中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (02): 93-96.doi: 10.3969/j.issn.1671-4091.2015.02.00

• 临床研究 • 上一篇    下一篇

长期使用Ca+1.25mmol/L透析液对透析患者矿物质代谢的影响

唐利,廖常彬,钟春梅   

  1. 四川，自贡市第三人民医院肾病科
  • 收稿日期:2014-06-25 修回日期:2014-12-08 出版日期:2015-02-12 发布日期:2015-02-12
  • 通讯作者: 唐利 1135334061@qq.com E-mail:1135334061@qq.com

The long-term effect of 1.25 mmol/l calcium in dialysate on mineral metabolism in maintenance hemodialysis patients

  • Received:2014-06-25 Revised:2014-12-08 Online:2015-02-12 Published:2015-02-12

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摘要： 【摘要】目的 观察长期应用钙离子浓度为1.25mmol/L的低钙透析液(low calcium dialysate，LCaD)对维持性血液透析患者(maintained hemodialysis, MHD)矿物质代谢的影响。 方法 选择进行血液透析治疗3个月以上的慢性肾衰竭患者50例，分别观察应用低钙透析液3,6,9个月后钙磷，甲状旁腺激素的变化。 结果 应用1.25mmol/L的低钙透析液透析后不同血钙水平的组别及不同iPTH水平的组别血钙浓度均有明显下降。整体观察血磷在低钙透析3，6个月时无明显改变，9个月时有明显下降(P＜0.05)。血iPTH多在低钙透析3个月时无明显改变，应用至6,9个月后有明显升高(P＜0.05)。 结论 低钙透析可降低部分血液透析患者血钙水平，使得血磷更易控制；但同时可能加重SHPT，需同时合理使用钙剂及活性维生素D。

关键词: 血液透析, 1.25mmol/L钙浓度透析液, 矿物质代谢

Abstract: 【Abstract】 Objective To observe the long-term effect of 1.25 mmol/l calcium in dialysate (LCaD) on mineral metabolism in maintenance hemodialysis (MHD) patients. Methods A total of 50 chronic renal failure patients with MHD for more than 3 months were randomly recruited from our hospital. The effects of LCaD on serum calcium, phosphorus, and intact parathyroid hormone (iPTH) were observed after the treatment for 3, 6, 9 months. Results After the use of LCaD, we found that serum calcium level dramatically declined in the patients with different serum calcium levels and different serum iPTH levels (P＜0.05). Serum phosphorus was unchanged after the treatment of LCaD for 3 and 6 months, but decreased after the treatment for 9 months (P＜0.05). Serum iPTH was unchanged after the treatment for 3 months, and increased significantly after the treatment for 6 and 9 months (P＜0.05). Conclusion Low calcium in dialysate can decrease the serum calcium level in some of MHD patients, and can effectively control the serum phosphorus. However, low calcium in dialysate will increase the risk of secondary hyperparathyroidism. Therefore, calcium and active vitamin D preparations should be supplemented at the same time.

Key words: hemodialysis, 1.25mmol/L calcium concentration in dialysate, mineral metabolism