BackgroundTo evaluate the clinical efficacy of supra‐hemodiafiltration with endogenous reinfusion (Supra‐HFR) for pruritus in uremic maintenance hemodialysis (HD) patients and explore the possible mechanism.MethodsThis study prospectively included 60 patients with uremia who underwent maintenance hemodialysis and developed pruritus. Patients were randomly divided into a study group (30 cases) and a control group (30 cases). Patients in the study group underwent dialysis once a week with Supra‐HFR and twice a week with HD. The group received HD dialysis 3 times a week. Visual analog scales (VAS) scores, 5‐D itch scale scores, and 12‐Item Pruritus Severity Scale (12‐PSS) were used to evaluate the itching degree of patients. Quality of life was assessed using KDTA and SF‐36 scores. Blood levels of hypersensitive C‐reactive protein, calcium ion (Ca2+), phosphorus ion (P3+), free parathyroid hormone (iPTH), and β2‐microglobulin (β2‐MG) were compared between the two groups before treatment and at follow‐up 24 weeks after treatment.ResultsBefore treatment, there was no significant difference in VAS, 5‐D itch scale, and 12‐PSS score between the study group and the control group (all p > 0.05). After 24 weeks of treatment, the VAS score of the study group (2.82 ± 0.91) was significantly lower than that of the control group (7.47 ± 1.32, p < 0.001), the 5‐D itch scale score of the study group (9.47 ± 2.34) was significantly lower than that of the control group (18.53 ± 4.02, p < 0.001), the 12‐PSS score of the study group (11.20 ± 1.81) was significantly lower than that of the control group (16.47 ± 2.09, p < 0.001). KDTA of the study group (64.17 ± 8.07 vs. 47.83 ± 13.46, p < 0.001) and SF‐36 scores (65.37 ± 6.28 vs. 55.90 ± 14.28, p = 0.002) were significantly higher than that in the control group. The levels of hs‐CRP, P3+, iPTH, and β2‐MG in the study group after treatment were lower than those before treatment, and lower than those in the control group after treatment (all p < 0.05).ConclusionsThe Supra‐HFR can effectively reduce the itching symptoms of uremia patients and improve their quality of life.
Objective: To observe the effect of ticagrelor on the function of a tunneled cuffed catheter (TCC) in maintenance hemodialysis (MHD) patients.Methods: Eighty MHD patients (control group: 39 cases, observation group: 41 cases) using TCC as vascular access were enrolled from January 2019 to October 2020 in this prospective study. Patients in the control group were routinely treated with aspirin for antiplatelet therapy, while patients in the observation group were treated with ticagrelor. The catheter life time, catheter dysfunction, coagulation function, and antiplatelet drug-related adverse events of the two groups were recorded. Results:The median life time of TCC in the control group was significantly higher than that in the observation group. Moreover, the log rank test showed that the difference was statistically significant (p < 0.001). Conclusion:Ticagrelor may reduce the incidence of catheter dysfunction and prolong the life time of the catheter by preventing and reducing the thrombosis of TCC in MHD patients, without obvious side effects.
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