| Objective:Uremia belongs to end-stage renal disease.Dialysis is an effective method to maintain life in uremic patients,including hemodialysis and peritoneal dialysis.Calcium and phosphorus metabolism disorders are common in dialysis patients.Calcium salt deposition can lead to bone and cardiovascular calcification,leading to ischemic cardiomyopathy,heart failure,and even life-threatening cardiovascular events.And calcium and phosphorus metabolism disorder and cardiovascular disease affect dialysis quality and survival rate of dialysis patients.CVD cardiovascular diseases mainly include arterial calcification,atherosclerosis,and vascular calcification,and it is a simple and direct method to evaluate carotid artery calcification through cervical vascular ultrasound.The aim of this study was to compare the effects of hemodialysis(HD)and peritoneal dialysis(PD)on calcium and phosphorus metabolism and carotid calcification in patients with end-stage nephropathy.Method: Select 80 uremic patients who have been treated in our hospital for more than 6months from 2016 to 2017,divided into two groups: hemodialysis and peritoneal dialysis,there were 40 patients in each group,and 40 patients in each group.The indexes of albumin,cholesterol,triglyceride,low density lipoprotein,creatinine,urea nitrogen,uric acid,hemoglobin c-reactive protein,carotid intima-media thickness and carotid plaque were compared between the two groups,and the changes of serum calcium,phosphorus and parathyroid hormone in 0 months(Less than 1 month),3 months and 6months of treatment,respectively.According to the calcification of carotid artery,80 patients were divided into calcification group and non-calcified group.The age,blood calcium,blood phosphorus,parathyroid hormone and other biochemical indexes were compared between calcified group and non-calcified group.Results: After 3 months of treatment and 6 months of treatment,the level of phosphorus and parathyroid hormone in the peritoneal dialysis group were significantly lower than those in the hemodialysis group(P < 0.05),and the level of blood calcium wassignificantly higher than that in the hemodialysis group(P < 0.05).The incidence of high calcium,high phosphorus,high parathyroid hormone,low calcium,low phosphorus and low parathyroid hormone in peritoneal dialysis group was not significantly higher than that in hemodialysis group after treatment for 0 months(P > 0.05).The incidence of hyperparathyroid hormone in hemodialysis group was significantly lower than that in hemodialysis group(p < 0.05).After six months of treatment,the level of Alb and creactive proteinin peritoneal dialysis group was significantly lower than that in hemodialysis group(p < 0.05),however,the levels of creatinine,urea nitrogen,triglyceride,total cholesterol,low density lipoprotein,hemoglobin and uric acid were not significantly different from those of hemodialysis.After 0 and 6 months of treatment,the incidence of carotid intima-media thickness(IMT)and carotid calcification was not significantly different between hemodialysis group and peritoneal dialysis group(0.05%).The age and serum phosphorus level in calcified group were significantly higher than those in non-calcified group(p < 0.05),and blood phosphorus was an important risk factor for carotid artery calcification progression in dialysis patients.Conclusion: Carotid calcification is not uncommon in hemodialysis and peritoneal dialysis,and there is no significant difference in the incidence of calcification.But compared with hemodialysis,peritoneal dialysis can better control calcium and phosphorus metabolism,in clinical work,we should choose the most suitable dialysis method according to the actual situation of the patients. |
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