Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

Abstract

Purpose: Uraemic pruritus (UP) is one of the most common complications in patients with end-stage renal disease (ESRD) undergoing dialysis and greatly undermines their quality of life. The present study was designed to compare the clinical effect of high-flux hemodialysis (HFHD) with hemodialysis filtration (HDF) in the treatment of UP in ESRD patients, and to explore the possible underlying mechanisms.

Materials and methods: In this 12-week randomized and controlled trial, the clinical efficacy of HFHD or HDF on UP patients undergoing dialysis was evaluated. A total of 51 uremia patients suffering from pruritus from January 2009 to May 2013 were recruited and randomly assigned to intervention (n = 27) and control (n = 24) groups. The control group was received only HDF therapy, and the intervention group underwent HFHD treatment three times a week for 12 weeks.

Results: The scores for Visual Analogue Scale in both two groups were obviously decreased, but the Visual Analogue Scale scores in the intervention group had a better improvement than the control group within 12 weeks. The PSQI and SF-12 values in the intervention group had a better improvement than the control group within 12 weeks. In comparison of the changes from baseline between the control groups, there was greater improvement in BUN, creatinine, calcium, phosphorus, PTH, β2-MG, histamine, CRP and IL-6 levels of intervention group.

Conclusions: Our results demonstrate that HFHD has a better efficacy in the treatment of UP than HDF. HFHD has an exactly therapeutical efficacy in the UP associated with the inhibition of microinflammation state in dialysis patients.

Keywords: End-stage renal disease; Hemodialysis; Inflammation; Pruritus; Uremia.