The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

Figures & data

Table 1. Treatment characteristics of patients undergoing two experimental HDHP.

Parameters	EHDHP	LHDHP	p Value^a
Treatment duration (min)	239 ± 10	240 ± 8.0	0.729
Blood flow rate
Hemoperfusion plus  hemodialysis (mL/min)	175 ± 12	178 ± 14	0.471
Hemodialysis (mL/min)	250 ± 10	248 ± 5.5	0.535
Pre-HDHP body weight (kg)	65.20 ± 15.29	64.90 ± 16.78	0.954
Ultrafiltration volume (mL)	2450 ± 386.24	2410 ± 369.65	0.936

Notes: Data are depicted as means ± SD.

^aStudent’s t-test for unpaired data.

Figure 1. The comparison of the RR for small water-soluble solutes between two HDHP modes. Data are depicted as % (means ± SD). There were no significant differences in RR of urea and Cr between two methods. Cr, creatinine.

Table 2. Uremic toxins concentrations in pre-HDHP and post-HDHP specimens.

		EHDHP			LHDHP
	MW (Da)	Before	After	p Value^a	Before	After	p Value^a
Cr (µmol/L)	113	762.3 ± 232.8	292.0 ± 88.4	<0.001	757.5 ± 223.4	345.7 ± 64.5	<0.001
Urea (mmol/L)	60.1	22.5 ± 7.3	6.4 ± 2.1	<0.001	20.1 ± 7.8	5.6 ± 1.8	<0.001
PTH (pg/L)	9500	520.9 ± 186.0	412.9 ± 123.4	0.037	634.7 ± 199.0	448.7 ± 154.5	0.002
β2-M (mg/L)	11,800	66.2 ± 17.2	53.1 ± 15.8	0.017	68.4 ± 20.3	40.4 ± 12.1	<0.001
IL-1 (ng/L)	17,500	222.7 ± 56.8	136.7 ± 32.3	<0.001	229.5 ± 64.2	116.4 ± 23.2	<0.001
IL-6 (ng/L)	23,000	178.7 ± 49.1	138.3 ± 28.9	0.003	176.9 ± 35.8	125.4 ± 23.8	<0.001
TNF-α (ng/L)	17,000	77.8 ± 17.3	48.2 ± 11.8	<0.001	77.0 ± 16.4	42.0 ± 11.0	<0.001

Notes: Data are depicted as means ± SD. No statistical significance of uremic toxins concentrations at start of each HDHP mode (all p > 0.05). Cr, creatinine; PTH, parathyroid hormone; β₂-M, Beta 2 microglobulin; IL-1, interleukin-1; IL-6, interleukin-6; TNF-α, tumor necrosis factor α; MW, molecular weight.

^aPaired-sample Student’s test for uremic toxins concentrations comparisons between pre-HDHP and post-HDHP. The concentrations of toxins with molecular weight larger than 0.5 kDa were corrected for hemoconcentration because of ultrafiltration, see “Materials and methods” section.

Figure 2. The comparison of the RR for middle-sized molecules between two HDHP modes. The concentrations of middle-sized molecules were corrected for hemoconcentration because of ultrafiltration, see “Materials and methods” section. Data are depicted as % (means ± SD). *p < 0.05 versus EHDHP. PTH, parathyroid hormone; β2-M, Beta 2 microglobulin.

Figure 3. The comparison of the RR for cytokines between two HDHP modes. The concentrations of cytokines were corrected for hemoconcentration because of ultrafiltration, see “Materials and methods” section. Data are depicted as % (means ± SD). *p < 0.05 versus EHDHP. IL-1, interleukin-1; IL-6, interleukin-6; TNF-α, tumor necrosis factor.

Table 3. Interdialytic events during HDHP treatments.

Event	EHDHP	LHDHP	p^a Value
Number of dialysis sessions	20	20
Symptoms [No. (%)]
Any type	9(45)	13(65)	0.341
Symptomatic hypotension	4(20)	6(30)	0.716
Cramps	3(15)	4(20)	1.000
Chest pain	2(10)	3(15)	1.000

Note: No. (%); a, test.