Effects Of Different Blood Purification Methods On Calcium And Phosphorus Metabolism In Maintenance Hemodialysis Patients

Objective : To understand the influences of calcium,phosphorus,parathyroid hormone(PTH)and other biochemical indexes in maintence hemodialysis(MHD)patiences by comparing three different blood purification treatment methods of low flux hemodialysis(LFHD),high flux hemodialysis(HFHD),hemodiafiltration(HDF),and to explore optimal hemodialysis mode for MHD patients with disturbance of calcium and phosphorus metabolismand,and to find a bettet treatment for secondary hyperparathyroidism(SHPT),and in order to improve the clinical symptoms and the quality of life in MHD patients so as to provide clinical value.Method:60 cases of the patients with uraemia were selected strictly according to the inclusion criteria and exclusion criteria in center of blood purification,Yijishan Hospital of Wannan Medical College,from January,2015 to December,2016,divided into group LFHD,group HFHD and group HDF+LFHD according to different blood purification treatments.20 cases in each group were observed for 1 years.Analyzed and compared the changes of calcium,phosphorus and PTH before and after 1 years of MHD patients in each group.Investigated the effect of different blood purification methods on calcium,phosphorus,PTH in MHD patients.Result: Within group comparison,the changes of serum calcium in MHD patients were not of statistical difference in both of three groups(P>0.05).Changes of phosphorus and PTH in MHD patients were not of statistical difference in the group LFHD(P>0.05),which had significantly difference in the group HFHD(P <0.05)and group HDF+LFHD(P<0.05).Among three groups reduction rates of serum calcium were not of statistical difference(P>0.05).Compared with HFHD group and HDF+LFHD group,respectively,differences in the decrease rate of serum phosphorus were significance in LFHD group(P<0.05).Reduction rates of serum phosphorus for HFHD group and HDF+LFHD group were 15.88±22.65,10.68±26.68,respectively,which were not of statistical significance(P>0.05).Compared with HFHD group and HDF+LFHD group,respectively,differences in the decreasing rates of PTH were significance in LFHD group(P<0.05).Reduction rates of PTH for HFHD group and HDF+LFHD group,were 28.28±27.85,35.41±30.14,respectively,which were not of statistical significance(P>0.05).Conclusion: Compared to LFHD,HFHD and HDF can effectively reduce the level of serum phosphorus and PTH.HDF and HFHD both could improve disorders of calcium-phosphorus metabolism in MHD patients and effectively treat SHPT.