The Clinical Study Of Combining Reduced Calcium Dialysate And 1, 25(OH)₂D₃ With Calcium Carbonate In The Treatment Of Secondary Hyperparathyroidism In Maintenance Hemodialysis Patients.

Objective:To evaluate the efficiency and security of combining reduced calcium dialysate and 1,25(OH)₂D₃ with calcium carbonate on treating secondary hyperparathyroidism in maintenance hemodialysis patients. Methods:23 maintenance hemodialysis patients with correct serum calcium above 8.00mg/dl and intact PTH above 300pg/ml,were divided into 2 groups.One group with iPTH 300-600pg/ml receive 1, 25 (OH)₂D₃ 2-3ug/w, another group with iPTH 600-1000pg/ml receive 1, 25 (OH)₂D₃ 4-6ug/w. At equal pace combinate calcium carbonate and reduced calcium dialysate (dialysate Ca²⁺ 1.25mmol/l).The full course of study is 20 weeks. Test the serum calcium, phosphorus, calcium-phosphorus product, iPTH, AKP and the variance of drug dosage before and during the study period. Results:The full course of treatment decreased the serum phosphorus, calcium-phosphorus product and iPTH level in the secondary hyperparathyroidism patients , the serum calcium level was stable during the study period. Side effects were minimal and well tolerated. Conclusion:Reasonably adjust the dosage of 1, 25 (OH)₂D₃ with calcium carbonate and reduced calcium dialysis could receive good therapeutic effects, the effects are notable in the early stage of treatment. And the treatment has good safety. Objective:To observe the effects of polystyrene sulfonic lanthanum for caicium and phosphorusmetabolism in chronic renal failure due to adenine.Methods:Ninty male Waster rats fed by adenine 300mg/kg per day. Then divided the succeedrats models into five groups fed with different drugs. The first three groups fed withpolystyrene sulfonic lanthanum was 1.5g/kg 0.75g/kg 0.375g/kg per day,the fourthgroup fed with calcium carbonate and the fifth group fed with no drug. Each groupcontinuum fed with correspond drugs for 22 days. Observe the variety avoirdupoisafter 7,14,21days, detected serum Ca P PTH. Urea Cre K, RBC Hb PLT andHCT levels after 10,21 days. After 22 days, the rats were killed and the kidney wasused for analysis. All of the data were measured and analyzed by using SPSS system.Results:The group fed with polystyrene sulfonic lanthanum of 1.5g/kg per day couldsignificantly reduce serum phosphrous levels in rats models. It also can reduce theserum kalium levels appropriately. The calcium carbonate group could evidentlyincrease serum calcium level.Conclusion: Polystyrene sulfonic lanthanum (1.5g/kg dosage group) could efficiently reduce the serum phosphrous levels in rats models of Chronic Renal Failure made by adenine. It also can reduce the serum kalium levels appropriately.