| Objective Calcium and phosphorus metabolism disorder is a serious threat to the quality of life and survival of patients among the Chronic Kidney Disease(CKD),which draw our more and more attention to itself in recent years.However,current research show that dialysis patients calcium and phosphorus metabolism control rate is low.Therefore,we retrospectively analyzed serum calcium,phosphorus and intact parathyroid hormone(iPTH)among the Maintenance Hemodialysis(MHD)patients treated in Hemodialysis Center of People’s Hospital of Yuxi city,the target levels of serum calcium,phosphorus and iPTH met which suggested by the Kidney Disease Outcomes Quality Initiative(KDOQI),and factors affecting serum calcium,phosphorus and iPTH levels.To provide an effective basis for improving the Compliance rate of calcium-phosphorus metabolism in clinical work.Methods.During the period of January 1,2012 to December 31,2016 five years of screening,from hemodialysis center of Yuxi People’s Hospital,dialysis age greater than or equal to 6 months in MHD patients with end-stage renal disease in 117 cases,clinical data was collected from selected patients to death,renal transplantation,hemodialysis,termination of losing follow-up,turn the other dialysis center or to the date of termination of the study.KDOQI guidelines recommend the serum calcium,serum phosphorus,iPTH control objectives to evaluate the MHD patients in Yuxi People’s Hospital of serum calcium and phosphorus,iPTH compliance rate,and analyze the influence of age,primary disease,dialysis frequency,dialysis mode,especially calcium supplements,various kinds of phosphate binder on the influence of the level of serum calcium,phosphorus,iPTH.Results1.The standard rate of blood phosphorus,calcium and iPTH were 41.9%,50%and 21.4%,respectively.2.3 times per week hemodialysis group serum phosphorus level was significantly lower than the 2 times a week hemodialysis group(1.87 + 0.44mmol/L vs 2.17 +0.54mmol/L,P=0.006);3 times a week hemodialysis group Kt/V is higher than 2 times per week hemodialysis group(1.43 + 0.34mmol/L vs 1.22 + 0.66mmol/L,P=0.049).3..The age of patients in the high phosphorus level group was significantly younger than that in the non high phosphorus group(46.05±12.55 vs 56.92±12.11,P<0.001).4.Non elderly patients(age<65 years)of serum phosphorus and iPTH levels were significantly higher in elderly patients(aged 65 years),phosphorus(2.02±0.49 vs 1.63±0.32,P<0.001),iPTH(680.19±510.60 vs 473.8±375.83,P=0.037).5.The level of serum phosphorus was significantly lower in the group taking calcium carbonate than that of Sevelamer group(1.85±0.42 vs 2.46±0.42,P<0.001);The level of serum calcium was significantly higher in the group taking calcium carbonate than that of Sevelamer group(2.23±0.11 vs 2.11±0.20,P=0.046).6.Taking the blood phosphorus level ossification in three alcohol shock treatment group was lower than that of taking Cinacalcet serum phosphorus level:serum phosphorus(1.63 + 0.26 vs 2.27 + 0.37,P=0.001),the level of serum calcium and iPTH of patients who taking the impact of ossification in three alcohol is higher than the level of taking cinacalcet,but the difference was not statistically significant.7.Age was negatively correlated with serum phosphorus level,BMI and iPTH were positively correlated with serum phosphorus levels.Conclusion.Calcium and phosphorus metabolism in patients with MHD control is not satisfactory;dialysis three times a week than dialysis twice a week is better for blood phosphorus and dialysis adequacy;serum phosphorus and iPTH levels of patients under 65 years old is higher;compared with those taking servicetek Rahm patients taking calcium carbonate to higher serum calcium level;age,dialysis age,BMI,iPTH are the risk factors of serum phosphorus level. |
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