| Objective: To explore the relationship between mineral bone disorder(MBD)related indicators and nutritional-inflammation status in patients with maintenance hemodialysis(MHD)in Zunyi Medical University Affiliated Hospital,the purpose to better control chronic kidney disease-mineral bone disorder(CKD-MBD).Methods: A total of 95 adults with stage CKD5 undergoing MHD in hemodialysis centers from March 2018 to October 2018 in Zunyi Medical University Affiliated Hospital were collected.CKD-MBD assessment indicators include predialysis calcium(Ca),phosphorus(P),and intact parathyroid hormone(i PTH).Moreover,predialysis Ca is maintained at 2.1 to 2.5 mmol/L,P is maintained at 1.13 to 1.78 mmol/L,and i PTH is maintained at 150 to 600 pg/m L(that is,maintained at 2-9 times normal high limit),respectively,which was the target range of the three indexes.If all the above three indicators were within the target range,it was defined as the standard group,and any one of the indicators was not the group,it was defined as the non-standard group.Nutrition indicators are albumin(ALB),prealbumin(PA),inflammatory indicators is C-reactive protein(CRP),and common indicators of nutrition and inflammation are ?2 microglobulin.Comparing the differences between the clinical indicators of the standard group and non-standard group,and the factors affecting the blood Ca,P,and i PTH levels fasting predialysis were analyzed.Summarizing the influencing factors of MBD and its relationship with nutritional-inflammatory status in patients with MHD in Zunyi Medical University Affiliated Hospital.Results: According to the inclusion and exclusion criteria,a total of 95 patients met the criteria,including 57 males(60%),38 females(40%),and the average age(52.79±13)years.The etiology of the patients studied: 49 cases of chronic glomerulonephritis(51.58%),11 cases of diabetes(11.58%),10 cases of hypertension(10.53%),3 cases of obstructive nephropathy(3.16%),2 cases of nephrotic syndrome(2.11%),8 cases of diabetes complicated with hypertension(8.42%),and the remaining causes were 12 cases(12.63%).There were 8 cases(8.42%)in the standard group and 87 cases(91.58%)in the non-standard group.(1)Comparison between the standard group and the non-standard group: the magnesium(Mg),CRP,serum creatinine(Scr)and ?2 microglobulin predialysis in the standard group were significantly lower than the non-standard group(P<0.05).The ALB and PA predialysis were significantly higher in the standard group than those in the non-standard group(P<0.05).(2)Multivariate logistic regression analysis showed that:(1)Predialysis high uric acid(UA)and postdialysis high mean arterial pressure are independent risk factors leading to blood Ca disorders;(2)Predialysis low 25-(OH)D is independent risk factor for blood P disorders.Conclusion:1.Patients with maintenance hemodialysis have a higher incidence of mineral bone disorder,and the nutritional status of the standard group is better than that of the non-standard group,and the inflammation status of the standard group is better than that of the non-standard group.2.Maintenance hemodialysis patients with predialysis high uric acid and postdialysis high mean arterial pressure are more likely to lead to blood calcium disorders.3.Maintenance hemodialysis patients with predialysis the low 25-hydroxy vitamin D is more likely to lead to blood phosphorus disorders. |
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