Analysis of the effects of hemodiafiltration and hemoperfusion on calcium,phosphorus,parathyroid hormone and nutritional status in MHD patients
Objective To explore the effects of hemodiafiltration(HDF)and hemoperfusion(HP)on calcium,phosphorus,parathyroid hormone and nutritional status in maintenance hemodialysis(MHD)patients.Methods 135 patients were selected as the research subjects,and the patients were divided into group A,group B and group C according to random numerical table,with 45 cases in each group.Group A was treated with 12 sessions of low-flux hemodialysis(LFHD)every 4 weeks;Group B was treated with 10 sessions of LFHD,1 session of HDF,and 1 session of LFHD+HP every 4 weeks;Group C was treated with 8 sessions of LFHD,2 sessions of HDF,and 2 sessions of LFHD+HP every 4 weeks.The blood calcium,blood phosphorus,parathyroid hormone and nutritional status indicators[serum albumin(ALB)and hemoglobin(Hb)]of the three groups were compared.Results Before treatment,the levels of parathyroid hormone,blood phosphorus and blood calcium in group A were(357.79±235.00)pg/ml,(2.01±0.72)mmol/L and(1.82±0.28)mmol/L,those in group B were(343.44±225.90)pg/ml,(2.11±0.77)mmol/L and(1.87±0.27)mmol/L,and those in group C were(395.10±267.41)pg/ml,(2.32±0.80)mmol/L and(1.95±0.26)mmol/L.After treatment,the levels of parathyroid hormone,blood phosphorus and blood calcium in group A were(380.51±307.68)pg/ml,(2.22±0.86)mmol/L and(1.86±0.26)mmol/L,those in group B were(264.58±131.71)pg/ml,(1.85±0.58)mmol/L and(1.99±0.20)mmol/L,and those in group C were(304.38±191.63)pg/ml,(1.93±0.50)mmol/L and(2.02±0.23)mmol/L.Before treatment,there were no statisticall difference in parathyroid hormone,blood phosphorus and blood calcium levels among the three groups(P>0.05).After treatment,the levels of parathyroid hormone,blood phosphorus and blood calcium were compared among the three groups,and there was statistical difference(P<0.05).There was no statistical significance in blood calcium,blood phosphorus and parathyroid hormone levels in group A before and after treatment(P>0.05).The levels of blood phosphorus and parathyroid hormone after treatment in group B and group C were lower than those before treatment(P<0.05),and the level of blood calcium was higher than that before treatment(P<0.05),but there was no statistically significant difference in the comparison of the levels of parathyroid hormone,blood phosphorus,and blood calcium between group B and group C after treatment(P>0.05).Before treatment,ALB and Hb levels were(36.44±5.25)and(75.89±18.52)g/L in group A,(35.10±5.76)and(80.02±18.61)g/L in group B,and(37.12±5.77)and(79.90±18.17)g/L in group C,respectively.After treatment,ALB and Hb levels were(37.45±4.89)and(84.93±23.54)g/L in group A,(39.87±4.70)and(100.16±19.48)g/L in group B,and(40.03±4.62)and(100.02±21.08)g/L in group C,respectively.Before treatment,there was no significant difference in ALB and Hb levels among the three groups(P>0.05).After treatment,Hb levels of all three groups were elevated compared with those before treatment,and there was statistical significance(P<0.05).ALB levels were elevated in group A after treatment compared with that before treatment,but there was no statistical difference(P>0.05).ALB levels in group B and group C were elevated after treatment compared with that before treatment,and there was statistical significance(P<0.05),but there was no statistical difference in ALB level between group B and group C after treatment(P>0.05).Conclusion For MHD patients,LFHD treatment alone failed to effectively improve calcium and phosphorus metabolism disorders and secondary hyperparathyroidism in patients.Combined treatment with HDF and HP can better clear blood phosphorus,parathyroid hormone and increase blood calcium,increase the frequency of HDF and HP,and will not increase the incidence of malnutrition in patients,but this method has no further effect on improving calcium and phosphorus metabolism disorders and secondary hyperparathyroidism in patients.
HemodiafiltrationHemoperfusionMaintenance hemodialysisCalciumPhosphorusParathyroid hormoneNutritional status
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