Correlative Analysis Of Serum Phosphorus Variability And Sufficiency Of Dialysis In Maintenance Hemodialysis Patients

Objective:To explore the correlation between plasma phosphorus variability and adequacy of dialysis in patients with maintenance hemodialysis(MHD),and further provide theoretical basis for clinical intervention.Methods:In this study,137 patients who underwent MHD treatment at the Blood Purification Center of the First Hospital of Shanxi Medical University from October 2016 to October 2017 were selected as study subjects,and their dialysis age was≥3 months.The general conditions of MHD patients included age,Sex,dialysis age,body mass index(BMI),ultrafiltration volume,laboratory biochemical indicators include determination of phosphorous(P),serum phosphorus coefficient(CV),and whiteness before dialysis in patients every 3 months.Protein(albumin,ALB),parathyroid hormone(iPTH),hemoglobin(Hb),calcium(Ca),and high sensitivity C-reactive protein(hs-CPR),triglyceride(TG),low-density lipoprotein(LDL),high-density lipoprotein(HDL),total cholesterol(TC),creatinine(Serum creatinine,Scr),blood urea nitrogen(BUN).According to the urea clearance index(Kt/V),the patients were divided into two groups: 81 patients with adequate dialysis(Kt/V≥1.2)and 56 patients with insufficient dialysis(Kt/V<1.2).The differences between the indicators,and using Spearman rank correlation,Logistic stepwise regression analysis of serum phosphorus variability and other indicators and the adequacy of dialysis.Results:(1)Of the 137 MHD patients in the study,81 were in the dialysis full group and 56 in the dialysis insufficient group.Compared with the dialysis sufficient group,the dialysis insufficiency group was gender,dialysis age,Hb,hs-CPR,TG There were no statistically significant differences in LDL,HDL,TC and other indicators(P>0.05);in age(P=0.018),BMI(P=0.016),ultrafiltration volume(P=0.035),Ca(P=0.039).The differences among the indexes of P(P=0.007),P-CV(P<0.001),ALB(P=0.001)and iPTH(P=0.003)were statistically significant(P<0.05).(2)Univariate correlation analysis showed that age(r=0.202,P=0.018),BMI(r=0.201,P=0.018),P(r=0.222,P=0.009),and P-CV(r=0.485,P=0.001)and iPTH(r=0.252,P=0.003)were positively correlated with dialysis adequacy,ALB(r=-0.287,P=0.001),ultrafiltration volume(r=-0.192,P=0.025),Ca(r=-0.174,P=0.042)was negatively correlated with dialysis adequacy.(3)Logistic stepwise regression analysis of multivariate logistic regression showed that the patients were old(OR=1.050,95%CI: 1.006~1.096,P=0.026)and low ALB(OR=0.879,95%CI: 0.808~0.956,P=0.003.),Phosphorus variability(OR = 3.416,95% CI: 1.493 ~ 7.814,P =0.004)is an independent risk factor for dialysis adequacy in MHD patients.Conclusion:(1)There is a correlation between serum phosphorus variation and adequacy of dialysis in MHD patients.(2)Phosphorus hypervariability is an independent risk factor for dialysis adequacy in MHD patients.(3)As soon as possible to control the stability of blood phosphorus is beneficial to improve the dialysis adequacy of patients with MHD,further improve the quality of life of patients,and prolong the survival of patients.