关键词: 活性维生素D, 低钙透析液, 继发性甲状旁腺功能亢进, 血液透析

Abstract: Objective To investigate the effect and adverse reaction of active vitamin D and low calcium dialysate on secondary hyperparathyroidism in 13 new hemodialysis patients. Methods Hemodialysis with low calcium dialysate(1.25mmol/L) was applied for 13 patients first. As to calcium-phosphorus product less than 55mg2/dl2, therapy of active vitamin D was begun according to the severities of hyperparathyroidism. Serum calcium, phosphorus, calcium-phosphorus product, iPTH and other side effects were observed. Results After 2months of treatment, serum calcium markedly elevated from (8.37±0.82)mg/dl to (9.24±0.97)mg/dl(P＜0.05). There was no significant difference in the change of serum phosphorus and calcium-phosphorus product.The iPTH significantly declined from (590.8±274.0)pg/ml to(305.3±227.9) pg/ml(P＜0.05). Following 5-16 months,serum phosphorus (5.54±1.06)mg/dl and calcium-phosphorus product (51.43±11.4)mg2/dl2 were apparently higher than pre-therapy(P＜0.05). The lever of serum calcium, phosphorus and calcium-phosphorus product were somewhat higher than those after 2 months of treatment. The iPIH of 11 patients fluctuated between 150～320pg/ml, 2 patients did not achieve fine effect, 13 patients endured well to low calcium dialysate, there were no adverse reaction including muscle spasm, hypotension or arrhythmia. Conclusions Therapy of active vitamin D and low calcium dialysate on secondary hyperparathyroidism in new hemodialysis patients is effective. It is recommended to use low calcium dialysorus for those patients whose serum phosphorus is high and calcium is not too low.Using of available calcium-containing phosphorus binders witch could increase to patients calcium load and low calcium dialysate may reduce calcium-phosphorus product without enhancing the risk of cardiovascular calcification.

Key words: Low calcium dialysate, Secondary hyperparathyroidism, Hemodialysis