{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T18:14:12Z","timestamp":1774635252531,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018557","name":"Science and Technology Project of Nantong City","doi-asserted-by":"publisher","award":["MSZ2023047"],"award-info":[{"award-number":["MSZ2023047"]}],"id":[{"id":"10.13039\/501100018557","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n To evaluate the association between high-flux\u2013based hemodialysis prescription combined with nutritional intervention and nutritional status and clinical outcomes in renal failure patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients admitted between January 2020 and August 2024 were divided into an observation group (high-flux hemodialysis, n\u2009=\u2009115) and a control group (Conventional blood purification, n\u2009=\u2009115). Renal function [\u03b22-microglobulin (\u03b22-MG), serum creatinine (Scr), blood urea nitrogen (BUN)], inflammatory markers [interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-\u03b1 (TNF-\u03b1)], and nutritional indices [serum albumin (ALB), prealbumin (PA), transferrin (SF)] were compared. Cox multivariate analysis identified prognostic factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Both groups exhibited post-treatment reductions in uremic markers (\u03b22-MG: P\u2009<\u20090.05; Scr: P\u2009<\u20090.05; BUN: P\u2009<\u20090.05) and inflammation (IL-6: P\u2009<\u20090.05; CRP: P\u2009<\u20090.05; TNF-\u03b1:P\u2009<\u20090.05), with no baseline differences (P\u2009>\u20090.05). The observation group demonstrated significantly greater reductions in uremic markers and inflammatory markers versus controls (P\u2009<\u20090.05). Nutritional parameters (ALB, PA, SF) increased post-treatment in both groups (P\u2009<\u20090.05). Survival rates were higher in the observation group (P\u2009<\u20090.05). Deceased patients were predominantly\u226560 years old, had cardiovascular comorbidities, and exhibited higher conventional blood purification utilization (P\u2009<\u20090.05).Lower ALB (P\u2009<\u20090.05) and elevated IL-6, CRP, TNF-\u03b1 (P\u2009<\u20090.05) correlated with mortality.A reduced Cox model identified IL-6 (HR: 1.107, 95%CI: 1.063\u20131.153) and TNF-\u03b1 (HR: 1.069, 95%CI: 1.012\u20131.130) as independent predictors of poor outcomes (P\u2009<\u20090.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 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-\u03b1 levels were identified as significant predictors of mortality in the reduced Cox model.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0345943","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:28:22Z","timestamp":1774632502000},"page":"e0345943","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-flux hemodialysis combined with nutritional intervention: Effects on the nutritional status and clinical outcomes of patients with renal failure"],"prefix":"10.1371","volume":"21","author":[{"given":"Yang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongrong","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1471-0633","authenticated-orcid":true,"given":"Xuehua","family":"Pu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1887-872X","authenticated-orcid":true,"given":"Yaqing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binbin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"12","key":"pone.0345943.ref001","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1159\/000523761","article-title":"Blood 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Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome)","volume":"15","author":"P Stenvinkel","year":"2000","journal-title":"Nephrol Dial Transplant"},{"issue":"3","key":"pone.0345943.ref015","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1159\/000126926","article-title":"Cytokine dysregulation in chronic kidney disease: how can we treat it?","volume":"26","author":"JJ Carrero","year":"2008","journal-title":"Blood Purif"},{"issue":"10","key":"pone.0345943.ref016","first-page":"85","article-title":"Effects of individualized nutritional intervention on nutritional status and quality of life of dialysis patients with chronic renal failure","volume":"29","author":"Y LI","year":"2023","journal-title":"China Food and Nutrition"},{"issue":"2","key":"pone.0345943.ref017","doi-asserted-by":"crossref","first-page":"2276911","DOI":"10.1080\/0886022X.2023.2276911","article-title":"The correlation between serum growth differentiation factor 15 and malnutrition in patients with end-stage kidney disease on hemodialysis","volume":"45","author":"L Ling","year":"2023","journal-title":"Ren Fail"},{"issue":"2","key":"pone.0345943.ref018","first-page":"199","article-title":"Effects of high-throughput hemodialysis on microinflammatory response and blood purification indexes in elderly patients with chronic renal failure","volume":"47","author":"Q Luo","year":"2023","journal-title":"Guizhou Medicine"},{"issue":"48","key":"pone.0345943.ref019","article-title":"Efficacy and safety of Shenkang injection in the treatment of chronic renal failure: A protocol of a randomized controlled trial","volume":"100","author":"J Mei","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"pone.0345943.ref020","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/jorc.12378","article-title":"Protein energy wasting and long-term outcomes in nondialysis dependent chronic kidney disease","volume":"48","author":"BB Franco","year":"2022","journal-title":"J Ren Care"},{"issue":"4","key":"pone.0345943.ref021","first-page":"365","article-title":"Effects of different blood purification methods on nutritional status and inflammatory response in elderly patients with chronic renal failure","volume":"46","author":"Y Xie","year":"2023","journal-title":"Chinese J Continuing Medical Educ"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0345943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:28:25Z","timestamp":1774632505000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0345943"}},"subtitle":[],"editor":[{"given":"Tarek Samy","family":"Abdelaziz","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0345943","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]}}}