北京市2007年慢性维持性血液透析患者钙磷代谢分析

Analysis the calcium and phosphorus metabolism disorders in Beijing chronic maintenance hemodialysis patients

目的分析北京市在透的血液透析患者钙磷代谢状况,寻找存在的问题,提出改进建议。方法以KDOQI指南为依据,分析2007年北京市在透析的血液透析患者校正的血钙、血磷、钙磷乘积和全段iPTH的水平、达标率,及其在不同年龄、性别的分布情况,并与DOPPS Ⅱ期和Ⅲ期结果相比较。结果2007年北京市在透析血液透析患者校正的血钙、血磷、钙磷乘积和iPTH的达标率分别为53.6%、50.2%、71.3%和28.5%。除了血iPTH外,其他指标均好于2006年和2005年。校正的血钙、血磷、钙磷乘积和iPTH四项指标中1项达标占17.3%,2项达标占27.3%,3项达标占32.9%,四项均达标占16.7%。与DOPPS Ⅱ期研究结果比较,单项和四项达标率好于DOPPSⅡ期结果。结论有相当比例的血液透析患者未能满意的控制钙磷代谢紊乱及其继发性甲状旁腺功能亢进,有待于我们的进一步努力。

Objective Abnormalities in serum calcium, phosphorus and parathyroid hormone （PTH） con- centrations are common in patients with hemodialysis patients and have been associated with increased morbidity and mortality. Clinical trials have been conducted to clearly identify categories of calcium, phosphorus and iPTH levels associated with the cardiovascular （CVD） risk. We compare calcium, phosphorus and iPTH levels of liD patients that provided by Beijing Dialysis Outcomes and Practisce survey in 2007 with DOPPS （the international trends in the Dialysis Outcomes and Practice Patterns Study, an international study of hemodialysis practices and associated outcomes）, in order to realize the calcium and phosphorus metabolism of liD patients in Beijing. Methods Analysis the data of serum calcium, phosphorus and iPTH levels of HD patients in Beijing in 2007. Results Categories of serum calcium during 2.11 ～2.37mmol/L pre-HD presents 51.6%, serum phosphorus during 1.13 ～1.78mmol/L pre- HD presents 50.2%, Ca×P product lower than 55 mg2/dL2 presents 71.3% and level of iPTH during 150-300pg/ml presents 28.5% of all. All four items up to par present 16.7% in 2007, compared with DOPPS Ⅱ data （5.5%）. Conslusions There are more HD patients who had abnormal mineral metabolism and secondary hyperparathyroidism, we should pay more attention to them.