Study Of Relationship Between Dialysate Calcium Concentration And Hypertension, Adverse Reaction In Maintenance Hemodialysis Patients

Objective:Studies the different dialysate calcium density (DCC) regarding the dialysis patient blood pressure as well as the clinical bad event's influence. Discusses what is the best DCC.Method:Surpasses 3 month-long the selection to June 1,2009 in this central maintenance hemodialysis patient altogether 273, is at the floor according to the patient to divide into two groups. A group is 141 people, B group is 132 people, these patients start the DCC are 1.25mmol/l, on July 23 A group of patient's DCC upward to 1.5mmol/l, on September 12 B group of patient's DCC upward are 1.35mmol/l. Around each time adjustment each group of patients do own comparison research as well as two group of patients the mutual comparison research, the viewing time to each time adjust same time each all around, Compared with under the different DCC the patient blood pressure's change as well as the muscle spasm, the disgusting vomit, the headache, the chest stuffy, gives off heat, the arrythmia and so on untoward effect formation rate.Results:â‘ A group of patient DCC by the 1.25mmol/l rise to 1.5mmol/l later in the dialysis muscle spasm's formation rate obvious reduction, in the dialysis hypertension and the headache formation rate will elevate; Same time A group (DCC=1.5mmol/l) and B group (DCC=1.25mmol/l) compares, in A group of dialysis muscle spasm's formation rate must be short in B group, but hypertension and the headache formation rate A group must be higher than B group; B group of patient DCC rises by 1.25mmol/l to 1.35mmol/l, In dialysis muscle spasm formation rate obvious reduction, but in the dialysis hypertension and the headache formation rate elevates not obviously, has not achieved statistics difference; Same time A group (DCC=1.5mmol/l) and B group (DCC=1.35mmol/l) the comparison, in A group of dialysis muscle spasm's formation rate must be short in B group, but has not achieved statistics difference, in the dialysis hypertension and the headache formation rate A group is higher than B group, has statistics difference.â‘¡Relevant analysis:In DCC and dialysis hypertension's formation rate present related (r=0.926, p<0.01), after dialyzate calcium density and dialysis, hypertension's formation rate present related (r=0.833, p<0.05), in the DCC and the dialysis muscle spasm's formation rate assumes the inverse correlation, in dialyzate calcium density and dialysis headache formation rate present relevance (r=0.939, P=0.005), in dialysis in headache formation rate and dialysis hypertension's formation rate present relevance, (r=0.928, P=0.008).â‘¢Multi-factor regression analysis:After DCC is in the dialysis the blood pressure and the dialysis, the blood pressure independent influencing factor, DCC is in the dialysis the muscle spasm, the headache independent influencing factor.â‘£Blood serum calcium ion and iPTH change:After using the DCC=1.25mmol/l hemodialysis, blood serum calcium ion obvious drop (P<0.05); After using the DCC=1.35mmol/l hemodialysis, the blood serum calcium ion elevates, but has not achieved statistics the difference (P>0.05), iPTH level not obvious change (P>0.05); After using the DCC=1.5mmol/l hemodialysis, the blood serum calcium ion elevates obviously (P>0.05).Conclusion:(1)Low DCC(1.25-1.35mmol/l) may cause in the patient dialysis hypertension's formation rate drop, and will not increase hypotension's risk. The high DCC (1.35-1.5mmol/l) may cause in the patient dialysis the muscle spasm formation rate reduction, but DCC(1.5 mmol/1) causes the headache the formation rate markup. (2) DCC that uses a 1.25 mmols/1 presents the obvious calcium negative symmetry;But use DCC of 1.35 mmols/1 to present calcium null balance;DCC that uses a 1.5 mmols/1 then presents positive calcium symmetery.(3) DCC is the independent influencing factor for blood pressure after the dialysis, in the dialysis, in blood pressure as well as dialysis muscle spasm and headache.(4) DCC=1.35mmol/L is possibly the appropriate DCC, both can reduce the muscle spasm the formation rate and not obvious to increase in the dialysis hypertension and the headache formation rate.