Factors Affecting PTH In Maintenance Hemodialysis Patients And Its Effect On Bone Metabolism

Objectives Parathyroid hormone(PTH)is one of the important uremic toxins,in recent years,studies have pointed out that the final PTH levels higher than 500 pg / ml or less than 150 pg / ml patients,patients with cardiovascular and cerebrovascular accident,sudden death The probability increased significantly.The aim of this study was to analyze the influencing factors of PTH abnormalities and their effects on bone metabolism,to identify high risk groups and to guide clinical treatment.Methods According to the inclusion and exclusion criteria,135 patients who underwent maintenance hemodialysis at the Blood Purification Center of North China University of Science and Technology Hospital from June 2015 to September 2016 were selected as the subjects.Collection of all patients with age,dialysis age,primary disease,body mass index BMI and other general information.(AL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),serum creatinine(Scr),serum creatinine(Hb),serum albumin(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),low density lipoprotein(LDL-C),low density lipoprotein The According to the KDOQI guidelines,patients with parathyroid hormone levels in MHD patients should be maintained at 150 to 300 pg / ml.Patients were divided into low parathyroid hormone group(PTH <150pg / ml),normal parathyroid hormone group(150pg / ml " PTH " 300 pg / ml),high parathyroid hormone group(PTH> 300 pg / ml).The differences of PTA levels and the effects of PTH on bone metabolism were analyzed by chi-square test,one-way ANOVA and multiple linear regression analysis.Results The study of 135 patients,14 patients with low PTH(10.4%),PTH normal patients 16(11.9%),high PTH 105(77.7%).The results of each group show:(1)(5.7%: 13.4%;5.7%: 15.9%)in the low PTH group and PTH normal group,the difference was statistically significant(P <0.05),and the difference was statistically significant(P = 0.049).(2)There was no significant difference in age and body mass index(BMI)between the three groups(P = 0.929;P = 0.300).(3)PTH normal group was significantly lower than the high PTH group and low PTH group,the difference was statistically significant(P = 0.004).(4)There was no significant difference in the primary disease between the three groups(P = 0.931;P = 0.061;P = 0.530;P = 0.413).(5)The levels of serum creatinine(Scr),carbon dioxide binding capacity(CO2CP),hemoglobin(Hb),C-reactive protein(CRP),albumin(Alb),triglyceride(TG),triglyceride There were significant differences in total cholesterol(TC),low density lipoprotein(LDL-C),serum calcium(Ca),phosphorus(P)and alkaline phosphatase(ALP)in the three groups(P <0.05).(6)The results showed that the levels of PTH in maintenance hemodialysis patients were correlated with gender factors and Hb,Scr,CO2 CP,Ca and P(P <0.05)by multivariate linear regression analysis.Conclusions 1 Factors affecting PTH levels in maintenance hemodialysis patients were sex,serum creatinine,carbon dioxide binding,hemoglobin.PTH levels in women with maintenance hemodialysis were higher than those in men.PTH levels were positively correlated with serum creatinine and serum phosphorus,and were negatively correlated with hemoglobin,carbon dioxide binding and serum calcium.2 The effect of PTH levels on bone metabolism in maintenance hemodialysis patients included a decrease in serum calcium levels and an increase in serum levels.