低钙透析液治疗维持性血液透析患者动力缺失性骨病临床观察.docVIP

低钙透析液治疗维持性血液透析患者动力缺失性骨病临床观察 　　[摘要] 目的:观察低钙透析液治疗维持性血液透析患者动力缺失性骨病的有效性和安全性以及对钙磷代谢的影响。方法:选取合并动力缺失性骨病的维持性血液透析患者31例,应用1.25 mmol/L钙浓度透析液治疗12个月,观察不同时期(第1、3、6、12个月)患者血iPTH、血钙、血磷、血钙磷乘积、血红蛋白、白蛋白等指标的变化及相关不良反应。结果:所有患者治疗前血清总钙、血磷、钙磷乘积均高于NKF-K/DOQI指南推荐的目标范围,iPTH均 　　[关键词] 低钙透析液;动力缺失性骨病;血液透析;甲状旁腺素 　　[中图分类号] R692.5[文献标识码]A [文章编号]1673-7210(2010)06(c)-054-03 　　 　　Clinical observation of low calcium dialysate on adynamic bone disease of the maintained hemodialysis patients 　　LI Yongquan, ZHANG Xinzhou, WANG Kang, ZHANG Wanfan, HUANG Xuanzhu 　　(Department of Nephrology, the Peoples Hospital of Shenzhen City the Second Clinical Medical College of Jinan University, Shenzhen 518020, China) 　　[Abstract] Objective: To observe the effectiveness and safety of low calcium dialysate in maintained hemodialysis (MHD) patients with adynamic bone disease. Methods: 31 cases of maintained hemodialysis patients with adynamic bone diseasereceived treatment of low calcium dialysate (calcium concentration 1.25 mmol/L) for a period of 12 months. Levels of serum iPTH, calcium, phosphorus, calcium-phosphorus product, albumin and hemoglobin were analyzed at 1, 3, 6, 12 months. Results: Levels of serum iPTH, calcium, phosphorus, calcium-phosphorus product in all patients exceeded the range recommended by the guideline of NKF-K/DOQI before the treatment; after treatment with low calcium dialysate 1 month, level of serum iPTH increased significantly, and increased gradually with the treatment time prolonged, and reached a peak at 12 months; at the same time, levels of serum calcium, phosphorus, calcium-phosphorus product decreased gradually from 1 to 6 months compared with before treatment, but changed slightly in the following 6 months. There was no significant change in serum albumin and hemoglobin level and dosage of erythropoietin during treatment. The majority of patients tolerated low calcium dialysate well, no significant hypotension and hyperspasmia appeared during treatment. Conclusion: The low c