Serum Parathyroidhormone Levels And Influencing Facors Analysis In Elderly Hemodialysis Patients

Objective: Analyze the abnormal situation and influencing factors ofparathyroid hormone levels in elderly hemodialysis patients.Methods: Select the maintenance hemodialysis patients over threemonths in a stable condition from the Second Affiliated Hospital ofChongqing Medical University’s blood purification center of duringDecember2013, exclude recent infection, severe cardiovascular andcerebrovascular events, bleeding, fractures, liver disease, autoimmunedisease, parathyroid resection, patients below the dry weight standards. Inpre-dialysis test hemoglobin (Hb), high-sensitivity C-reactive protein(Hs-CRP), calcium (Ca), phosphorus (P), triglycerides (TG), low densitylipoprotein (LDL), serum albumin (ALB), parathyroid hormone (iPTH),blood urea nitrogen (BUN) and serum creatinine (Scr) of the same beforeand after dialysis, calculate Kt/V value. The patients were divided intoelderly group (≥65years) and young group (<65years).Results：1. A total of116hemodialysis patients met criteria,67males,49 females, elderly group accounted for43(37.1%), young groupaccounted for73(63.9%),mean age59.5±16.9(20~89), with anaverage duration of dialysis was36.1±26.8(3~143) months. Of whichdiabetic nephropathy43cases, chronic glomerulonephritis33cases,hypertensive nephropathy27cases, polycystic kidney disease8cases, otherkidney disease5cases.2. In hemodialysis patients, iPTH <60pg/ml accounted for19(16.4%),60pg/ml≤iPTH <150pg/ml accounted for27(23.3%),150pg/ml≤iPTH≤300pg/ml accounted for34(29.3%),300pg/ml <iPTH≤600pg/ml accounted for21(18.1%), iPTH>600pg/ml accounted for15(12.9%).3. The primary cause of renal faliure in elderly group was diabeticnephropathy, young group was chronic glomerulonephritis. That elderlygroup has the lower dry weight, the smaller number of people using VitDthan young group was statistically significant, P <0.05. Elderly group andyoung group without significant difference in sex ratio, BMI, mean arterialpressure, dialysis duration, Kt/V values, P>0.05.4. Mean iPTH levels was lower in elderly group than younggroup(361.2±435.2pg/ml), higher incidence when iPTH <150pg/ml oriPTH <60pg/ml. Elderly group, Hs-CRP levels was higher than younggroup, but BUN, Cre, TG levels lower, these were statistically significant,P <0.05. 5. In elderly group, iPTH levels with BMI, P, BUN, Cre, Hb, ALB waspositively correlated, with Ca negative correlation,but with age, dialysisduration, Kt/V values, Hs-CRP,TG, LDL no correlation. In elderly group,iPTH levels with dialysis duration, Cre was positively correlated, with agenegative correlation, with Kt/V values, dry weight, HGB, Ca, P, Hs-CRP,ALB, TG, LDL no correlation.Conclusions：1.Elderly hemodialysis patients with diabetic nephropathy mainly, hadpoor nutritional status, severe micro-inflammation, was significantly lowerin serum parathyroid hormone levels.2. Serum parathyroid hormone levels in elderly hemodialysis patientswas affected by nutritional status, rather than young hemodialysis patientswhose serum parathyroid hormone levels increased significantly with theextension of the duration of dialysis.