Abstract:

Objective To explore the therapeutic effect of levocarnitine combined with ultrapure dialysis on maintenance hemodialysis(MHD) patients and its effect on cardiac function and expression of irisin and Klotho protein(s-Klotho) in peripheral blood.
Methods A total of 186 MHD patients were divided into observation group and control group according to different treatment methods. The patients in the control group were given routine dialysis treatment, while those in the observation group were treated with levocarnitine combined with ultrapure dialysis. After 3 months, the quality of life, inflammatory factors, oxidative stress index, cardiac function, irisin and s-Klotho concentrations and complications were observed.
Results After treatment, the scores of SF-36 in the two groups were significantly higher than those before treatment, and the scores of SF-36 in the observation group were higher than those in the control group(P＜0.05); the levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) in the two groups were significantly lower than those before the treatment(P＜0.01), and the levels of IL-6, TNF-α and CRP in the observation group were lower than those in the control group(P＜0.05 or P＜0.01); the levels of SOD, MDA and GSH-Px in the two groups were significantly lower than before the treatment(P＜0.01), and the levels of SOD, MDA and GSH-Px in the observation group were significantly lower than those in the control group(P＜0.01). The levels of cardiac output(CO) and left ventricular ejection fraction(LVEF) in the two groups were significantly higher than those before treatment, and the levels of CO and LVEF in the observation group were significantly higher than those in the control group(P＜0.01), the levels of irisin and s-Klotho in the two groups were significantly higher than those before the treatment(P＜0.01), and the level of irisin and s-Klotho in the observation group was significantly higher than that in the control group(P＜0.01). The incidence of complications in the observation group was significantly lower than that in the control group(P＜0.01).
Conclusion Levocarnitine combined with ultrapure dialysis can significantly improve the inflammatory state and oxidative stress of MHD patients, improve their cardiac function, and reduce the expression of irisin and s-Klotho in peripheral blood.

Key words: renal dialysis, levocarnitine, iridoxin, Klotho protein