Effect of Combination Hemodialysis Hemoperfusion on Lowering Leptin Level in Patients with Kidney Failure Receiving Routine Hemodialysis: A Multi-Center Study
Ilsya Asti Naraswari(1), Metalia Puspitasari(2*), Yulia Wardhani(3)
(1) Internal Medicine Specialist Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Sardjito Hospital
(2) Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Sardjito Hospital
(3) Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Sardjito Hospital
(*) Corresponding Author
Abstract
Background: Leptin clearance during conventional haemodialysis (HD) has been found to be minimal or absent. Some authors reported the possibility of decreasing leptin serum levels with high flux membranes, but limited date are available. Leptin has been reported as a marker of inflammation and long-term complications such as cardiovascular events leading to increased quality of life deterioration. Haemodialysis hemoperfusion (HD+HP) has been reported to effectively decrease middle-sized and macromolecular toxin concentrations. In the present study, we compared the effectiveness of high-flux HD and HD + HP can effectively remove serum leptin levels, and is expected to reduce cardiovascular events in patients with kidney failure.
Objective: To assess the influence of HD+HP therapy on serum leptin level in routine haemodialysis patients.
Metode: Quasi experimental with pre and post exposure measurements in 26 kidney failure patients who received routine HD at three hospital sites were selected according to inclusion criteria and divided into intervention group (HD twice a week + Hemoperfusion once a week) and control group (HD twice a week). Serum leptin levels were compared before and after 8 weeks of therapy, and differences were then compared from each group.
Result: Leptin levels reduced significantly (p = 0.017) in the control group (High-Flux HD). Serum leptin levels decreased in HD+HP group but there was no significant differences (p = 0.784). Significant differences were not observed between two modalities (HD and HD+HP) (p = 0.258).
Conclusion: Haemodialysis plus hemoperfusion once a week for 8 weeks was not found effectively lowering leptin level compared high-flux HD alone.Keywords
References
Dong L, Liu X, Qu L, Xue Q. Hemodialysis plus hemoperfusion on uremia and micro-inflammatory state. Int J Clin Exp Med [Internet]. 2020;13(4):2724–30. Available from: www.ijcem.com/
Korczynska J, Czumaj A, Chmielewski M, Swierczynski J, Sledzinski T. The causes and potential injurious effects of elevated serum leptin levels in chronic kidney disease patients. Int J Mol Sci. 2021;22(9):1–12.
Mandolfo S, Borlandelli S, Imbasciati E. Leptin and β2-microglobulin kinetics with three different dialysis modalities. International Journal of Artificial Organs. 2006;29(10):949–55.
van Tellingen A, Grooteman MPC, Schoorl M, ter Wee PM, Bartels PCM, Schoorl M, et al. Enhanced long-term reduction of plasma leptin concentrations by super-flux polysulfone dialysers. Nephrology Dialysis Transplantation [Internet]. 2004 May 1;19(5):1198–203. Available from: https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh122
Huu DN, Quy QDB, Thu HNT, The CP, Hong QNT, Duc LN, et al. A Combination of Hemodialysis with Hemoperfusion Helped to Reduce the Cardiovascular-Related Mortality Rate after a 3-Year Follow-Up: A Pilot Study in Vietnam. Blood Purif. 2021;50(1):65–72.
Chen SJ, Jiang GR, Shan JP, Lu W, Huang HD, Ji G, et al. Combination of maintenance hemodialysis with hemoperfusion: A safe and effective model of artificial kidney. International Journal of Artificial Organs. 2011;34(4):339–47.
Ronco C BR. Hemoperfusion: technical aspects and state of the art. Crit Care. 2022.
Noor S, Alam F, Fatima SS, Khan M, Rehman R. Role of leptin and dyslipidemia in chronic kidney disease. Pak J Pharm Sci. 2018;31(3):893–7.
Lee MC, Chen YC, Ho GJ, Shih MH, Chou KC, Hsu BG. Serum leptin levels positively correlate with peripheral arterial stiffness in kidney transplantation patients. Transplant Proc. 2014;46(2):353–8.
Liu S, Liu H, Wang Z, Teng L, Dong C, Gui T, et al. Effect of changing treatment to high-flux hemodialysis (HFHD) on mortality in patients with long-term low flux hemodialysis (LFHD): a propensity score matched cohort study. BMC Nephrol. 2020;21(1):4–9.
Cai W, Miao S, Wang P, Xing L. [Efficacy and mechanism of hemoperfusion plus hemodialysis for peripheral neuropathy of uremic patients on maintenance hemodialysis]. Zhonghua Yi Xue Za Zhi [Internet]. 2015 May 5;95(17):1319–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26081662
Cheng W, Luo Y, Wang H, Qin X, Liu X, Fu Y, et al. Survival Outcomes of Hemoperfusion and Hemodialysis versus Hemodialysis in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis. Blood Purif. 2021;213–25.
Zhao D, Wang Y, Wang Y, Jiang A, Cao N, He Y, et al. Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus. Blood Purif [Internet]. 2022;51(10):812–22. Available from: https://www.karger.com/Article/FullText/525225
Schiffl H. High-Flux Dialyzers, Backfiltration, and Dialysis Fluid Quality. Semin Dial. 2011;24(1):1–4.
DOI: https://doi.org/10.22146/actainterna.101288
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