Effect Of Different Blood Purification Techniques On Fibroblast Growth Factor23 In Maintenance Hemodialysis Patients Of Country

Objective: To investigate the effect of different blood purification techniques on minerals disorder in maintenance hemodialysis patients of country, Especially the effect of fibroblast growth factor23, to provide clinical guidance for patients to choice the blood Purification techniques.Methods: ninety two maintenance hemodialysis patients were divided into four groups according to the blood purification techniques, A group : patients receive conventional hemodialysis treatment(18cases),B group:patients receive conventional hemodialysis and high-flux hemodialysis(HFHD) treatment(25case),C group : patients receive conventional hemodialysis and hemofiltration(HDF) treatment(25cases),and hemoperfusion,D group patients receive conventional and hemodialysis(HP) treatment(24 cases).All patients were treated for three months. fibroblast growth factor23, parathyroid hormone, calcium, phosphorus, Serum urea nitrogen, creatinine and so on before and after treatment were measured and compared among the groups. Statistical analysis was performed using SPSS13.0 software. Quantitative datum were expressed as mean± standard deviation and analyzed by Student’s t test. The relationship was analyzed using Pearson’s correlation coefficient analysis P<0.05 was considered statistically significant.Results : The serum FGF23 in B group, C group and D group before treatment were(687.48±294.44),(693.44±299.87) and(710.75±285.71) pg/ml, and after treatment were(536.24±223.89),(325.32±141.32) and(424.04±158.63) pg/ml, There were significant differences in Serum FGF23 level after treatment compared with that before treatment(P<0.05). The descend rate of serum FGF23 among the three groups were(22.50±2.8)%,(52.54±6.2)% and(36.52±4.6)%,There were significant differences in the descend rate of serum FGF23.The serum PTH in B group, C group and D group before treatment were(463.68±243.05),(474.72±304.67) and(469.29±277.97)ng/L and after treatment were(349.62±146.14),(202.46±117.43) and(271.32±121.24) ng/L, There were significant differences in Serum PTH level after treatment compared with that before treatment(P<0.05). The descend rate of serum PTH among the three groups were(25.44±14.3) %,(49.06±11.9) % and(36.69±10.2) %, There were significant differences in the descend rate of serum PTH. The serum phosphorus in B group, C group and D group before treatment were(2.17±0.68),(2.15±0.63) and(2.19±0.58) mmol/L. and after treatment were(1.66±0.43),(1.54±0.49), and(1.62±0.48)mmol/L. There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups(P<0.05).The descend rate of serum phosphorus among the three groups were(23.09±14.5)%,(36.37±11.6)%,(25.65±12.4)%,There were no significant differences in the descend rate of serum phosphorus among the three groups(P>0.05).The serum FGF23, PTH, Calcium, phosphorus in A group before treatment were(665.33±276.55) pg/ml,(439.33±325.63) ng/L,(2.06±0.45) mmol/L and(1.98±0.51)mmol/L, and after treatment were(674.16±207.13) pg/ml,(434.08±109.18)ng/L,(2.15±0.42) mmol/L and(1.92±0.43)mmol/L, There were no significant differences in them after treatment compared with that before treatment(P>0.05).Conclusions : HD can only clear serum phosphorus. HFHD, HDF and HP can clear serum phosphorus, PTH and FGF23 effectively, while HDF has better clearance effect on FGF23.Furthermore, there are addition benefit on the bases of clearance about FGF23 and PTH, the serum phosphorus declined more, and the serum calcium more. From The effect of treatment, the HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients. But think about economic condition and clinical effect, patient can choose high-flux hemodialysis or Hemodiafiltration.