Investigation Into The Effects Of The Metabolism Of Calcium And Phosphorus In CAPD And HD

Objective:To investigate the infiuence of continuous ambulatory peri-toneal dialysis (CAPD) and conventional hemodialysis (HD) in chronic renal failure (CRF) patients on the calcium and phosphorus metabolism in order to get the better modulation,prevent related complications,improve quality of life in patients with CRF and decrease the hospitalization rate and mortality.Methods:Selected 88 patients undergoing dialysis, with all dialysis time being longer than 6 months in our hospital.All the patients were detected in the morning with fasting blood test for serum calcium, phos-phorus, parathyroid hormone (PTH), urea, creatinine and albumin, record-ing urine for 24 hours and detecting uric urea concentration and urine creatinine concentrations.All tests were by consistent implemented in our hospital laboratory.All patients were tested every 3 months,taking the average of multiple dates.Serum calcium values were corrected by serum albumin.Residual renal function(RRF) was calculated by the average clearance rate of urine urea and creatinine.Group:(1)according to the different ways,all of patients were divided into CAPD group and HD group;(2)according to RRF>2ml/min and≤2ml/min,each group were divided into two subgroups;(3)according to dialysis time≤2 years and>2 years,each group were divided into two subgroups.Results:1.Compared with the CAPD group, the average serum calcium and phosphorus concentration showed no significantly difference in the HD group(P> 0.05); the average serum PTH concentration in the HD group was significantly higher than that of CAPD group (P<0.05); compared with the CAPD group,the serum phosphorus and PTH concentration in the dialysis time> 2 years subgroup of HD group were significantly higher (P<0.05).2. In the HD group, the serum calcium and PTH concentration in the RRF≤2ml/min sub-group showed no significant difference compared with RRF> 2ml/min sub-group (P>0.05); in the dialysis time> 2 years sub-group, the serum phosphorus and PTH concentration were higher than that of dialysis time≤2 years subgroup (P<0.05).In the CAPD group, between the serum dialysis time≤2 years sub-group and> 2 years sub-group,the serum calcium, phosphorus,and PTH concentration showed no significant difference (P> 0.05).No matter CAPD group or HD group, the phosphorus concentration in RRF≤2ml/min subgroups were significantly higher than that of RRF> 2ml/min sub-group (P<0.05).3.Compared with HD, the percentage of patients with RRF> 2ml/min was significantly higher in CAPD group(P<0.05).4.In the CAPD group, the serum calcium, phosphorus and PTH concentration were not correlated with dialysis time (r=0.096,0.078,0.206; P>0.05); the serum phosphorus concentration was negatively correlated with RRF (r=-0.492, P<0.05).In the HD group, the phosphorus and PTH concentration was positively correlated with dialysis time (r= 0.457,0.359; P<0.05); the serum phosphorus concentration was negatively correlated with RRF (r=-0.567, P<0.05).Conclusion:1.For the effect on the serum calcium,CAPD and HD show no signi-ficantly difference;for the removal of serum phosphorus and PTH,CAPD is significantly better than HD.2.Calcium and phosphorus metabolism disorder in HD patients shows the aggravation with the dialysis time prolongation.Compared with HD, CAPD can modulate relatively better on calcium and phosphorus metabolism.