INTRODUCTION Combined hemodialysis (HD) and hemadsorption (HA) therapy has shown the highest clearance rates for middle and large-sized uremic toxin molecules and reduced mortality rates among maintenance HD (MHD) patients. This study aims to investigate the effectiveness of combined HD and HA therapy in patients undergoing MHD. METHODS Forty patients with end-stage renal disease (ESRD) were divided into three groups: HD only (14), HD+biweekly HA (14), and HD+weekly HA (12). The duration of the study was 8 weeks. Uremic toxins (β2-microglobulin, leptin, parathyroid hormone), inflammatory markers (interleukin-6, C-reactive protein), and symptoms (appetite, pruritus, sleep quality) were assessed before the start and at the completion of therapy. Changes in the parameters were compared between the three groups. Mean differences of parameters in each group were also compared between before and after therapy. RESULTS Decrease in BUN level (-61.34 mg/dL [95% CI:-71.33 to -51.34], p <0.0001) and pruritus score (-3.93 [95% CI:-6.89 to -0.97], p=0.013) was significantly larger in HD+biweekly HA group compared to the others. Only HD + biweekly HA group showed significant reductions in CRP level (-0.10 mg/L [95%: -0.18 to -0.01], p=0.034), VAS appetite score (10.43 [95% CI: 4.99 to 15.87], p = 0.001), and pruritus score (-3.93 [95% CI: -6.89 to -0.97], p =0.013) after therapy. Both HD+biweekly HA (-2.79 [95% CI: -4.97 to -0.60], p=0.016) and HD+weekly HA group (-2.33 [95% CI: -4.59 to -0.08], p=0.044) exhibited a significant improvement in sleep quality score after therapy. CONCLUSIONS HD combined with a biweekly HA is associated with a greater reduction in BUN level and better improvement of pruritus in ESRD patients compared to HD alone. HD+biweekly HA can significantly reduce CRP levels, alleviate pruritus, improve appetite, and enhance sleep quality.

中文翻译：

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血液透析-血液吸附联合疗法在改善维持性血液透析患者尿毒症毒素清除、炎症标志物和症状方面的有效性。


简介 血液透析 (HD) 和血液吸附 (HA) 联合治疗显示出中型和大尺寸尿毒症毒素分子的清除率最高，并降低了维持性 HD (MHD) 患者的死亡率。本研究旨在探讨 HD 和 HA 联合治疗对 MHD 患者的有效性。方法 40 例终末期肾病 (ESRD) 患者分为三组：仅 HD（14 例）、HD+两周一次 HA（14 例）和 HD+每周 HA（12 例）。研究持续时间为8周。在治疗开始前和治疗完成时评估尿毒症毒素（β2-微球蛋白、瘦素、甲状旁腺激素）、炎症标志物（白介素-6、C-反应蛋白）和症状（食欲、瘙痒、睡眠质量）。比较三组之间的参数变化。还比较治疗前后各组参数的平均差异。结果 BUN 水平（-61.34 mg/dL [95% CI：-71.33 至 -51.34]，p <0.0001）和瘙痒评分（-3.93 [95% CI：-6.89 至 -0.97]，p=0.013）下降与其他组相比，HD+每两周一次的 HA 组明显更大。仅 HD + 每两周一次 HA 组的 CRP 水平（-0.10 mg/L [95%：-0.18 至 -0.01]，p=0.034）、VAS 食欲评分（10.43 [95% CI：4.99 至 15.87]，p）显着降低= 0.001）和治疗后瘙痒评分（-3.93 [95% CI：-6.89 至 -0.97]，p = 0.013）。 HD+每两周一次 HA (-2.79 [95% CI: -4.97 至 -0.60], p=0.016) 和 HD+每周 HA 组 (-2.33 [95% CI: -4.59 至 -0.08], p=0.044) 均表现出治疗后睡眠质量评分显着改善。结论 与单独 HD 相比，HD 联合每两周一次 HA 与 ESRD 患者 BUN 水平的更大降低和瘙痒的更好改善相关。 HD+每两周一次HA可显着降低CRP水平，缓解瘙痒，改善食欲，增强睡眠质量。