Objective: To explore the efficacy and mechanism of hemoperfusion (HP) plus hemodialysis (HD) for peripheral neuropathy of uremic patients on maintenance hemodialysis.
Methods: A total of 66 uremic patients on hemodialysis during January 2014 and April 2011 were assigned randomly into HP+HD, low-flux HD and high-flux HD groups (n=22 each). The serum levels of leptin, endothelin-1 (ET-1), parathyroid hormone (PTH) and β-2 microglobulin were observed pre and post-treatment. And sensory conduction velocity (SCV) was detected simultaneously.
Results: After 12-week treatment, the clinical symptoms of group HP+HD improved significantly with an effective rate of 90.91% while improvement was not obvious in groups high-flux and low-flux HD with effective rates of 31.82% and 13.64%. In HP+HD group, the levels of leptin, ET-1, PTH and β-2MG decreased, sensory conduction velocity increased (P<0.05) and clinical symptoms improved apparently. While in low-flux HD and high-flux HD groups, leptin, ET-1, PTH and β-2MG had no decrease and SCV showed no improvement (P>0.05). Correlation analysis showed that the levels of leptin, ET-1 and β-2MG were negatively correlated with SCV (r=-0.57, r=-0.47, r=-0.56). Yet PTH had no correlation with SCV (r=-0.23).
Conclusion: Hemoperfusion plus hemodialysis may improve the clinical symptoms of peripheral neuropathy of uremic patients on maintenance hemodialysis. And it is probably due to the fact that HP+HD effectively removes such plasma middle and macromolecular toxins as leptin, ET-1, PTH and β-2MG.