Study On The Correlation Between Residual Renal Function And Calcium, Phosphorus Metabolism Or Cardiac Function In Elderly Peritoneal Dialysis Patients

Objective: To investigate the relationship between residual renal function and calcium, phosphorus metabolism or cardiac function in elderly peritoneal dialysis patients, To provide clinical reference for improving heart function and prognosis of patients with peritoneal dialysis.Methods: 63 elderly patients with ESRD who were done maintenance peritoneal dialysis were collected, according to their residual renal function(GFR) levels,they were divided into 2ml group(GFR was at < 0 ~ 2ml/min/1.73m2), 2~4mlgroup(GFR was at 2~4ml ml/min/1.73m2), 4ml group(GFR was at>4 ml/min/1.73m2). the general situation and serum calcium, phosphorus, calcium phosphorus product, cardiac calcification, left ventricular end diastolic diameter(LVEDD), end systolic diameter(LVEDS), interventricular septal thickness(IV ST), left ventricular posterior wall thickness(LVPWT), ejection fraction(EF) were compared among three groups.the correlation between residual renal function indexes(GFR) and blood phosphorus, calcium phosphorus product, cardiac calcification and EF were analyzed at the same time.Results: Among 63 peritoneal dialysis patients, the average serum calcium level was(2.45 + 0.41)mmol/L, average serum phosphorus levels was(1.95+0.51)mmol/L, serum parathyroid hormone level was(167.8 + 91.2) pg/ml. the cardiovascular calcification rate was 47.6%. the dialysis time In 2~4ml group was significantly shorter than that in 0~2ml group,that in>4ml group was significantly shorter than that in 2 ~4ml group(P< 0.05); the poor nutrition ratio in 2~4ml group was less than that in 0~2ml group, the nutrient poor ratio in > 4ml group was less than that in 2 ~ 4ml group(P < 0.05). the LVEDS, LVEDD, ST,LVPWT in 2 ~ 4ml group, 4ml group were significantly lower than those in 0 ~ 2ml group(P < 0.05), the EF was higher than that in 0~2ml group(P<0.05); the LVEDS, LVEDD, ST, LVPWT in>4ml group were significantly lower than those in 2 ~4ml group, the EF was higher than that in 2~4ml group(P<0.05). Pearson correlation analysis showed there were a negative correlation between GFR level and serum phosphorus, calcium phosphorus product, cardiac calcification(r=-0.532,-0.639,-475, P< 0.05), the correlation between it and cardiac function indexes(EF) were positively correlate- ed(r=0.835, P<0.05). Conclusion:the preservation of residual renal function, controlling serum phosphorus level and reducing calcium phosphor- rus product, reasonable using active Vitamin D3, in order to reduce the risk of cardiovascular calcification of patients with peritoneal dialysis, can improve their heart function, there is positive significance to reduce mortality rate.