血液透析与腹膜透析患者的血清钙、磷与全段甲状旁腺激素水平比较  

Comparison of serum calcium, phosphate and intact parathyroid hormone in Chinese hemodialysis and peritoneal dialysis populations

作　　者：冯韵霖[1,2] 陈瑾[1,2] 杨帆[3] 李贵森[1,2] 陈秀玲[1,2] Feng Yun-lin;Chen Jin;Yang Fan;Li Gui-sen;Chen Xiu-ling(Nephrology Division, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, 610072,China;School of Mecicine UESTC, Chengdu, Scihuan, 610054, China;The First People’s Hospital of Guangyuan, Guangyuan, Sichuan, 628000, China)

机构地区：[1]四川省人民医院肾内科,四川成都610072 [2]电子科技大学附属医学院,四川成都610072 [3]广元市第一人民医院,四川广元628000

出　　处：《当代医学》2017年第25期18-20,共3页Contemporary Medicine

摘　　要：目的慢性肾脏病矿物质与骨异常(CKD-MBD)是CKD患者的常见并发症。关于CKD-MBD的现有数据重点关注血液透析(HD)患者。关于中国腹膜透析(PD)患者中CKD-MBD的研究极少,尤其缺乏大样本对比性研究。我们希望比较HD和PD的CKD-MBD相关参数。方法收集本单位定期HD和PD患者的人口统计学资料。对于PD患者,采集空腹血标本及前1天全部尿液和透析液。对于HD患者,采集1周第1次透析前后血标本。测定标本的生化全套。计算CKD-MBD各相关指标达到KDIGO指南目标的患者百分数。比较两组间各变量差异。结果入选499例患者,包括140例PD患者和359例HD患者。PD组血清磷(P)显著更低,血清钙(Ca)及全段甲状旁腺激素(i PTH)水平与HD组类似。PD组中P达标患者更多(HD组44.2%,PD组50.3%,P<0.01)。相比之下,HD组中透析充分性达标患者更多(HD组88.5%,PD组58.7%,P<0.01)。结论本研究结果表明PD患者血清P控制优于HD患者,而HD患者的透析充分性优于PD患者。Objective Chronic kidney disease mineral and bone disorder(CKD-MBD)is a common complication in CKD patients.The availabledata on CKD-MBD mainly focuses on hemodialysis(HD)patients.There are few such studies in Chinese peritoneal dialysis(PD)population,especiallylarge scaled comparative studies.We aimed to compare the impact of HD and PD on CKD-MBD related parameters in end stage renal diseasepatients.Methods We collected demographic data of regular HD and PD patients in our hospital.For PD patients,fasting serum samples and totalurine and total dialysate in the previous24hours were collected.We measured urine volume as well as urea nitrogen and creatinine concentrationsof24-hour urine and dialysate samples,and biochemical panel of serum samples.For HD patients,serum samples were obtained immediately beforeand after the first HD session of a week.Biochemical panel of pre-dialysis serum sample and BUN of post-dialysis serum sample were measured.The percentages of patients who had reached targets of Ca,P,iPTH and Kt/V set by KDIGO guideline were calculated.Results499patients wereenrolled,including140PD patients and359HD patients.Serum phosphate is significantly lower in PD group and serum cCa and iPTH were comparablebetween the twp groups.The proportion of patients who had reached KDIGO target of P was significantly higher in PD group than that in HDgroup(44.2in HD vs.50.3in PD,P<0.001).In contrast,the percentage of patients who had reached KDIGO target of Kt/V was significantly higherin HD group than that in PD group(88.5%in HD vs.58.7%in PD,P<0.001).Conclusion Our results indicated PD patients have better control of serumphosphate than HD patients,while HD patients had better dialysis adequacy outcome than PD patients.

关 键 词：钙 磷 全段甲状旁腺激素 血液透析 腹膜透析 

分 类 号：R692.5[医药卫生—泌尿科学]