Objective   To investigate the influence of long-term blood purification on atherosclerosis (AS) in maintenance hemodialysis (MHD) patients by measuring serum levels of homocysteine (Hcy) and carotid artery intima-medial thickness (IMT).    Methods   Seventy-two MHD patients visiting our hospital from June 2006 to December 2007

according to their blood purification mode

were assigned to three groups: hemodialysis(HD

n=25)

hemodialysis+hemodiafiltration (HD+HDF

n=30)

hemodialysis+continuous renal replacement therapy (HD+CRRT

n=17). Another 25 healthy subjects served as controls. Serum Hcy was detected before and after one-year treatment and meanwhile color Doppler ultrasonography was performed to check IMT of carotid artery and atheromatous plaques.    Results   The serum levels of Hcy

IL-6

MCP-1

hs-CRP in MHD patients were significantly higher than those in healthy controls (P0.01). The serum levels of Hcy decreased after the treatment of HDF and CRRT (P0.01). After one-year treatment

IMT and area of carotid artery plaques in HDF and HD+CRRT groups were lower than those in HD group. Serum level of Hcy was associated with carotid artery IMT and area of carotid artery plaques (r=0.46

P0.05; r=0.52

P0.01).    Conclusion   Hcy may be an independent risk factor for cardiovascular disease. HD+HDF and HD+CRRT can clear Hcy effectively and improve the survival rate of MHD patients.