Effects of different hemodialysis modalities combined with low-calcium dialysate on mineral metabolism and vascular calcification in maintenance hemodialysis patients with chronic kidney disease

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Objective

This research looked at how different types of hemodialysis, when combined with low-calcium dialysate (LCD), affect mineral balance and blood vessel hardening in patients with chronic kidney disease (CKD) who are on maintenance hemodialysis (MHD).

Methods

Data was gathered from 192 MHD patients, who were divided into four groups. Each group received LCD treatment along with one of the following hemodialysis methods: conventional hemodialysis (HD), high-flux HD (HFHD), hemodiafiltration (HDF), or HD with hemoperfusion (HP). Treatments were done three times a week for four hours over six months. Blood samples were taken to measure various health markers, and CT scans were used to check for calcification in blood vessels.

Results

After treatment, levels of inflammation and mineral balance improved in all groups. The HD + HP group showed the greatest improvements, followed by HDF and HFHD groups. The rates of vascular calcification were lower in the HDF, HFHD, and HD + HP groups compared to the HD group, with the HD + HP group having the best results.

Conclusion

Using HD + HP along with LCD is effective for CKD patients on MHD. It helps correct mineral imbalances, improves kidney function, reduces inflammation, and lowers the risk of vascular calcification.

Opportunities for Clinics and Patients

Based on the trial data, clinics can set clear goals for improving patient outcomes by implementing the HD + HP method with LCD. Measurable outcomes include better mineral balance, reduced inflammation, and lower vascular calcification rates.