Retrospective Analysis Of CKD-MBD In Peritoneal Dialysis Patients With A New Phosphorus Binding Agent

Objective To observe the effects of different phosphorus binders on calcium and phosphorus metabolism of CKD-MBD patients,and to compare the effects of calcium and phosphorus binders and non calcium and phosphorus binders on calcium,phosphorus,parathyroid hormone and other important indicators.Methods 109 peritoneal dialysis patients with hyperphosphatemia who met the inclusion criteria during regular follow-up in the peritoneal dialysis center of Hangzhou hospital of traditional Chinese medicine from 2015 to 2019 were divided into two groups:the non calcium phosphate binding agent group and the calcium phosphate binding agent group according to the different drugs taken and selected.The clinical data of both groups were treated for more than half a year.Retrospective cohort study was used to observe the different treatments PTH,blood calcium,blood phosphorus,blood pressure and hemoglobin were the main clinical indexes of CKD-MBD before and after the treatment.It was effective to reduce blood phosphorus to less than 1.6mmo/l,and statistical treatment was carried out.Results The results of this study show that:1.Both the calcium phosphate binding agent and the new phosphate binding agent have good phosphorus reducing effect,the blood phosphorus level of the calcium group before treatment is 2.02±0.27 and after treatment is 1.55 ± 0.34,P<0.05;the blood phosphorus level of the new group before treatment is 2.03 ±0.27,after treatment is 1.59 ± 0.34,P<0.05,the two groups have statistical significance in the efficacy(P<0.05).However,there was no significant difference between the two groups(P>0.05).2.The new phosphorus binding agent was weaker than the calcium group(312.00(139.70425.3)before treatment,196.30(92.30380.25)after treatment,P<0.05).However,the serum calcium level of the new phosphorus bond(2.40 ± 0.17 before treatment,2.43±0.18 after treatment)was lower than that of the calcium group(2.34 ± 0.20 before treatment,2.42 ± 0.26 after treatment),P<0.05.3.In the clinical symptoms,the incidence of restless legs in the new phosphorus bond group was significantly lower than that in the calcium group(P.4.The new phosphorus binding agent can reduce the level of cholesterol and LDL(P<0.05).5.The level of uric acid decreased significantly after the treatment with calcium phosphate binder(P<0.05).6.The comparison between the two groups showed that after treatment,the systolic pressure of the new phosphorus binding group was significantly higher than that of the calcium phosphorus binding group,and the ejection fraction was significantly lower than that of the calcium phosphorus binding group,with a statistical difference(P<0.05).The number of patients with left ventricular hypertrophy in the calcium phosphorus binding group increased compared with the previous group,with a statistical difference(P<0.05).Conclusion Non calcium phosphate binding agent can reduce blood phosphorus safely and effectively.The effect of phosphorus reduction is similar to that of calcium phosphate binding agent,but hypercalcemia rarely occurs.Among the related factors of phosphorus reduction effect of peritoneal dialysis patients,dialysis age is an independent risk factor of phosphorus reduction effect of peritoneal dialysis patients.