Du Juan, Wang Songyan, Yu Wangbo, Li Shuang, Xu Jingbo
Department of Endocrinology, Jilin Province People's Hospital, Changchun 130021, China.
Department of Nephrology, Jilin Province People's Hospital, Changchun 130021, China.
Chronic Dis Transl Med. 2017 Aug 7;3(3):181-185. doi: 10.1016/j.cdtm.2017.07.001. eCollection 2017 Sep.
To evaluate the parathyroid function in maintenance hemodialysis patients from 4 hemodialysis centers and to analyze the cause of the dysfunction.
This cross-sectional study included patients with chronic renal disease undergoing maintenance hemodialysis treatment at 4 hemodialysis centers in Changchun, China, between March 2014 and August 2015. A total of 337 patients were asked to complete a questionnaire including their name, gender, age, hemodialysis duration, the use of calcium carbonate and vitamin D3 supplements, health education status, hemofiltration frequency, appetite, and education level. Serum intact parathyroid hormone (iPTH), phosphorus, total calcium, blood urea nitrogen (BUN), and creatinine (Cre) levels were obtained from clinical information. Patients with iPTH data were divided into 2 groups: Normal group: the patients with an iPTH level < 100 pg/ml (28 subjects); Abnormal group: the patients with an iPTH level > 100 pg/ml (136 subjects). Intergroup differences were analyzed using the -test. The enumeration data were analyzed by the test.
The iPTH levels were not monitored for 173 maintenance hemodialysis patients (51.3%) but for 164 patients (48.7%). Of the 164 patients, 28 (17.1%) had a normal serum iPTH level, while the other 136 (82.9%) had an abnormal iPTH level. The maintenance hemodialysis duration and phosphorus levels in the Abnormal group were higher than those in the Normal group ( < 0.05). The appetites of patients in the Abnormal group were better than those of patients in the Normal group ( < 0.05).
A lower proportion of patients on hemodialysis had a normal iPTH level. The phosphorus levels of patients on hemodialysis should be controlled via dietary interventions.
评估来自4个血液透析中心的维持性血液透析患者的甲状旁腺功能,并分析功能障碍的原因。
这项横断面研究纳入了2014年3月至2015年8月在中国长春4个血液透析中心接受维持性血液透析治疗的慢性肾病患者。共337例患者被要求完成一份问卷,内容包括姓名、性别、年龄、血液透析时长、碳酸钙和维生素D3补充剂的使用情况、健康教育状况、血液滤过频率、食欲和教育程度。从临床信息中获取血清完整甲状旁腺激素(iPTH)、磷、总钙、血尿素氮(BUN)和肌酐(Cre)水平。有iPTH数据的患者分为2组:正常组:iPTH水平<100 pg/ml的患者(28例);异常组:iPTH水平>100 pg/ml的患者(136例)。组间差异采用t检验分析。计数资料采用χ²检验分析。
173例维持性血液透析患者(51.3%)未监测iPTH水平,164例患者(48.7%)进行了监测。在这164例患者中,28例(17.1%)血清iPTH水平正常,另外136例(82.9%)iPTH水平异常。异常组的维持性血液透析时长和磷水平高于正常组(P<0.05)。异常组患者的食欲优于正常组患者(P<0.05)。
血液透析患者中iPTH水平正常的比例较低。应通过饮食干预控制血液透析患者的磷水平。