Different Dialysis Methods On Renal Osteodystrophy-related Factors Such As Phosphorus,Calcium,PTH,ALP And β₂-Microglobulin

ObjectiveComparison of different dialysis modalities in the general hemodialysis (HD), hemofiltration (HD+HF), hemodiafiltration (HD+HDF) and high-flux hemodialysis (HFHD) in maintenance hemodialysis patients related to renal osteodystrophy factors, such as calcium(Ca), phosphorus(P), parathyroid hormone(PTH), alkaline phosphatase (ALP) and p2-microglobulin(β2-MG) and other effects of renal osteodystrophy in a patient. Select the best way to improve dialysis results in improving the quality of life of dialysis patients.MethodsSelect from January 2009 to March 2010 in our hospital hemodialysis center line of hemodialysis patients 64 cases were consistent with K/DOQI renal osteopathy The main clinical manifestations of skin itching, metastatic calcification, joint, bone lesions, and biochemical indicators of high serum phosphorus, low calcium and parathyroid hormone increased bone mineral density examination showed decreased bone mineral densityfive diagnostic criteria.20 cases of chronic glomerulonephritis, hypertensive nephropathy in 16 cases,17 cases of diabetic kidney, polycystic kidney in 3 cases,7 cases of obstructive nephropathy, gouty nephropathy in 1 case.35 males and 29 females. Aged 35 to 85 years, the average age 67.61±0.11 years, through age 3 to 100 months, the average through age 59.09±0.44 months. Selected patients with stable disease, excluding cancer, systemic autoimmune diseases, infections, severe liver disease and other diseases. Dialysis three times a week, every 4 hours. Patients using JH2000, JH2028 and JH3038 dialysis machine, using bicarbonate dialysate, dialysate flow rate 500-800ml/min Germany Faison selected by the Sri Lankan F6 dialyzer, APS high flux dialyzer, by dialysis into ordinary hemodialysis (HD), hemofiltration (HD+HF), (weekly time), hemodiafiltration (HD+HDF) (weekly time) and high-flux hemodialysis (HFHD) four groups, other dialysis parameters (the number of dialyzer, blood flow, ultrafiltration volume, duration of dialysis remain relatively stable) per cycle through the peripheral venous blood test taken before the serum phosphorus, calcium, PTH,β2-microglobulin, calcium and phosphorus product calculated using the self-control, group control mode, the data presented as mean±standard deviation (x±s) that for each set of data normality and homogeneity of variance test. Each set of data normality test and homogeneity of variance test. Meet the test of normality and homogeneity of variance test, Own comparison uses pairs the T-test, the groups were compared with a decline in the rate of the relevant factor randomized complete block SNK test, analysis of P<0.05 statistically significant difference.ResultsFour kinds of Dialysis except HD on PTH, P2-Microglobulin can remove, the high flux hemodialysis is more effective than the other 3 kinds of dialysis on the clearance rate of PTH andβ2-microglobulin. On the impact of PTH:decreased rate of 35.78±17.12, before and after treatment was significantly (a=0.05, P<0.05). Of theβ2-microglobulin:decreasing rate of 68.89±17.45, before and after treatment was significantly (a=0.05, P<0.05).ConclusionHigh-flux hemodialysis, hemofiltration can effectively reduce serum phosphorus levels, lower calcium and phosphorus product, high clearance rat of parathyroid hormone (PTH) andβ2-microglobulin (β2-MG), thus improving calcium and phosphorus metabolic disorders.