Abstract

Background: To observe the impact of different incident dialysis modalities on the cardiac structure and function of elderly uremic patients.

Methods: After screening, 79 elderly dialysis patients were included, including 29 hemodialysis (HD) patients, 26 HD plus hemodiafiltration (HD+HDF) patients, and 24 HD plus hemoperfusion (HD+HP) patients. The β2-microglobulin (β2-MG) and intact parathyroid hormone (iPTH) levels were measured before the initial dialysis and 6 months afterward; at the same time, cardiac structure and function were documented by echocardiography.

Results: There were significant differences in the levels of plasma β2-MG and iPTH 6 months later in the HDF and HP groups (all p < 0.05). After 6 months of treatment, the left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) decreased in the HP group, while the ejection fraction (EF) increased significantly in both the HP and HDF groups (all p < 0.05). The EFs in the HP and HDF groups were significantly higher than that in the HD group, while the LVESV and LVEDV in the HP group were significantly lower than those in the HD group (all p < 0.05). The differences in LVEDV, E/A, and EF in the HP and HDF groups were greater than those in the HD group (all p < 0.05).

Conclusion: HP and HDF can clear β2-MG and iPTH, and improve the cardiac structure and functional efficiency in elderly uremic patients.