全段甲状旁腺素iPTH与CKD(国外英文资料).docVIP

全段甲状旁腺素iPTH与CKD(国外英文资料) The iPTH objective is confused (the naval general hospital, zhou chunhua) The iPTH target value recommended by the KDOQI guide The American K/DOQI clinical practice guide recommends measuring the full length of PTH (1 ~ 84PTH). The target value is: CKD3, the iPTH target is 35 ~ 70pg/ml; At CKD4, the target is 70-110pg/ml; CKD5 includes dialysis patients with a target of 150-300pg/ml. In order to achieve iPTH target for CKD5 period in patients undergoing hemodialysis or abdomen, such as serum iPTH level 300 pg/ml, should start active vitamin D treatment, goal is to reduce the level of serum iPTH and the target was 150 ~ 300 pg/ml. For with high calcium and/or hyperphosphatemia, parathyroid function of invalid serious drug treatment already (the level of serum iPTH lasting 800 pg/mL), recommended for parathyroidectomy. Second, the iPTH rate is low according to the KDOQI guidelines Beijing in 2007 patients with hemodialysis blood iPTH registration data (14.6%), serum iPTH is a mean of 421.5 + / - 489.2 pg/ml, according to the target value of KDOQI guidelines recommend blood iPTH success rate was 28.5%. The level of iPTH between the ages of 21 and 30 significantly increased to 718.3 + + 582.6 pg/ml, with a minimum of 8.8%. Beijing blood purification quality control and improvement center annual report published in 2011 (ADR - 2011) data of 4616 patients, criteria, as KDOQI guidelines suggest iPTH success rate is only 20.4% pg/ml. Foreign DOPPS Ⅱ period research data shows,Serum calcium, phosphorus, calcium phosphorus and iPTH rates were 42.50%, 44.40%, 61.40%, 26.20% respectively. The current statistics, especially the domestic statistics, show that the iPTH target is difficult to meet the standard. This leads to confusion over the iPTHs target value. Is the goal worth setting out for clinical needs? Do our hemodialysis patients have to follow this target? The confusion of the iPTH target value The KDOQI guidelines are used to set the strength