| Objectives:(1)Retrospective analysis of serum calcium,phosphorus and i PTH levels in patients with maintenance hemodialysis in different areas of Jiangxi Province(2)Based on the KDOQI and KDIGO guidelines,To analyze the blood calcium,blood phosphorus and i PTH of maintenance hemodialysis patients in different regions of jiangxi province,and discusses the factors affecting the standards of serum calcium,blood phosphorus and whole blood parathyroid hormone.METHODS:Patients undergoing maintenance hemodialysis in multi-center hemodialysis rooms in jiangxi province were investigated from January 2018 to December 2018.General data of 747 MHD patients were collected according to inclusion and exclusion criteria.collection of MHD patients before hemodialysis blood calcium,phosphorus,blood immunoreactive parathyroid hormone and other test results.According to the standards of KDOQI and KDIGO guidelines,Calcium and phosphorus metabolism disorder and hyperparathyroidism of maintenance hemodial-ysis patients in jiangxi province were analyzed,and the factors affecting the standards of blood calcium,blood phosphorus and whole blood parathyroid hormone were analyzed.Results:(1)(1)According to the KDOQI guidelines,the compliance rate of blood calcium,blood phosphorus and blood i PTH in 747 MHD patients was 40.70%,31.33% and28.78%.(2)According to the KDIGO guidelines,the compliance rate of blood calcium,blood phosphorus and blood i PTH in 747 MHD patients was 53.55%,19.01% and60.24%.(2)(1)According to KDOQI guidelines,747 MHD patients with low calcium,high calcium,low phosphorus,high phosphorus,low i PTH,high i PTH incidence39.22%,20.08%,7.5%,61.18%,23.96%,47.26%.(2)According to the KDIGO guidelines,747 MHD patients with low calcium,high calcium,low phosphorus,high phosphorus,low i PTH,high i PTH incidence 39.22%,7.23%,1.87%,79.12%,19.54%,20.21%.(3)(1)According to the KDOQI guidelines,the compliance rates of blood calcium,blood phosphorus and blood i PTH of MHD patients in grade II grade A hospitals were 34.91%,23.67% and 27.22%.(2)The compliance rate of blood calcium,blood phosphorus and blood i PTH of MHD patients in grade III grade A hospitals was 39.58%,33.72% and 26.93%.(3)The compliance rates of blood calcium,blood phosphorus and blood i PTH of MHD patients in provincial hospitals were 50.33%,33.11%,35.76%.(4)Blood phosphorus level in grade III grade A hospitals was significantly lower than that in grade II grade A hospitals [1.89(1.50,2.28)vs.2.13(1.68,2.56),P=0.000].The serum calcium level in provincial hospitals was higher than that in grade III grade A hospitals [2.22(2.09,2.36)vs.2.12(1.98,2.27),P =0.000].(5)The serum calcium level of patients who had been on dialysis for more than37 months was significantly higher than that of patients who had been on dialysis for3-12 months or 13-26 months [2.2(2.03,2.37)vs.2.08(1.94,2.29)vs.2.14(1.98,2.30),P=0.001].The serum i PTH level of patients who had been on dialysis for more than37 months was significantly higher than that of patients who had been on dialysis for3-12 months or 13-26 months [315(178,641)VS 232(130,392)VS 270(145,431),P=0.000].(6)Blood phosphorus levels in MHD patients aged over 60 years were significa-ntly lower than those aged below 45 years and those aged 45-60 years [1.84(1.46,2.18))vs.2.16(1.70,2.51)vs.2.09(1.55,2.48),P=0.000].Blood i PTH of MHD patients older than 60 years old was significantly lower than that of patients younger than 45 years old and patients between 45 and 60 years old [245(131,440)VS345(200,652)VS 299(172,523),P=0.000].(7)Blood calcium level of MHD patients with diabetes is lower than that of MHD patients without diabetes [2.09(1.96,2,27)vs.2.18(2.02,2.35),P=0.004].Blood phosphorus level of MHD patients with diabetes is lower than that of MHD patients without diabetes [1.7(1.38,2.13)vs.2(1.6,2.42),P=0.000].Blood i PTH level of MHD patients with diabetes is lower than that of MHD patients without diabetes [230(107,394)vs.298(167,555),P=0.000].(8)Serum calcium in female MHD patients was higher than that in male MHD patients [2.2(2.03,2.36)vs.2.15(1.98,2.31),P=0.011].(9)Serum phosphorus in patients receiving hemodialysis twice a week was higher than that in patients receiving hemodialysis three times a week [2.005(1.6,2.42)vs.1.89(1.46,2.78)P=0.029].(10)Binary Logistic regression analysis showed that hospital grade,dialysis blood flow and weekly dialysis frequency were the factors influencing the blood calcium standard.The factors influencing the standard of blood phosphorus include weekly dialysis frequency,i PTH and diabetes.Conclusions:The standards of serum calcium,blood phosphorus and i PTH in patients with maintenance hemodialysis in jiangxi province are not ideal,especially there is a certain gap between the standards of primary hospitals and tertiary hospitals and provincial hospitals.The blood i PTH level of MHD patients with more than 2 years of dialysis age were higher.MHD patients over 60 years old have lower blood phosphorus level and i PTH level.Blood phosphorus and blood i PTH levels were lower in MHD patients with diabetic.dialysis frequency per week,diabetes mellitus and i PTH are the factors that affect the blood phosphorus level of MHD patients.Weekly dialysis frequency,blood flow and hospital grade were the factors affecting the blood calcium standard. |
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