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血液铝水平在血液透析和腹膜透析患者中的变化。

Blood Aluminum Levels in Patients with Hemodialysis and Peritoneal Dialysis.

机构信息

Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan.

College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

出版信息

Int J Environ Res Public Health. 2022 Mar 24;19(7):3885. doi: 10.3390/ijerph19073885.

Abstract

Background. This retrospective observational study attempted to examine the prevalence of abnormal blood aluminum levels in dialysis patients, and to explore the association of pathogenic factors, such as demographic, clinical, laboratory as well as the use of phosphate binding drugs, drugs for secondary hyperparathyroidism and erythropoiesis-stimulating drugs with the blood aluminum levels. Methods. The study included 1175 patients (874 hemodialysis and 301 peritoneal dialysis), recruited from Chang Gung Memorial Hospital in November 2020. Patients were stratified into two groups by their blood aluminum levels, as normal (<2 µg/dL, n = 1150) or abnormal (≥2 µg/dL, n = 25). Results. The patients aged 60.4 ± 13.2 years and were dialyzed for 8.6 ± 8.1 years. The average blood aluminum level was 1.0 ± 0.4 µg/dL. Patients with abnormal blood aluminum levels received more sevelamer than patients with normal blood aluminum level (p = 0.014). Patients with abnormal blood aluminum levels had higher platelet count (p = 0.001), triglyceride (p < 0.001) and total iron binding capacity (p = 0.003) than patients with normal blood aluminum levels. Moreover, the cardiothoracic ratio was higher in patients with abnormal blood aluminum levels than patients with normal blood aluminum levels (p = 0.003). Conclusions. The prevalence of abnormal blood aluminum levels was low at 2.2%. Nevertheless, the linking of cardiothoracic ratio of more than 0.5 as well as elevated blood platelet count and triglyceride level with blood aluminum levels are interesting, and warranted more researches in this area.

摘要

背景。本回顾性观察研究试图检查透析患者血液铝水平异常的发生率,并探讨与致病因素的关联,如人口统计学、临床、实验室以及磷酸盐结合药物、继发性甲状旁腺功能亢进症药物和促红细胞生成素药物的使用与血液铝水平的关系。

方法。本研究纳入了 2020 年 11 月从长庚纪念医院招募的 1175 名患者(874 名血液透析和 301 名腹膜透析)。根据血液铝水平将患者分为两组,正常(<2 µg/dL,n = 1150)或异常(≥2 µg/dL,n = 25)。

结果。患者年龄 60.4 ± 13.2 岁,透析时间 8.6 ± 8.1 年。平均血液铝水平为 1.0 ± 0.4 µg/dL。血液铝水平异常的患者接受的司维拉姆治疗多于血液铝水平正常的患者(p = 0.014)。血液铝水平异常的患者血小板计数(p = 0.001)、甘油三酯(p < 0.001)和总铁结合力(p = 0.003)均高于血液铝水平正常的患者。此外,血液铝水平异常的患者心胸比高于血液铝水平正常的患者(p = 0.003)。

结论。血液铝水平异常的发生率较低,为 2.2%。然而,心胸比大于 0.5以及血小板计数和甘油三酯水平升高与血液铝水平之间的关联很有趣,需要在这方面进行更多的研究。

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