Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: A retrospective observational study.
Ning An, Haishan Zhou, Xianhui Li, Xinyin Yu, Haijuan Yang, Liping Zhai, Yuhua Huang, Cuiwei Yao
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引用次数: 0
Abstract
Objective: To investigate the effects of low-calcium and standard-calcium dialysate in patients with chronic kidney disease on peritoneal dialysis, and find out which dialysate has less vascular calcification effect.
Methods: A total of 141 patients who had undergone peritoneal dialysis (PD) for 2 years in the PD centre from January 2012 to December 2017 were included and divided into two groups according to the calcium concentration of the PD fluid used. There were 79 cases in the low-calcium group, with a dialysate calcium concentration of 1.25 mmol/L and 62 cases in the standard-calcium group, with a dialysate calcium concentration of 1.75 mmol/L. The demographic characteristics and clinical information before initiation of PD were collected and compared between the two groups. Information on the serum calcium, phosphorus and PTH, systolic and diastolic blood pressures and the use of antihypertensive and phosphate-lowering drugs in the second year of dialysis was also collected and compared between the two groups. Vascular calcification was assessed in patients on PD treatment.
Results: The mean serum calcium concentrations before initiation of PD in the low- and standard-calcium groups were 1.94 ± 0.27 and 1.89 ± 0.28 mmol/L, respectively. The serum calcium concentrations after PD were 2.30 ± 0.21 and 2.41 ± 0.23 mmol/L, respectively. After PD, the serum calcium concentration in both groups was significantly increased (p < 0.05). The serum calcium concentration in the low-calcium group after PD treatment was lower than that in the standard-calcium group, and the difference was statistically significant (p < 0.05). Compared with the standard-calcium group, patients in the low-calcium group had significantly higher parathyroid hormone concentrations (p < 0.05). More types of phosphate-lowering drugs were used (59.49%) in the low-calcium group than that in the standard-calcium group (35.48%; p < 0.05). The number of antihypertensive drug usage were also higher in the low-calcium group, and the difference was statistically significant (p < 0.05). As for the vascular calcification effect, the two groups have shown no statistical difference in abdominal aortic calcification rate, carotid arteriosclerosis rate and aortic arch calcification rate (p < 0.05).
Conclusion: We found that low-calcium PD fluid may increase the PTH level and the proportion of CKD patients using antihypertensive drug and phosphorus-lowering drug, but the vascular calcification effect of the low and standard calcium PD fluid needs further exploration. This paper provides new evidence for the choice of dialysate for PD, low-calcium dialysate has no outstanding advantages for long term dialysis.
目的：探讨低钙和标准钙透析液对慢性肾脏病患者腹膜透析的影响，找出哪种透析液血管钙化作用较小。方法：对141例腹膜透析患者进行为期2个月的腹膜透析 纳入2012年1月至2017年12月在PD中心的年数，并根据所用PD液的钙浓度分为两组。低钙组有79例，透析液钙浓度为1.25 mmol/L，标准钙组62例，透析液钙浓度为1.75 mmol/L。收集两组患者在帕金森病发作前的人口学特征和临床信息并进行比较。还收集了两组透析第二年的血清钙、磷和PTH、收缩压和舒张压以及抗高血压和降磷酸盐药物的使用情况，并对其进行了比较。对接受PD治疗的患者进行了血管钙化评估。结果：低钙组和标准钙组在PD开始前的平均血清钙浓度为1.94 ± 0.27和1.89 ± 0.28 mmol/L。PD后的血清钙浓度为2.30 ± 0.21和2.41 ± 0.23 mmol/L。PD后两组血清钙浓度均明显升高（p p p p p p 结论：我们发现低钙PD液可能会增加PTH水平和CKD患者使用降压药和降磷药的比例，但低钙标准PD液的血管钙化作用有待进一步探索。本文为PD透析液的选择提供了新的依据，低钙透析液在长期透析中没有突出的优势。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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