低钙透析对老年高钙血症血液透析患者的影响

The Effect of Low Calcium Dialysate in Elderly Hemodialysis Patients With Hypercalcemia

目的探讨低钙透析在伴高钙血症的老年维持性血液透析患者中的应用。方法将48例伴高钙血症的老年维持性血液透析患者给予1.25 mmol/L钙浓度透析液治疗3个月,比较更改透析液治疗前及应用后1、3个月时血钙、血磷、钙磷乘积、全段甲状旁腺激素(iPTH)水平。结果低钙透析液治疗1个月后患者血钙、血磷、钙磷乘积明显降低,3个月后下降更明显;iPTH水平在治疗1个月后无变化,3个月后明显上升,差异有统计学意义(P<0.05)。结论高钙、高磷、低iPTH血症老年患者采用低钙透析液治疗可有效地降低血钙、血磷、钙磷乘积,提升iPTH水平。

Objective To investigate low calcium dialysate in maintenance hemodialysis senile patients of hypercalcemia. Methods 48 maintenance hemodialysis senile patients of hypercalcemia who had used low calcium dialysate （calcium concentration 1.25 mmol/L） for a period of 3 months. The serum calcium, phosphorus, calcium-phos- phorus product and intact parathyroid hormone （iPTH） levels before and 1, 3 months after the change of dialysate were compared. Results There was significant diference between low-calcium dialysate was used before and after 1 months in serum calcium, serum phosphorus, calcium-phosphorus product. After 3 months, the decline was more pronounced. The level of serum iPTH had no change after 1 months of treatment, but after 3 months was signifcantly increased, the difference was statistically significant （P 〈 0.05）. Conclusion The senile patients of hypercalcemia with low calcium dialysate dialysis can effectively reduce serum calcium, serum phosphorus, calcium-phosphorus product , and improve iPTH levels.