Greene S V, Falciglia G, Rademacher R
Renal Dietitian, Community Limited Care Dialysis Center, Cincinnati, OH, USA.
J Ren Nutr. 1998 Apr;8(2):77-82. doi: 10.1016/s1051-2276(98)90046-2.
To compare three different mean serum phosphorus ranges on outcomes related to the control and treatment of hyperparathyroidism (HPTH), to nutritional status, and to quality of life (QOL) in adult hemodialysis (HD) patients.
Patients were grouped based on the mean of five monthly phosphorus levels achieved during the study period. Group 1 included patients whose mean phosphorus levels over the period was <6.0 mg/dL (n = 24); group 2 averaged between 6.0 and 6.9 mg/dL (n = 14); and group 3 averaged >7.0 mg/dL (n = 16). Descriptive comparisons were made between phosphorus groups.
Fifty-four stable, adult HD patients participated voluntarily.
Intact-parathyroid hormone (iPTH), calcium x phosphorus product (Ca x P), and change in iPTH, albumin (alb), total protein (tpro), weight (wt) and body mass index (BMI), and scores on a QOL survey. Baseline physical and lab characteristics.
No difference was found between phosphorus levels of <6.0 mg/dL and levels of 6.0 to 6.9 mg/dL in iPTH, Ca x P levels allowing safe calcitriol therapy, nor response to calcitriol treatment. Patients with phosphorus levels >7.0 mg/dL had midstudy iPTH greater than phosphorus levels <6.0 mg/dL. Otherwise the three groups did not differ significantly in iPTH levels. Phosphorus levels 6.0 to 6.9 mg/dL was associated with lowest wt and BMI, but alb and tpro did not differ between the phosphorus groups. Phosphorus levels of >7.0 was associated with highest creatinine levels and youngest age. Subjects in the phosphorus levels of <6.0 mg/dL gp were more likely than the 6.0 to 6.9 mg/dL gp to describe their diet as sufficient and, at baseline, were more likely to relate diet to QOL.
Comparison of three levels of serum phosphorus on indicators of outcome in the control and treatment of secondary hyperparathyroidism showed no significant difference in outcome between phosphorus levels of <6.0 mg/dL and phosphorus levels 6.0 to 6.9 mg/dL. However, the data suggests that phosphorus levels of >7.0 mg/dL may relate to significantly higher iPTH and unacceptable Ca x P levels. There were no differences between the groups, suggesting less favorable outcome at any of the three phosphorus levels regarding nutritional status or QOL in this small group of stable, adult HD patients.
比较三种不同的平均血清磷范围对成年血液透析（HD）患者甲状旁腺功能亢进症（HPTH）的控制和治疗效果、营养状况及生活质量（QOL）的影响。
根据研究期间五个月的磷水平均值对患者进行分组。第1组包括研究期间平均磷水平<6.0mg/dL的患者（n = 24）；第2组平均磷水平在6.0至6.9mg/dL之间（n = 14）；第3组平均磷水平>7.0mg/dL（n = 16）。对各磷水平组进行描述性比较。
54名稳定的成年HD患者自愿参与。
完整甲状旁腺激素（iPTH）、钙磷乘积（Ca×P）、iPTH的变化、白蛋白（alb）、总蛋白（tpro）、体重（wt）和体重指数（BMI），以及生活质量调查得分。基线身体和实验室特征。
在iPTH、允许安全使用骨化三醇治疗的Ca×P水平以及对骨化三醇治疗的反应方面，<6.0mg/dL的磷水平与6.0至6.9mg/dL的磷水平之间未发现差异。磷水平>7.0mg/dL的患者在研究中期的iPTH高于磷水平<6.0mg/dL的患者。除此之外，三组在iPTH水平上无显著差异。磷水平在6.0至6.9mg/dL与最低的体重和BMI相关，但各磷水平组之间的alb和tpro无差异。磷水平>7.0mg/dL与最高的肌酐水平和最年轻的年龄相关。磷水平<6.0mg/dL组的受试者比6.0至6.9mg/dL组的受试者更有可能认为他们的饮食充足，并且在基线时，更有可能将饮食与生活质量联系起来。
对继发性甲状旁腺功能亢进症控制和治疗结果指标的三种血清磷水平进行比较，结果显示<6.0mg/dL的磷水平与6.0至6.9mg/dL的磷水平在治疗结果上无显著差异。然而，数据表明，磷水平>7.0mg/dL可能与显著更高的iPTH和不可接受的Ca×P水平相关。各组之间没有差异，表明在这一小群稳定的成年HD患者中，在任何三种磷水平下，营养状况或生活质量的结果都不太理想。
