Vitamin C Dialysate Is The Impact Of Secondary Hyperparathyroidism

Background and ObjectiveSecondary hyperparathyroidism is one of the common complications in the patients of Chronic renal failure.With the continues progression of the blood purification technology, the survival rate of patients who have been suffering Chronic renal failure is also gradual increase, but the incidence of Secondary hyperparathyroidism is also increasing as a result of the lower blood calcium which was caused by the factors as the lack of active vitamin D3,phosphorus retention and the PTH resistance of bone tissue. According to surveys, about 40% of dialysis patients had Secondary hyperparathyroidism, the serious Secondary hyperparathyroidism has become one of the major causes of death for the long-term hemodialysis patients.The hazards of Secondary hyperparathyroidism is mainly renal osteodystrophy, the serious bone damage make the calcium and phosphorus metabolism become abnormal, cause the skin itching, anemia, nervous tissue and cardiovascular system damage, cause great suffering to patients, and even life-threatening. In recent years, a lot of research on the Secondary hyperparathyroidism in its treatment have achieved some successes,including:the use of phosphate binders, calcium and calcium receptor agonists complement and the application of active vitamin D3, as well as surgical treatment, these treatments significantly decrease the body damage of the Secondary hyperparathyroidism patients.We know that vitamin C is one of the important vitamin to maintain human' health,which is extensively involved the body's oxidation, reduction and hydroxylation of other metabolic processes and plays an important role to the maintenance of normal physiological function of the body. In addition to the vitamin C is rich in products, easy to use, cheap and can greatly save the cost of treatment, but also large extently solve the patient's economic difficulties. Studies have shown that vitamin C is a strong anti-oxidants, the vitamin C can significantly reduce the body's oxidative stress, protecting vascular endothelial function with the use of dialysis fluid. There are data to show that vitamin C can affect the blood concentration of intact parathyroid hormone and the parathyroid function through its activity in the parathyroid hormone receptors and the parathyroid calcium sensing receptor. In this study, we have use the way of adding vitamin C into the dialysis fluid to reduce the lack of vitamin C of the body to Comprehend the action of vitamin C-containing dialysate on secondary hyperparathyroidism of maintenance hemodialysis Patients and guide the clinical treatment of Secondary hyperparathyroidism.Samples and methodsEighty-two stable maintenance hemodialysis patients in our department were enrolled in the research, male 46 cases, female 36 cases, aged 25-75 years old.all of the dialysis patients who were selected with the laws of at least 3 months. They were divided into two groups randomly with the conventional dialysis fluid group (A) group and the vitamin C dialysate group (B) group.there were 40 cases in group A and 42 cases in group B. The condition of all patients were stable for more than one month.They dialysised with three times a week, each 4 hours. They did not use vitamin C or vitaminE drugs and not associate with severe infection,active bleeding,liver and gallbladder diseases,malignant tumor or autoimmune disease activity of acute period in the state of nearly a month. The calcium and vitamin D drugs were not used in this experiment. We tested the plasma concentration of iPTH,Ca,P,ALP,VitC pre-and post-treatment before hemodialysis and calculate the Ca×P,during this period the group A of patients used conventional dialysis fluid and the group B of patients used vitamin C dialysate for hemodialysis.ResultsThe plasma level of iPTH,ALP rose slightly,Ca,P,Ca×P had no obviously change,VitC descended after hemodialysis with routine dialysate,the difference was statistically significant;but the level of plasma iPTH,ALP were significantly lower than before, the difference was statistically significant, Ca,P,Ca×P had no obviously change,VitC rose slightly after hemodialysis with vitC-containing dialysate.ConclusionsA lot of vitamin C can be lost during the hemodialysis with routine dialysate; Vitamin C can reduce the plasma level of iPTH,ALP and prevent the secondary hyperparathyroidism; But the suitable use of vitamin C in clinical is also to be solved.