The Comparative Study Of Different Blood Purification Modes In Treating Hyperphosphatemia Of Patients With Uremia

Objective: Recently, many researches verified that, calcium-phosphorus metabolism is one of the main complications that the patients with uremia are faced with. Elevated serum phosphate is the most significant independent risk factors of cardiovascular event and mortality for patients with ESRD and MHD. At present, the main therapeutic measures include instruction of phosphorus intake, adequate dialysis, using phosphate binder, and falling back to parathyroidectomy when necessary, of which there are both merits and demerits. However, how to use these methods rationally for the dialysis patients to attained target value of serum phosphate is still a worldwide medical problem. In consideration of the convenience of hemodialysis,especially for outpatients who have better compliance. Otherwise, it’s easy for clinician to master.Therefore, we design this clinic trial. This research is aimed at exploring the effective hemodialysis methods to reduce blood phosphate, so as to furthestly improve the patients’ quality of life and prolong their survival time.Methods: Thirty-two patients adhering to low phosphorus diet with uremia in blood purification department of Xingtai People’s Hospital were chosen and devided into 4 groups randomly and averagely. Patients of group A receive common hemodialysis thrice a week(4h/time); Patients of group B receive common hemodialysis twice a week(4h/time) plus on-line hemodiafiltration once a week(4h/time); Patients of group C receive high-flux hemodialysis thrice a week(4h/time); Patients of group D receive long-term hemodialysis thrice a week(5h/time). Sixty days later, serum calcium,calcium-phosphorus product and parathyroid of the subjects were tested.Results: Serum phosphate, serum calcium, calcium-phosphorus product and parathyroid hormone got substantial improvement with statisticalsignificance. After comparision among the three groups of B、C and D, no statistical difference could be seen between group B and C. While compared with group B and C, all of the indexes of group D got the most obvious improvement with statistical significance.Conclusion: All of the hemodiafiltration, high-flux hemodialysis and long-term hemodialysis can respectively improve hyperphosphatemia of maintenance hemodialysis patients. Among the three dialysis modes, the author prefer the clinical application of long-term hemodialysis more.