腹膜透析患者的钙磷代谢紊乱及其影响因素

Disorders of calcium and phosphorus metabolism and mfluence factors in peritoneal dialysis patients.

目的 通过对目前腹膜透析患者钙磷代谢情况进行调查,以期发现钙磷代谢紊乱的发生原因和促进因素。方法 53例透析6月以上的持续性不卧床式腹膜透析患者,测定其血清钙、磷和iPTH水平,计算透析充分性和饮食元素钙和元素磷摄入水平。结果 本组患者普遍存在血磷水平升高及钙磷乘积升高。血钙、血磷和钙磷乘积水平分别与开始透析时间,残余肾Kt/V和CCr以及二氧化碳结合力相关(P值均小于0.05或0.01)。丧失残余肾功能的患者血磷和钙磷乘积明显升高(P值均小于0.05或0.01)。血钙和血磷水平与透析Kt/V和CCr,以及饮食元素钙和元素磷摄入水平无关(P值均大于0.05)。结论 目前的腹膜透析患者普遍存在钙磷代谢紊乱,尤以高磷血症为突出,并随着透析的进程而有加重趋势,其主要原因为残余肾功能的丧失,腹膜透析液中钙离子水平偏高也具有部分影响作用。

Objectve By investigated the calcium and phosphorus metabolism in peritoneal dialysis patients,to determined its causing and promoting factors.Methods Among S3 continued ambulatory peritoneal dialysis patients whose dialysis time was more than 6 months,serum calcium,phosphorus,iPTH had been assayed,and dialysis adequacy and intake of calcium element and phosphorus element from diet had been calculated.Results Elevated serum phosphorus level and multiplication of calcium and phosphorus were found in this group of patients.Serum calcium,phosphorus,and multiplication of calcium and phosphorus had positive relationship with dialysis time,residual renal Kt/ V and CCr,carbon dioxide combining power respectively.( P less than 0.05 or 0.01) .There were no relationship between serum calcium,serum phosphorus and dialysis Kt/V,dialysis CCr,intake of calcium and phosphorus from diet.(P large than 0.05 respectively) .Conclusion Disorders of calcium and phosphorus metabolism,especially hyper-phosporemia,are common feature in peritoneal dialysis patients.These disorders become more critical following the dialysis process.Decline of residual renal function take main responsibility of these disorders,and high calcium level in dialysate also involve in it.