Effect Of Maintenance Peritoneal Dialysis And Hemodialysis On Serum Ca, P And IPTH In Uremic Patients

Objective: To observe the effects of continuous ambulatory peritoneal dialysis(CAPD),low-flux hemodialysis(LFHD),and high-flux hemodialysis(HFHD)on calcium and phosphorus metabolism and total parathyroid hormone(iPTH)in patients with uremia It guides the choice of dialysis methods for uremic patients.Methods:Collection of 204 patients with uremia in the hospital affiliated to Qinghai University from December 2014 to December 2017,According to the dialysis method,they were divided into LFHD group,HFHD group and CAPD group,including 67 in LFHD group,60 in HFHD group and 77 in CAPD group.The demographics and calcium,phosphorus,iPTH and other biochemical indicators were compared before and after 12 months of blood purification treatment,and statistical analysis was carried out to draw conclusions.Results:1.There was no significant difference in serum calcium,phosphorus,iPTH and other biochemical indexes before the first treatment(p>0.05).There was no significant difference in serum calcium between the three groups after 12 months of treatment(p>0.05).After treatment,the serum calcium levels of the three groups were higher than those before treatment(p<0.05).3.There was a statistically significant difference in serum phosphorus between the three groups after 12 months of treatment(p<0.05).The mean serum phosphorus level was lower in the CAPD group than in the other two groups(p<0.05).Serum phosphorus levels in the CAPD group and the HFHD group were lower than those before treatment after 12 months of treatment,and the difference was statistically significant(p<0.05).4.There was no statistical difference in serum iPTH levels between the three groups after 12 months of treatment(p>0.05).There was no significant difference in serum iPTH levels between the LFHD group before and after 12 months of treatment(p>0.05).The mean iPTH values in the CAPD group and the HFHD group were lower than those before treatment,and the difference was statistically significant(p<0.05).After 12 months of treatment,the total cholesterol in the CAPD group and the HFHD group was statistically different(p<0.05).There were significant differences in TC levels between the CAPD group and the LFHD group(p<0.05).There was no statistical difference in blood TC levels between the HFHD group and the LFHD group(p>0.05),and the mean serum TC water was higher in the CAPD group than in the other two groups.There was no significant difference in serum TC level after treatment for 12 months(p>0.05).6.There was a statistically significant difference in serum albumin levels between the CAPD group and the HFHD group after 12 months of treatment(p<0.05).There was a statistically significant difference in serum ALB levels between the CAPD group and the LFHD group(p<0.05),and the CAPD group was lower than the other two groups.There was no significant difference in serum ALB levels between the HFHD group and the LFHD group(p>0.05).After 12 months of treatment,serum ALB levels in the HFHD group and the LFHD group were higher than before treatment.The serum ALB level in the CAPD group was lower than that before treatment,and the difference was statistically significant(p<0.05).Conclusion:1.Compared with LFHD,CAPD and HFHD treatment can effectively remove serum P.In terms of P clearance,CAPD is superior to HFHD.However,there were no differences in Ca and iPTH clearance between the LFHD,CAPD,and HFHD dialysis methods.2.CAPD is more prone to hypoproteinemia than HFHD and LFHD.