Hemoperfusion Union Hemodialysis Treatment for the Relationship betwen Insulin Resistance and Malnutrition in the End-stage Diabetic Nephropathy( ESDN) Patients

Objective: To explore hemoperfusion union hemodialysis treatment for the relationship among insulin resistance and micro-inflammation and malnutrition in the end-stage diabetic nephropathy( ESDN) patients. Methods: There were 75 patients with ESDN who were devided into three groups: 25 cases were treated by simply hemodialysis( HD group) in the first group, 28 cases were treated by hemodialysis combined with hemofiltration group( HD + HDF group)) in the second group and 22 were treated by cases hemodialysis series hemoperfusion group( HD + HP group) in the third group,To compare correlation with situations of patients who were before and after treatment in various groups including: insulin resistance,C-reactive protein( CRP),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),hemoglobin( Hb),serum albumin( Alb),fasting insulin( FINS),fasting blood glucose( FBS) and body mass index( BMI). To applicate Daugirdas formula for dialysis adequacy( KT / V) and analysis impact of hemoperfusion series hemodialysis treatment for ESDN patients,insulin resistance,micro-inflammation and malnutrition,including 16 cases of healthy people as a control group. Results: Before treatment,there was no significant difference from insulin resistance, inflammation and micro-nutrient status in three groups( P 0. 05),However,CRP,TNF-α and IL-6 in three groups were higher than those in the control group( P 0. 01); After 12 weeks hemoperfusion therapy,there were significantly association with hemoperfusion therapy and those indicators which were insulin resistance,CRP,TNF-α,IL-6,Hb,Alb and BMI; Insulin resistance and nutritional status were improved after HD + HP treatment( P 0. 05),there was statistical significance comparing with those only by HD and those by HD + HDF( P 0. 05); inflammatory factors were higher before treatment than after treatment,inflammatory factors in HD + HP group were significantly lower than the other two groups( P 0. 001),and higher than the normal control group( P 0. 05),there was statistical significance between only by HD and those by HD + HDF( P 0. 05),There was no statistical significance( P 0. 05) between those factors before and after treatment in HD group. Conclusion: ESDN patients treated by hemodialysis had those stiations that were insulin resistance,micro-inflammation and malnutrition. Hemoperfusion could effectively remove inflammatory mediators,reduce ESDN patients insulin resistance,and improve the nutritional status