Effect of serum phosphorus variation on hemodialysis patients with end stage of renal disease

ZHANG Yanan; GAO Bihu; WANG Xin; PIAO Mingji

doi:10.3969/j.issn.1671-6450.2017.10.009

Abstract：Objective To explore the effect of variation of serum phosphorus on hemodialysis patients with end stage of renal disease (ESRD).Methods One hundred and eighty patients with end stage of renal disease who underwent hemodialysis in our hospital from June 2010 to June 2015 were selected and clinical data were collected.According to the results of hemodialysis,the patients were divided into high variant group and low variant group according to the median CV of blood phosphorus variation,CV ≥ 0.226 mmol/L was high variant group,CV < 0.226 mmol/L was low variant group.The effect of CV level on patients with hemodialysis was analyzed.Kaplan Meier method was used to analyze the survival rate and log rank method was used to test significance.Cox proportional hazards model was used to analyze the key factors of death.Results The mean age of the patients was (66.51±11.34) years old,39 patients (21.7％) died due to cardiovascular death,21 patients (11.7％) died of cardiovascular disease,the all-cause mortality 28.4％(27/95) was higher than that in the low variant group 18.8％(16/85) (P<0.05).Cox regression analysis found that aging,high and low variability of blood phosphorus and serum albumin in hemodialysis patients is due to the independent risk factors of death (OR=0.082,95％CI 1.712-4.467;OR=0.323,95％CI 1.022-2.137;OR=0.372,95％CI 1.621-13.721).The survival rates of 12 and 18 months in the high variant group were lower than those in the low variant group (P<0.05).Conclusion The risk of all cause death and cardiovascular death in patients with end stage renal disease hemodialysis is significantly higher than that in patients with low blood phosphorus variability,and the stability of serum phosphorus can improve the survival rate of hemodialysis patients and improve their survival.