de Précigout V, Combe C, Blanchetier V, Larroumet N, Pommereau A, Potaux L, Aparicio M
Service de Néphrologie-Hémodialyse, Hôpital Pellegrin, Bordeaux, France.
Nephrol Dial Transplant. 1995;10(6):821-4.
In eight patients remaining acidotic after more than 1 year of bicarbonate haemodialysis, we studied the effect of correcting the chronic metabolic acidosis using acetate-free biofiltration for 4 months on the course of secondary hyperparathyroidism. An AN69 capillary membrane was employed with a bicarbonate infusion rate initially set at 1.8 l/h in all patients and then adjusted in each one to obtain a predialysis bicarbonate of > or = 23 mmol/l. Standard blood chemistry parameters were determined every 2 weeks. Measurements of PTH, calcifediol and calcitriol, as well as calcium-PTH curves were determined at the beginning and end of the study. While acetate-free biofiltration appears to be an adequate technique for the correction of chronic metabolic acidosis when bicarbonate dialysis fails, this study indicates that it does not influence secondary hyperparathyroidism in haemodialysed patients. The level of intact PTH did not vary significantly and the calcium-PTH curves at 0 and 4 months were superimposable with no significant differences in the set point and the slope of the curves.
在8例接受碳酸氢盐血液透析1年多后仍存在酸中毒的患者中，我们研究了采用无醋酸盐生物滤过4个月纠正慢性代谢性酸中毒对继发性甲状旁腺功能亢进病程的影响。所有患者均使用AN69毛细血管膜，初始碳酸氢盐输注速率设定为1.8 l/h，然后对每例患者进行调整以获得透析前碳酸氢盐≥23 mmol/l。每2周测定一次标准血液化学参数。在研究开始和结束时测定甲状旁腺激素（PTH）、骨化二醇和骨化三醇水平，以及钙-PTH曲线。虽然当碳酸氢盐透析失败时，无醋酸盐生物滤过似乎是纠正慢性代谢性酸中毒的一种合适技术，但本研究表明，它对血液透析患者的继发性甲状旁腺功能亢进没有影响。完整PTH水平无显著变化，0个月和4个月时的钙-PTH曲线可重叠，曲线的设定点和斜率无显著差异。
