低钙透析液对高钙、高磷腹膜透析患者钙磷代谢的影响

Effect of Low Calcium Dialysate on Serum Calcium-phosphate Metabolism in Peritoneal Dialysis Patients

【目的】观察在高钙、高磷的腹透患者中应用低钙透析液调节钙磷代谢的有效性。【方法】选择高钙、高磷,甲状旁腺激素(PTH)<150pg/ml的患者21例,改用低钙透析液(BaxterPD4透析液)进行持续性非卧床腹膜透析(CAPD)治疗,观察透析开始时、3个月后、6个月后的血钙、血磷及PTH水平。【结果】治疗后3个月,血钙、血磷均下降,与透析开始时相比有统计学意义,PTH有所上升,但无统计学意义。治疗6个月后,血钙、血磷较透析开始时下降明显,PTH上升明显,且差异均有显著性。【结论】使用低钙透析液能够有效纠正高钙、高磷及低PTH患者的钙磷失衡,有利于提高患者的生存质量。

[Objective]To observe the availability of low calcium dialysate on serum calcium and phosphorus metabolism in peritoneal dialysis patients with hypercalcinemia and hyperphosphatemia. [Methods] Twenty one patients with hypercalcinemia, hyperphosphatemia and PTH〈150pg/ml were undertaken CAPD with low calcium dialysate. Before and after using the low calcium dialysate therapy for 3 and 6 months, the serum calcium,phosphorus and intact parathyroid hormone were measured. [Results] After 3 months the levels of serum calcium and phosphorus decreased significantly（ P〈0.05）, and the level of serum PTH increased slightly（ P 〈0.05）. After 6 months the levels of serum calcium and phosphorus decreased significantly（ P 〈0.05）, and the level of serum PTH also increased significantly（ P 〈0, 05）. [Conclusion]Low calcium dialysate could effectively correct the imbalance of calcium and phosphorus of the patients with hypercalcinemia, hyperphosphatemia and hypo-PTH, and it could also correct the metastatic calcification and improve the quality of life.