Effect Of Hemodialysis Combined With Hemoperfusion On Secondary Hyperparathyroidism Of Maintenance Hemodialysis Patients

Objective: The study through observation the treatment of hemoperfusion combined with hemodialysis on maintenance hemodialysis patients with secondary hyperparathyroidism(SHPT),analysis the effect on the related biochemical indexes of the two groups after treatment including serum calcium(Ca),phosphorus(P),calcium-phosphorus product,intact parathyroid hormone(iPTH),blood urea nitrogen(BUN),serum creatinine(Cr),?2-microglobulin(?2-MG),Cystatin C(CysC)and compute urea clearance index(Kt/V);and to investigate the changes of iPTH after the therapy of hemodialysis combined with hemoperfusion,and to discuss the treatment cycle on when we can reperformed the therapy of hemodialysis combined with hemoperfusion again,so as to provide a theoretical basis for selecting the therapy of hemodialysis combined with hemoperfusion for SHPT.Methods: We selected 40 maintenance hemodialysis patients from the Blood Purification Center in our Hospital,and randomly divided them into two groups: hemodialysis combined with hemoperfusion(HD + HP)group and routine hemodialysis(HD)group,20 patients in each group.To compare the changes of serum calcium(Ca),phosphorus(P),calcium-phosphorus product,intact parathyroid hormone(iPTH),blood urea nitrogen(BUN),serum creatinine(Cr),?2-microglobulin(?2-MG),Cystatin C(CysC)and compute urea clearance index(Kt/V)before and after treatment of the two groups;and to observe the changes of intact parathyroid hormone(iPTH),hemoglobin(Hb),platelet(PLT),serum albumin(Alb)on the 7th days,the 14 th days and the 28 th days in the HD+HP group after treatment.Statistical analyses were done by SPSS16.0 software;the measurement data were expressed as (?)±s,the two groups were compared with t test;the count datas were expressed as(n,n%),the two groups were compared by ?~2 test;the single sample interval compared with analysis of variance,and P<0.05 was statistically significant difference.Results: After treatment the level of serum P,calcium-phosphorus product,BUN and Cr of the two groups were significantly lower than those before treatment(P <0.05),serum Ca was significantly higher than that before treatment(P <0.05);there were no significant differences in the level of serum Ca,P,calcium-phosphorus product,BUN,Cr between the two groups after treatment(P> 0.05).The levels of iPTH,?2-MG and CysC in the HD + HP group were significantly lower than those before treatment(P <0.05);in HD+HP group the level of iPTH,?2-MG and CysC(268.05±100.16?40.31±14.75?6.56±2.14)were lower than those in HD group(435.28±147.17 ? 66.80±25.39 ? 9.85±2.58)after treatment,the difference was statistically significance(P <0.05).In the HP+HD group the iPTH level on the 14 th day and the 28 th day was higher than that on the first day,the difference was statistically significant(P <0.05);a further 2-2 comparision we found that,there was no significant difference in iPTH between the 14 th day and the 7th day(P>0.05).the level of iPTH on the 28 th day was higher than that of the 14 th day,the difference was statistically significant(P <0.05).Conclusion: 1.HD + HP was better than HD in the removal of iPTH,?2-MG,CysC.2.It is suggested that maintenance hemodialysis patients with SHPT can be re-performed HD + HP treatment on 2 weeks.