ĐÁNH GIÁ KẾT QUẢ LỌC MÁU HẤP PHỤ KẾT HỢP LỌC MÁU THƯỜNG QUY TRÊN BỆNH NHÂN LỌC MÁU CHU KỲ TẠI BỆNH VIỆN LÊ VĂN THỊNH

Abstract

Background: In patients with end-stage renal disease (ESRD), conventional hemodialysis does not effectively eliminate medium molecular weight toxins like β2-microglobulin, phosphorus, and PTH. These contribute to chronic symptoms such as pruritus, insomnia, and musculoskeletal pain. Objective: To evaluate the effectiveness of hemoperfusion on biochemical parameters (urea, creatinine, phosphate, parathyroid hormone, and β2-microglobulin) and clinical symptoms (pruritus, bone and joint pain, and insomnia) in patients undergoing maintenance hemodialysis. Methods: A cross-sectional study was conducted on 39 ESRD patients at the Hemodialysis Department of Le Van Thinh Hospital from April to September 2024. Each patient underwent hemoperfusion using the  cartridge once a month for three consecutive months. Biochemical parameters (urea, creatinine, phosphorus, PTH, β2-microglobulin) and clinical symptoms (itching, pain, insomnia) were measured before and after treatment. Results: After the first session, urea, creatinine, phosphorus, and PTH significantly decreased (p < 0.001). β2 microglobulin also showed a significant reduction (p = 0.005). Clinical symptoms improved notably: Pain reduced from 3.15 ± 1.2 to 1.74 ± 0.9 (p < 0.001); Itching from 3.95 ± 1.1 to 2.44 ± 0.8 (p < 0.001); Insomnia from 4.08 ± 1.3 to 2.97 ± 1.0 (p < 0.001). These effects remained stable after 3 months. Conclusion: Hemoperfusion has been shown to improve both biochemical markers and clinical symptoms in patients with end-stage renal disease (ESRD). This technique should be widely implemented in dialysis units.