialysis and/or hemodiafiltration (HDF) in patients with end-stage kidney disease (ESKD). Semin Dial. 2023;36(2):86-106.

11. Hestekin CN, Pakkaner E, Hestekin JA, et al. High flux novel polymeric membrane for renal applications. Sci Rep. 2023;13(1):11703.

12. Kandi M, Brignardello-Petersen R, Couban R, et al. Effects of Medium Cut-Off Versus High-Flux Hemodialysis Membranes on Biomarkers: A Systematic Review and Meta-Analysis. Can J Kidney Health Dis. 2022;9:20543581211067090.

13. Navarro-García JA, Rodríguez-Sánchez E, Aceves-Ripoll J, et al. Oxidative Status before and after Renal Replacement Therapy: Differences between Conventional High Flux Hemodialysis and on-Line Hemodiafiltration. Nutrients. 2019;11(11):2809.

14. Vega-Vega O, Caballero-Islas AE, Del Toro-Cisneros N, et al. Improved β2-Microglobulin and Phosphorous Removal with Expanded Hemodialysis and Online Hemodiafiltration versus High-Flux Hemodialysis: A Cross-Over Randomized Clinical Trial. Blood Purif. 2023;52(7-8):712-720.

15. Abdelhamid WAR, Soliman MM, El-Hameed ARA. Effects of Low-Flux and High-Flux Dialysis Membranes on Erythropoietin Responsiveness in Hemodialysis Patients. Int J Nephrol. 2022;2022:2984193.

16. Wang Y, Gan LY, Yang B, et al. High-flux Hemodialysis Does Not Increase Vitamin B Loss Compared With Low-flux Hemodialysis. J Ren Nutr. 2023;33(5):676-681.

17. Soleimani A, Tabatabaei SH, Soleimani M, et al. Correlation Between Serum Homocysteine Levels and Carotid Intima-media Thickening in Hemodialysis Patients. Iran J Kidney Dis. 2023;17(4):222-227.

18. Molano AP, Hutchison CA, Sanchez R, et al. Medium Cutoff Versus High-Flux Hemodialysis Membranes and Clinical Outcomes: A Cohort Study Using Inverse Probability Treatment Weighting. Kidney Med. 2022;4(4):100431.

19. Sánchez-Álvarez E, Rodríguez-García M, Locatelli F, et al. Survival with low- and high-flux dialysis. Clin Kidney J. 2020;14(8):1915-1923.

20. Blankestijn PJ, Fischer KI, Barth C, et al. Benefits and harms of high-dose haemodiafiltration versus high-flux haemodialysis: the comparison of high-dose haemodiafiltration with high-flux haemodialysis (CONVINCE) trial protocol. BMJ Open. 2020;10(2):e033228.

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Published

2025-08-15

Issue

Section

ORIGINAL | Dialysis

How to Cite

Clinical Efficacy of High-flux Hemodialysis for Treating Uremia and its Effect on Microinflammation and Nutritional Status. (2025). Iranian Journal of Kidney Diseases, 19(03), 165-171. https://doi.org/10.61882/ijkd.19.3.165

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