| Along with the advance of age and medical level, the incidence of end-stage renal disease (ESRD) has been increased year by year.Hemodialysis (HD), as one of the ways in which to treat this disease, has become an effective renal replacement therapy, can maximom patient’s life. Calcium and phosphorus metabolism disorder is one of common complications of maintenance HD (MHD), with its main clinical manifestations of the body skin itching. Some studies showed calcium-phosphorus metabolism disorder contribute to some concurrent disease, such as hyperparathyroidism. In general, if the patients had higher parathyroid hormone (PTH), hyperphosphatemia, would easily cause uremia in all kinds of clinical symptoms, cause certain effect to the quality of life of the patients, serious when cause threat to the patient’s life and health, even lead to death. Patients with long-term maintenance hemodialysis usually had calcium-phosphorus metabolism disorders.Clinical testing found obvious high blood phosphorus and the calcium-phosphorus product. A lot of research data show that the calcium-phosphorus product increases, subcutaneous soft tissue calcification rate and fatality rate has close relationship. Maintenance hemodialysis patients once appear calcium phosphorus metabolism disorders, can cause other diseases, such as itchy skin, vascular and heart valve calcification, renal bone disease, cardiac insufficiency, ischemic heart disease, increased the difficulty of the treatment of patients with maintenance hemodialysis, further threatening patients’ health.Patients with maintenance hemodialysis with calcium-phosphorus metabolism disorder, can appear different degree of symptoms of inflammation.Therefore, patient with micro inflammation state may also consider has calcium-phosphate metabolism disorder [4]. Under normal circumstances, the macromolecule organic toxin and chronic inflammatory reaction has close relationship.After long-term hemodialysis, inflammation and oxide metabolites in the body corresponding changes, destroy the balance of oxygen radical scavenging system, the oxidation and antioxidant status is in a state of instability,.The patient has close relation with the inflammatory response and its anti-inflammatory [5].Lots of research data show that the main cause of death in patients with maintenance hemodialysis was cardiovascular disease (CVD).As a result, through the control of calcium-phosphorus metabolism, can help to ensure the healthy of patients with maintenance hemodialysis, improve the patients life quality and level, alleviate or reduce fatality rate, improve their body condition at the same time, control the development of deaseas, reduce the chances of complications and prolong their life cycle.Therefore, the treatment of patients with maintenance hemodialysis with calcium-phosphorus metabolism disorder has important clinical significance [6]. Analysis found that the main cause of dialysis made the illness and death, at the same time, the cardiovascular disease is one of the main complications of calcium phosphorus metabolism disorder, which made the patients into end-stage renal disease, and it was the cause of death [7]. At the same time quite a number of cardiovascular diseases belong to the complications of atherosclerosis.Atherosclerosis (AS) is a complicated and systematic, changing process, many patients in the early renal failure presencted atherosclerosis, which mostly exist in the performance of the inflammation, but not obvious. The situation will be ignored by many patients in the early days.If the inspection of the patients with renal failure and without hemodialysis found that c-reactive protein (CRP) index elevated, means the patient may have atherosclerosis.Patients with maintenance hemodialysis in the body of various molecular products in different level of ascension, including advanced glycosylation end products (AGE), and advanced oxidation protein products (AOPP), the oboro inhibition C (CySC), the entire section parathyroid hormone (PTH), β2microglobulin(β2-MG), with half a long glycine (Hcy), c-reactive protein (CRP), etc. The reason is that frequent use of hemodialysis tools for a long time, causing a lot of bacteria hide in the tools.The bacteria cause certain stimulation of the mononuclear cells synthetic factor and the release of proinflammatory factor [7].Such factors including interleukin 1 (IL-1), interleukin 6 (IL-6) and interleukin 8 (IL-8), interleukin 18 (IL-18) and tumor necrosis factor and so on.With the rise of mononuclear cell synthesis and release of proinflammatory factor, the c-reactive protein increases. Patients with long-term maintenance hemodialysis residue a lot of uremic toxins, such toxins are important material of the inflammatory response, can also be expressed as the macromolecular uremic toxins.Under normal circumstances, dialysis can not eliminate or reduce the macromolecular uremic toxins, which makes the increasing of the uremic toxins. Although the medical technology and level got a qualitative leap by the 21st century, more incurable diseases were growing, further required improving the quality of researchers professional.It is only through constant research and exploration, can we treat more complex disease. The body of patients with hemodialysis saved a lot of macromolecules uremic toxins, modern medical cannot eliminate the macromolecular uremic toxins in the body of patients with maintenance hemodialysis, which can only reduce it, and the corresponding price and effect need to be changed.Effective treatment demand higher price. The current market is still a lack of effective drug which can significantly reduce the macromolecular uremic toxins. Current clinical use more is renal tubular auxiliary facilities treatment technology, which demand is very high, and the price is very high too, can’t extensively product and applicate. Therefore, whether the price or effect, are not suitable for long-term treatment for patients with maintenance hemodialysis [8].Renal failure is a disease with complex process, has the characteristics of irreversible and progressive.And it is also the inevitable result of the continuous development of kidney disease. The most effective treatment of chronic renal failure is hemodialysis. Hemodialysis is one of the best ways in clinical to maintain the life cycle of renal failure patients. Hemodialysis as an alternative therapy can help patients to eliminate or reduce the body toxins, and filtering the excess water in the body, help to improve the patient’s survival rate, prolong patient life cycle, and improve the quality of survival.lt is of profound significance for the treatment of renal failure patients. Hemodialysis is a big help in the treatment of patients with renal failure, but not of the body statement of molecule and ion metabolism imbalance improvements, including the secondary metabolism of thyroid function hyperfunction, iron deficiency anemia, calcium phosphate, hypoalbuminemia, etc.. Hemodialysis can cause other complications in the process of patients’ long-term hemodialysis.A significant number of patients had to suspend hemodialysis in the process of treatment, due to hemodialysis and the serious complications caused by hemodialysis [9].Because of long-term hemodialysis, the red blood cell of patients with maintenance hemodialysis was damaged, the small molecular substances such as protein, amino acid gradually loss.Patients appeared different degree of anemia, or malnutrition, immune function serious decline, further increased the difficulty the treatment, it will also promote other complications, such as hepatitis infection disease. Patients in the process of long-term hemodialysis, prone to anemia, after repeated treatment at the same time,.Low blood pressure also keeps happening, which will cause renal ischemia, or the lymphatic factor release in the body and further damage to the kidney tissues and cells function.Make the kidney burden heavier, originally use only for maintaining renal function not enough to cope with the body state of the kidney. Because patients have to long-term hemodialysis, the tissue and cell of the body are damaged, easily cause various complications.Such complications are closely related to the changes of tissues and the imbalance of cells statment [10]. This article is to explore the effect of hemodialysis union blood perfusion in patients with maintenance hemodialysis with calcium-phosphorus metabolism.,hope for the future provide the basis theory basis for clinical treatment.Objective:To explore the effect of hemodialysis union blood perfusion in patients with maintenance hemodialysis on calcium-phosphorus metabolism.Methods:Eighty patients with ESRD in hospital were enrolled from June 1,2013 to December 31. Forty patients were treated with blood perfusion combined hemodialysis (observation group), and 40 patients were treated with hemodialysis (control group). The serum calcium and serum phosphorus were collected.Results:Compared to the patients treated with HD, the patients treated with blood perfusion combined with hemodialysis had lower level of serum phosphorus, the calcium-phosphorus product, serum segment parathyroid hormone (iPTH), blood urea nitrogen (BUN), serum creatinine (Scr) and β2microglobulin (β2-MG),but higher level of serum calcium after 4 months and 6 months treatment. Furthermore, compared to the control group, the patients treated with blood perfusion combined with hemodialysis had lower procollagen amino terminal extension of the peptide (P1NP), beta content of collagen degradation products (β-CTX) and osteocalcin (BGP) after 6 months treatment.Conclusion:Blood perfusion combined with hemodialysis can effectively reduce serum phosphorus, serum calcium and phosphorus product and intact parathyroid pigment content, maintain normal calcium and phosphorus metabolism, and reduce the synthesis and secretion of bone tissue and reduce bone turnover.Little influence on the nutritional status of patients. For patients, this combination therapy, with a certain practical significance, is worthy of wide application in clinic. |
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