Clinical Curative Effect of High Flux Hemodialysis on Diabetic Nephropathy and Impact on Patients' Insulin Resistance_West China Medical Journal

Authors：

 NieXiaodong , HuXinan , LiSimeng

Department of Nephrology, the Fourth People's Hospital of Yibin, Yibin, Sichuan 644001, P. R. China;

Corresponding?author：

Keywords：

High flux hemodialysis; Diabetic nephropathy; Clinical efficacy; Insulin resistance

DOI：

10.7507/1002-0179.201600364

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Objective To explore the clinical curative effect of high flux hemodialysis on diabetic nephropathy (DN) and impact on patients' insulin resistance (IR). Methods A total of 96 patients with DN meeting the inclusion criteria treated between January 2013 and January 2014 were selected. The patients were randomly divided in to the observation group and control group with 48 in each. The control group received low flux hemodialysis, while the observation group underwent high flux hemodialysis. Before the treatment and in the first half of the year after the treatment, the clinical renal function and inflammatory indexes, lipid metabolism, and glucose metabolism related markers were recorded, and IR index (HOMA-IR) were calculated and compared. Results Before and after the treatment, the Kt/V showed no significant change in the two groups (P > 0.05). Serum creatinine levels was lower after the treatment compared with that before the treatment in both of the two groups; in the observation group, C-reactive protein, interleukin-6 and tumor necrosis factorαwere significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). HOMA-IR and fasting insulin levels in the observation group after the treatment were significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). No significant changes of fasting plasma glucose and glycosylated hemoglobin levels in the two groups before and after the treatment in patients were found (P > 0.05). Conclusion High flux hemodialysis therapy is effective on DN, which can effectively remove the body and large molecular type of inflammatory mediators, alleviate the micro inflammatory state, improve the IR status and correct the lipid metabolic abnormalities.

Citation： NieXiaodong, HuXinan, LiSimeng. Clinical Curative Effect of High Flux Hemodialysis on Diabetic Nephropathy and Impact on Patients' Insulin Resistance. West China Medical Journal, 2016, 31(8): 1325-1328. doi: 10.7507/1002-0179.201600364 Copy

1.	劉曉斌, 王涼, 劉斌, 等.高通量血液透析對老年糖尿病腎病患者胰島素抵抗及微炎癥狀態的影響[J].中華老年醫學雜志, 2014, 33(2):159-162.
2.	張豫文, 洪潔.炎癥因子與胰島素抵抗[J].診斷學理論與實踐, 2010, 9(1):90-94.
3.	Kumar D, Agarwal S, Karoli R, et al. Relationship between carotid intima thickness and silent cerebral infarction in patients with type 2 diabetic nephropathy[J]. J Assoc Physicians India, 2014, 62(4):316-322.
4.	畢學青, 姜埃利, 魏芳, 等.高通量透析不同超濾量對溶質清除的影響[J].中國血液凈化, 2014, 13(10):713-716.
5.	劉紅, 常明, 劉書馨, 等.高通量血液透析改善尿毒癥患者的周圍神經病變[J].中華腎臟病雜志, 2011, 27(10):779-780.
6.	Yilmaz MI, Sonmez A, Saglam M, et al. Ramipril lowers plasma FGF-23 in patients with diabetic nephropathy[J]. Am J Nephrol, 2014, 40(3):208-214.
7.	向茜, 張弦, 郭燕, 等.糖尿病腎病患者心瓣膜鈣化特點分析[J].中華臨床醫師雜志:電子版, 2014, 3(1):375-379.
8.	Xu J, Lee ES, Baek SH, et al. Effect of bilirubin on triglyceride synthesis in streptozotocin-induced diabetic nephropathy[J]. J Korean Med Sci, 2014, 29(2):155-163.
9.	崔玲玲, 單新莉, 李虹, 等.糖尿病腎病誘導期透析心血管并發癥護理對策[J].中華全科醫學, 2014, 12(3):487-488.
10.	Musante L, Tataruch DE, Holthofer H, et al. Use and isolation of urinary exosomes as biomarkers for diabetic nephropathy[J]. Front Endocrinol (Lausanne), 2014, 26(5):149-150.
11.	凌扣榮, 周文芳, 江瑞, 等.糖尿病腎病患者血液透析合并肺部感染的危險因素分析[J].中華醫院感染學雜志, 2013, 23(24):5941-5942.
12.	Eknoyan G, Beek G, Cheung A. Hemodialysis (HEMO) Study Group. Effect of dialysis dose and membrane flux in maintenance hemodialysis[J]. N Engl J Med, 2002, 347(19):2010-2019.
13.	Sato E, Amaha M, Nomura M, et al. LDL-apheresis contributes to survival extension and renal function maintenance of severe diabetic nephropathy patients:a retrospective analysis[J]. Diabetes Res Clin Pract, 2014, 3(14):375-381.
14.	譚琴, 劉建彬, 劉娟, 等.糖尿病腎病與非糖尿病腎病患者應用葡萄糖透析液進行持續性非臥床腹膜透析的全天血糖譜比較[J].中華糖尿病雜志, 2013, 5(1):17-22.
15.	Kumar GS, Kulkarni A, Khurana A, et al. Selenium nanoparticles involve HSP-70 and SIRT1 in preventing the progression of type 1 diabetic nephropathy[J]. Chem Biol Interact, 2014, 6(223):125-133.

1. 劉曉斌, 王涼, 劉斌, 等.高通量血液透析對老年糖尿病腎病患者胰島素抵抗及微炎癥狀態的影響[J].中華老年醫學雜志, 2014, 33(2):159-162.
2. 張豫文, 洪潔.炎癥因子與胰島素抵抗[J].診斷學理論與實踐, 2010, 9(1):90-94.
3. Kumar D, Agarwal S, Karoli R, et al. Relationship between carotid intima thickness and silent cerebral infarction in patients with type 2 diabetic nephropathy[J]. J Assoc Physicians India, 2014, 62(4):316-322.
4. 畢學青, 姜埃利, 魏芳, 等.高通量透析不同超濾量對溶質清除的影響[J].中國血液凈化, 2014, 13(10):713-716.
5. 劉紅, 常明, 劉書馨, 等.高通量血液透析改善尿毒癥患者的周圍神經病變[J].中華腎臟病雜志, 2011, 27(10):779-780.
6. Yilmaz MI, Sonmez A, Saglam M, et al. Ramipril lowers plasma FGF-23 in patients with diabetic nephropathy[J]. Am J Nephrol, 2014, 40(3):208-214.
7. 向茜, 張弦, 郭燕, 等.糖尿病腎病患者心瓣膜鈣化特點分析[J].中華臨床醫師雜志:電子版, 2014, 3(1):375-379.
8. Xu J, Lee ES, Baek SH, et al. Effect of bilirubin on triglyceride synthesis in streptozotocin-induced diabetic nephropathy[J]. J Korean Med Sci, 2014, 29(2):155-163.
9. 崔玲玲, 單新莉, 李虹, 等.糖尿病腎病誘導期透析心血管并發癥護理對策[J].中華全科醫學, 2014, 12(3):487-488.
10. Musante L, Tataruch DE, Holthofer H, et al. Use and isolation of urinary exosomes as biomarkers for diabetic nephropathy[J]. Front Endocrinol (Lausanne), 2014, 26(5):149-150.
11. 凌扣榮, 周文芳, 江瑞, 等.糖尿病腎病患者血液透析合并肺部感染的危險因素分析[J].中華醫院感染學雜志, 2013, 23(24):5941-5942.
12. Eknoyan G, Beek G, Cheung A. Hemodialysis (HEMO) Study Group. Effect of dialysis dose and membrane flux in maintenance hemodialysis[J]. N Engl J Med, 2002, 347(19):2010-2019.
13. Sato E, Amaha M, Nomura M, et al. LDL-apheresis contributes to survival extension and renal function maintenance of severe diabetic nephropathy patients:a retrospective analysis[J]. Diabetes Res Clin Pract, 2014, 3(14):375-381.
14. 譚琴, 劉建彬, 劉娟, 等.糖尿病腎病與非糖尿病腎病患者應用葡萄糖透析液進行持續性非臥床腹膜透析的全天血糖譜比較[J].中華糖尿病雜志, 2013, 5(1):17-22.
15. Kumar GS, Kulkarni A, Khurana A, et al. Selenium nanoparticles involve HSP-70 and SIRT1 in preventing the progression of type 1 diabetic nephropathy[J]. Chem Biol Interact, 2014, 6(223):125-133.

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Clinical Curative Effect of High Flux Hemodialysis on Diabetic Nephropathy and Impact on Patients' Insulin Resistance

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