FP461
EFFECTS OF HEMOPERFUSION ON PROTEIN-BOUND UREMIC TOXIN CLEARANCE AND THE QUALITY OF LIFE IN MAINTENANCE HEMODIALYSIS PATIENTS

INTRODUCTION AND AIMS: Objective: To observe the effects of hemoperfusion(HP) on the clearance of protein-bound uremic toxins, middle and large-molecule uremic toxins and quality of life in maintenance hemodialysis patients(MHD).

METHODS: Methods: 36MHD patients were randomly divided into two equal-size groups. hemodialysis (HD) group were treated with low-flux hemodialysisthree times a week; HD+HP group were treated with regular low-flux hemodialysis twice a week and the combination of hemodialysis with hemoperfusion once a week. The follow-up period was 36 weeks. Serum calcium, phosphorus, intact parathyroid hormone (iPTH), serum albumin, hemoglobin, ferritin, transferrin saturation,β2-microglobulin (β2-MG), ,hippuric acid (HA),indoxylsulphate(IS), p-cresylsulphate (PCS),the dialysis adequacy Kt/V and Blood pressure were compared before and after the study,the Kidney Disease Quality of Life Short Form( KDQOL-SF1.3) scale was used to assess the quality of life.

RESULTS: Result: 1.The concentration of protein bound uremic toxins,including HA and PCS, and the middle and large-molecule uremic toxin β2-MG,were compared before and after study.HD group showed no statistical difference (p>0.05) for all three toxins (HA:p=0.747; PCS:p=0.861; β2-MG: p=0.236). However, their concentrations in HD+HP group were significantly decreased (p<0.05) after the 36-week treatment(HA: p=0.040; PCS: p=0.041; β2-MG: p<0.001). At the end of the study, The HD+HP group was significantly lower than the HD group for all three toxins (HA: p=0.045; PCS: p=0.048; β2-MG: p=0.015).2.The concentration of protein bound uremic toxin IS was significantly higher (p=0.035) in the HD group after the 36-week treatment, and there was no statistical difference in HD+HP group (p=0.332). There was no significant difference between the two groups at the end of the study (p=0.137). 3 In the comparison quality of life, the two measured parameters, bodily pain and vitality score were significantly lower after treatment, compared to the baseline in HD group, with p-values of 0.049 and 0.009, respectin-vely. In HD+HP group, the dialysis related symptoms, effect of kidney diseaseand vitality score increased significantly compared to the baseline, with p-values of 0.032,0.025 and0.034, respectively.The effects of kidney disease, cognitive function, sleep, physical function, bodily pain, general health, social function andvitality were significantly better in HD + HP group than in HD group(p-values of 0.043, 0.049, 0.047, 0.032, 0.042, 0.024, 0.043 and 0.015, respectively).

CONCLUSIONS: Conclusion:Long-term use of HD+HP in the removal of protein-bound uremic toxins and middle and large-molecule uremic toxins in MHD patientswas significantly better than conventional HD, while significantly improved the quality of life