尿毒症患者血液透析治疗后并发高磷酸血症的影响因素

Influencing factors of hyperphosphatemia after hemodialysis in patients with uremia

目的探讨尿毒症患者血液透析(HD)治疗后并发高磷酸血症的影响因素。方法抽取焦作煤业(集团)有限责任公司中央医院于肾脏内科2018年1月至2021年1月收治的105例40~50岁行HD治疗的尿毒症患者作为研究对象,采用跟踪调查随访的方式记录研究对象的基本资料以及相关临床资料,根据患者HD后是否并发高磷酸血症进行分组,将并发高磷酸血症患者作为发生组(60例),未继发高磷酸血症患者作为未发生组(45例)。将两组患者的基本资料及临床资料进行分类比较,分析尿毒症患者经HD治疗后并发高磷酸血症的影响因素。结果发生组与未发生组在饮食、性别、透析时间及透析器材等方面比较差异有统计学意义(P<0.05);其他相关基础资料(年龄、教育程度等)比较差异未见统计学意义(P>0.05)。经Logistic回归性分析结果显示,性别、饮食习惯(依从性)、透析时间以及透析时的透析器材是患者HD后是否继发高磷酸血症的影响因素。其中高通量的透析器材、较短的透析治疗时间是影响并发高磷酸血症的保护因素(OR<1,P<0.05),其余均为危险因素(OR>1,P<0.05)。结论尿毒症患者HD后是否并发高磷酸血症与其性别、透析时间、饮食习惯(依从性)以及透析时的透析器材有关。

Objective To analyze the influencing factors of hyperphosphatemia in patients with uremia after hemodialysis(HD).Methods A total of 105 patients with uremia aged 40-50 years treated by HD in the Department of Nephrology of the Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from January 2018 to January 2021 were selected as the research subjects.And the basic data and relevant clinical treatment data of the study subjects were recorded by follow-up investigation.The patients were grouped based on whether they were had hyperphosphatemia after HD.The patients with hyperphosphatemia were regarded as the occurrence group(60 cases),and the patients without secondary hyperphosphatemia were regarded as the non occurrence group(45 cases).After that,the recorded data of patients in the two groups were classified and compared to analyze the influencing factors of patients with uremia complicated by hyperphosphatemia after HD treatment.Results There were significant differences in diet,gender,dialysis time and dialysis equipment between the occurrence group and the non occurrence group(P<0.05);there was no significant difference in other related basic data(age,education,etc.),P>0.05.Results of Logistic regression analysis showed that,gender,dietary habits(compliance),dialysis time and dialysis equipment during dialysis were the influencing factors of secondary hyperphosphatemia in patients after HD.Among them,high flux dialysis equipment and shorter dialysis treatment time were the protective factors for hyperphosphatemia(OR<1,P<0.05),and the rest indicators were risk factors(OR>1,P<0.05).Conclusions Whether patients with uremia are complicated with hyperphosphatemia after HD is related to their gender,dialysis time,eating habits(compliance)and dialysis equipment.