1.5mmol/L钙浓度透析液对血清总钙和全段甲状旁腺激素及血压的影响

Influence of 1.5mmol/L calcium dialysate on serum total calcium,iPTH and blood pressure

目的 针对血液透析患者出现的高钙血症 ,观察将透析液钙浓度从 1.75mmol/L(HCaD)降低到 1.5mmol/L(LCaD)后对血清钙、磷、全段甲状旁腺激素 (iPTH)和血压的影响。方法 选择存在高钙血症、使用HCaD的稳定HD患者 3 2例 ,改用LCaD透析 3个月。记录LCaD治疗前后透析中症状、透析前后收缩压 /舒张压和心率、血清总钙以及透析前全段甲状旁腺激素(iPTH)。结果 LCaD治疗 3个月后收缩压趋于正常 ,高钙血症得到纠正 ,低iPTH患者血清iPTH水平升高 ,LCaD没有影响活性维生素D的疗效。

Objectives To investigate the effects of decreasing dialysate calcium concentration from 1.75 mmol/L(HCaD)to 1.5 mmol/L(LCaD)on serum calcium,phosphate,iPTH and blood pressure during the treatment of hypercalcaemia in hemodialyzing patients.Methods Thirty two stable patients on HCaD dialysis who had hypercalcaemia were changed to LCaD for 3 months.The symptom,per and post dialysis blood pressure and heart rate,serum calcium,phosphate and iPTH were recorded.Results After LCaD dialysis for 3 months,systolic blood pressure and serum calcium concentration tended to become normal,iPTH level increased in patients with low iPTH level.Conclusion LCaD is beneficial to blood calcium concentration and systolic blood pressure control.