Current Status And Impact Factors Of Calcium And Phosphorus Metabolism In 207 Maintenance Hemodialysis Patients

Objective:To investigate the disorder of calcium and phosphorus metabolism in patients undergoing MHD in the blood purification center of Union Hospital of Fujian Medical University,and analyze the influencing factors of the above indicators.Method:The clinical data of 207 patients admitted to the Union Hospital of Fujian Medical University from March 1,2016 to March 1,2018 who underwent MHD with the duration of dialysis longer than 3 months were studied retrospectively.According to the Kidney Disease Outcome Quality Initiative guidelines,groups were divided according to the blood phosphorus,corrected calcium,iPTH and calcium-phosphorus product,to observe the compliance of the indicators,and compare the general data and laboratory examination results of each group.Finally,the risk factors of abnormal calcium and phosphorus metabolism were analyzed by multi-factor regression.Results:This study includes 207 cases(male 147,female 60)that ages from 18 years old to 91 years old with the average age of 58.99±15.69 years,while the average BMI was 21.78+3.26 kg/m2 and the average dialysis duration was 21.58+14.87 months.The top three primary diseases were diabetic nephropathy(70,33.82%),chronic glomerulonephritis(67,32.37%),hypertensive nephropathy(34,16.43%).According to the K/DOQI guidelines,the compliance rates of blood phosphorus,corrected calcium,calcium-phosphorus product and iPTH were as follows:38.64%;47.82%;62.32%;25.60%.The patients with diabetic nephropathy had lower lever of iPTH compared with non-diabetic nephropathy.The influencing factors of blood phosphorus were age,serum creatinine before dialysis and albumin.Age and dialysis duration were the influencing factors for correcting calcium.The influencing factors of iPTH were age and serum creatinine before dialysis.The factors influencing calcium-phosphorus product were serum creatinine before dialysis and corrected calcium.Conclusions:1.The compliance rate of calcium and phosphorus metabolism was on the low side,especially for iPTH(25.60%).2.Diabetic nephropathy is the most common cause(33.82%)of ESRD,while glomerulonephritis is the second cause(32.37%)and hypertensive nephropathy is the third cause(16.43%)of ESRD in our dialysis center.3.The average level of iPTH in patients with diabetic nephropathy is higher than that in patients with non-diabetic nephropathy.4.Age,dialysis age,serum creatinine before dialysis,and albumin were risk factors for calcium and phosphorus metabolic disorders.