| BackgroundHemodialysis is the primary means of treatment of end-stage renal failure(ESRD),which can significantly improve the patient's quality of life and prolong survival time.But a variety of long-term complications is still inevitable exist.Cardiovascular disease is a common complication of patients with maintenance hemodialysis(MHD)and main cause of death.Vascular calcification is a significant predictor of cardiovascular complications in MHD patients,while the disorder of calcium and phosphorus metabolism is closely related to vascular calcification.Dialysis Outcomes and Practice Study(DOPPS)mode display that serum calcium correction,phosphorus,the intact parathyroid hormone(iPTH)and calcium-phosphorus product has high incidence of abnormal and generally low compliance rates in hemodialysis patients,the current situation facing our country is more serious.ObjectiveIn this study,we will take cross-sectional survey about MHD patients in the First People's Hospital of Xinxiang City,acquaintance the characteristics of calcium and phosphorus metabolism and analyze the related factors.For a more comprehensive understanding of the current situation of calcium and phosphorus metabolism with MHD patients in this area,thus further treatment methods are discussed,in order to provide evidence for the prevention and reduction of complications and improve the prognosis and make better the quality of life of MHD patients.MethodA total number of 251 MHD patients over three months in the First People's Hospital of Xinxiang From January 2015 to July 2015 was selected to this investigation.On their questionnaire,including of clinical indicators and chemical detection index such as gender,age,duration of dialysis,primary disease,past history,application of drugs and serum hemoglobin(Hb),albumin(ALB),calcium,phosphorus and iPTH.Describing the metabolic characteristics of calcium and phosphorus,calculating the success rate,and analysing the characteristics of calcium phosphate metabolism of different gender,age,duration of dialysis,hemoglobin,albumin,primary disease and different iPTH in the patient population.ResultThe compliance rates of serum calcium,phosphorus,iPTH and calcium-phosphorus product with the research object were 31%,23.5%,27.9%,59.4%,and the average of their serum calcium,phosphorus,iPTH,calcium-phosphorus product were(1.99±0.33)mmol/L,(2.31±0.89)mmol/L,(438.47±411.43)ng/L,(4.53±1.79)mmol~2/L~2.There was statistical significance on the means of serum calcium,phosphorus,iPTH and calcium-phosphorus product with the group of ages?60 years and ages<60 years(P<0.05);There was significantly different on the average of serum iPTH with group of dialysis age?3 years and<3 years(P<0.05);it was obvious difference on the average of serum calcium-phosphorus product with the group of Hb?110g/L and<110g/L(P<0.05);the means of the serum calcium,phosphorus,iPTH and calcium-phosphorus product in the group of serum ALB?35g/L was significantly different with the group of ALB<35g/L(P<0.05);there were statistically significant on the means of serum calcium,phosphorus,iPTH and calcium-phosphorus product in the group of diabetic and non-diabetic(P<0.05);there was obvious differentce on the average of serum calcium,phosphorus in the group of iPTH?300ng/L and<300ng/L(P<0.05).ConclusionsThe MHD patients with serum calcium,phosphorus,iPTH,calcium-phosphorus product has low compliance rate in our Hospital,it is clear that young patients,non-diabetic patients,normal ALB patients has low calcium and has high phosphorus,high parathyroid hormone and high calcium-phosphorus product,the patient with iPTH?300ng/L has hyperphosphatemia and hypocalcemia prominent,long duration of dialysis patients with high parathyroid hormone prominent symptoms,non-anemic patients has obvious high calcium-phosphorus product. |
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