NGHIÊN CỨU SỰ THAY ĐỔI NỒNG ĐỘ Β2-MICROGLOBULIN, PARATHYROID HORMONE, UREA, CREATININE AND PHOSPHATE MÁU TRƯỚC VÀ SAU LỌC MÁU HẤP PHỤ HA 130 TRÊN BỆNH NHẬN SUY THẬN MẠN GIAI ĐOẠN CUỐI

Abstract

Background: In recent years, some studies have confirmed that hemoperfusion (HP) combined with HD in the treatment of end-stage kidney diseases (ESRD) patients can the complementary elimination of midle and large molecule weight uremic toxines and protein-bound uremic toxin (such as homocystein, parathyroid hormon, ß2-microglobulin, etc) in pathological progress. Objective: Evaluate the change of serum ß2-microglobulin (β2-M), parathyroid hormone (PTH), ure, creatinine and phosphate concentrations before and after using hemoperfusion HA 130 in patients with ESRD. Materials and Methods: cross-sectional study capture data at two points in time: before and after use HD plus HP HA 130. Total 147 ESRD patients using artificial renal periodic dialysis at Artificial Kidney Department at Le Van Thinh hospital, Thu Duc city from Juanary to September 2024 were recruited in this study. All of them were tested serum ß2-M, PTH, urea, creatinine and phosphate concentrations before use HD. In which, 42 people met with our inclusion criteria were assessed the same laboratory panels before and after use HD plus HP HA 130. Exclusion criteria: heart failure or myocardial infarction, active malignancy, coagulation dysfunction, thrombocytopenia, filter allergy…. Results: The average age of the survey group was 54,5 ± 16,1 years, and the patient’s gender were equal. The average concentration of ß2-M, PTH, urea, creatinine and phosphate has increased highly before use HD for 147 patients (ß2-M: 27470,65 ± 4659,12µg/L; PTH: 504,84 ± 683,02pg/mL; urea: 137,87 ± 37,45mg/dL; creatinine: 10,75 ± 3,25g/dL; phosphate: 2,12 ± 0,61mmol/L). Before and after use HD and HP HA 130 for 42 patients, the concentration of substances has decreased: ß2-M: 28759±4529 → 25949±8171µg/L; PTH: 876 ± 931 → 436 ± 558pg/mL; urea: 177 ± 212 → 47 ± 24mg/dL; creatinine: 10,7 ± 2,9 → 4,1 ± 1,7mg/dL;phosphate: 2,2 ± 0,6 → 0,95 ± 0,31mmol/L. There were statistically significant differences about the concentration between two times of testing (p<0,001). Conclusion: On ESRD patients the concentration of ß2-M, PTH, urea, creatinine and phosphate has increased highly. The concentrattion of substrates after use HP HA-130 has decreased, the difference has statistical meaning (p<0,001).