中国安徽省维持性血液透析患者矿物质和骨异常的调查。

Investigation on maintenance hemodialysis patients with mineral and bone disorder in Anhui province, China.

机构信息

Department of Nephrology, The Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.

Blood Purification Center, No. 2 People's Hospital of Fuyang City, 1088 Yinghe West Road, Fuyang, 236015, China.

出版信息

Int Urol Nephrol. 2023 Feb;55(2):389-398. doi: 10.1007/s11255-022-03328-9. Epub 2022 Aug 11.

DOI:10.1007/s11255-022-03328-9

PMID:35951256

Abstract

BACKGROUND

Chronic kidney disease-mineral bone disorder (CKD-MBD) is a common comorbidity in patients with CKD. The study aims to describe the control rates of serum-corrected calcium (Ca), phosphate (P) and intact parathyroid hormone (iPTH) and its risk factors among maintenance hemodialysis (MHD) patients in Anhui Province of China.

METHODS

The study was conducted in 27 hemodialysis centers of Anhui Province between January 1st 2020 and December 31th 2020. Chi-square test was used to compare the control rates of serum-corrected Ca, P and iPTH between the present study and DOPPS 4 or Anhui Province in 2014. Binary logistic regression analysis was used to explore the risk factors of the control rates of serum-corrected Ca, P and iPTH.

RESULTS

A total of 3 025 MHD patients were recruited in this study, with a mean age of 54.8 (SD: 12.8) years, and 60.1% were males. According to the Chinese Diagnosis and Treatment Guidelines for CKD-MBD, the control rates of serum-corrected Ca, P and iPTH in the present study were 57.9%, 20.0% and 56.0%, respectively. Based on KDOQI guidelines (2003), the control rates of the above indicators were 43.1%, 35.3% and 22.3%, respectively. The control rates of serum-corrected Ca, P and iPTH in this study were lower than those of DOPPS 4 (P < 0.001). Compared to the results of Anhui Province in 2014, the control rate of corrected Ca was higher (P < 0.001) and the control rate of iPTH was lower (P = 0.005). Age, residential area, BMI, dialysis vintage, albumin and hemoglobin levels were factors of serum-corrected Ca, P and iPTH not within target range.

CONCLUSION

The control rates of serum-corrected Ca, P and iPTH in MHD patients in Anhui Province are relatively low. Monitoring and management should be strengthened to improve the prognosis of patients undergoing dialysis.

摘要

背景

慢性肾脏病-矿物质和骨异常（CKD-MBD）是慢性肾脏病（CKD）患者常见的合并症。本研究旨在描述中国安徽省维持性血液透析（MHD）患者血清校正钙（Ca）、磷（P）和全段甲状旁腺激素（iPTH）的控制率及其危险因素。

方法

本研究于 2020 年 1 月 1 日至 12 月 31 日在安徽省 27 家血液透析中心进行。采用卡方检验比较本研究与 DOPPS4 或 2014 年安徽省的血清校正 Ca、P 和 iPTH 控制率。采用二项逻辑回归分析探讨血清校正 Ca、P 和 iPTH 控制率的危险因素。

结果

本研究共纳入 3025 例 MHD 患者，平均年龄为 54.8（SD：12.8）岁，其中 60.1%为男性。根据《中国慢性肾脏病矿物质与骨异常诊治指南》，本研究中血清校正 Ca、P 和 iPTH 的控制率分别为 57.9%、20.0%和 56.0%。根据 KDOQI 指南（2003 年），上述指标的控制率分别为 43.1%、35.3%和 22.3%。本研究中血清校正 Ca、P 和 iPTH 的控制率低于 DOPPS4（P<0.001）。与 2014 年安徽省的结果相比，校正 Ca 的控制率较高（P<0.001），iPTH 的控制率较低（P=0.005）。年龄、居住地区、BMI、透析龄、白蛋白和血红蛋白水平是血清校正 Ca、P 和 iPTH 未达到目标范围的因素。