# High-flux hemodialysis combined with nutritional intervention: Effects on the nutritional status and clinical outcomes of patients with renal failure

## TL;DR

High-flux hemodialysis with nutritional support improves kidney patients' health by reducing toxins, inflammation, and boosting survival.

## Contribution

Combining high-flux hemodialysis with nutritional intervention is shown to improve clinical outcomes in renal failure patients.

## Key findings

- High-flux hemodialysis with nutrition support reduces uremic markers and inflammation more effectively than conventional methods.
- The observation group had better survival rates and improved nutritional parameters compared to controls.
- Elevated IL-6 and TNF-α levels were identified as independent predictors of poor outcomes.

## Abstract

To evaluate the association between high-flux–based hemodialysis prescription combined with nutritional intervention and nutritional status and clinical outcomes in renal failure patients.

Patients admitted between January 2020 and August 2024 were divided into an observation group (high-flux hemodialysis, n = 115) and a control group (Conventional blood purification, n = 115). Renal function [β2-microglobulin (β2-MG), serum creatinine (Scr), blood urea nitrogen (BUN)], inflammatory markers [interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α)], and nutritional indices [serum albumin (ALB), prealbumin (PA), transferrin (SF)] were compared. Cox multivariate analysis identified prognostic factors.

Both groups exhibited post-treatment reductions in uremic markers (β2-MG: P < 0.05; Scr: P < 0.05; BUN: P < 0.05) and inflammation (IL-6: P < 0.05; CRP: P < 0.05; TNF-α:P < 0.05), with no baseline differences (P > 0.05). The observation group demonstrated significantly greater reductions in uremic markers and inflammatory markers versus controls (P < 0.05). Nutritional parameters (ALB, PA, SF) increased post-treatment in both groups (P < 0.05). Survival rates were higher in the observation group (P < 0.05). Deceased patients were predominantly≥60 years old, had cardiovascular comorbidities, and exhibited higher conventional blood purification utilization (P < 0.05).Lower ALB (P < 0.05) and elevated IL-6, CRP, TNF-α (P < 0.05) correlated with mortality.A reduced Cox model identified IL-6 (HR: 1.107, 95%CI: 1.063–1.153) and TNF-α (HR: 1.069, 95%CI: 1.012–1.130) as independent predictors of poor outcomes (P < 0.05).

High-flux-based hemodialysis prescription with nutritional support was associated with more effective clearance of uremic markers, improvements in nutritional status and inflammatory response, as well as better survival in renal failure patients. Elevated IL-6 and TNF-α levels were identified as significant predictors of mortality in the reduced Cox model.