The influence of different blood purification methods on blood phosphorus and parathyroid hormone in patients with mainte-nance hemodialysis

CUI Li; XING Guolan; ZHANG Ying; ZHANG Deying; ZHANG Lina; JI Sufang; CHEN Suzhen

doi:10.3969/j.issn.1004-437X2014.12.008

Abstract：Objective:To observe the influence of three different kinds of blood purification meth-ods for blood phosphorus and parathyroid hormone levels in patients with maintenance hemodialysis ( MHD) . Methods:60 patients with maintenance hemodialysis ( MHD) were selected as the re-search objects in the blood purification center of Jincheng people's hospital from January to June of 2013 . The blood phosphorus level of all patients was higher than 1 . 78 mmol/L and parathyroid hormone ( iPTH) level was higher than 300 pg/ml, based on the blood calcium concentration tend-ency for 1. 5 mmol/L in dialysate. They were randomly divided into three groups, including hemo-dialysis group ( HD group) , hemodialysis and blood perfusion group ( HD+HP group) , hemodial-ysis and hemodialysis filtration group ( HD +HDF group ) , and all patients were cured for 6 months. And then the levels of serum calcium, phosphate and intact parathyroid hormone ( iPTH)were detected. Results: ①The blood phosphorus of all the three groups patients after treatment were significantly decreased ( P<0 . 05 ) , and there was no statistically significant difference be-tween HD+HDF and HD+HP group (P>0. 05). Compared with HD group, both of the other two groups had statistical significance ( P<0 . 05 ) ;②The levels of serum iPTH before and after treatment didn’t significantly changed in the HD group (P>0. 05), however the levels of serum iPTH were significantly decreased in other two groups after treatment ( P<0 . 05 ) . There was a sig-nificant difference between HD+HDF group and HD +HP group ( P <0 . 05 ); ③The levels of blood calcium in all the three groups after treatment were increased, but there was no statistically significant difference between groups ( P >0 . 05 ) . Conclusion: All the three different kinds of blood purification methods could effectively remove blood phosphorus. The effect of HD+HDF and HD+HP was better than pure HD; HD +HDF and HD +HP could effectively remove serum iPTH, especially for HP + HD, but not pure HD.