Clinical Study of Three Different Modes of Blood Purification for Clearance of Serum Phosphate in Maintenance Hemodialysis Patients_West China Medical Journal

Authors：

PU Chao , CHEN Yongzhong , BAI Jianing , ZHU Zaizhi ,  XU Zhizhong.

Department of Nephrology, People’s Hospital of Meishan City, Meishan, Sichuan 620010, P. R. China;

Corresponding?author：

XU Zhizhong., Email: leshanmcliu@163.com

Keywords：

血液透析; 血液灌流; 血液透析濾過; 高磷血癥

DOI：

10.7507/1002-0179.20130159

Video：

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目的　觀察三種不同血液凈化方式[血液透析（HD）、血液透析濾過（HDF）、血液透析+血液灌流（HD+HP）]對維持性血液透析患者高磷血癥清除效果。方法　選擇2009年2月－2011年2月行維持性血液透析的48例高磷血癥患者為研究對象，所有患者在低鈣透析（1.25 mmol/L）的基礎，隨機分為HD組、HDF組、HD+HP組，每組16例，分別在治療時及治療后4周、8周檢查鈣、磷、鈣磷乘積和全段甲狀旁腺激素，并觀察其變化。結果　在治療4周、8周后，HDF組、HD+HP組磷較前均顯著下降（P值均＜0.05），兩組同時點相比較差異無統計學意義（P＞0.05）；HD組較前血磷無明顯變化（P＞0.05）。結論　HDF、HP清除維持性血液透析患者高磷有顯著的效果，而HD效果則不佳。

Citation： PU Chao,CHEN Yongzhong,BAI Jianing,ZHU Zaizhi,XU Zhizhong.. Clinical Study of Three Different Modes of Blood Purification for Clearance of Serum Phosphate in Maintenance Hemodialysis Patients. West China Medical Journal, 2013, 28(4): 495-498. doi: 10.7507/1002-0179.20130159 Copy

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6.	Sprague SM, Abboud H, Qin P, et al. Lanthanum carbonate reduces phosphorus burder in patients with CKD stage 3 and 4: a randomized trial[J]. Clin J Am Soc Nephrol, 2009, 4(1): 178-185.
7.	尹道馨，張東亮，劉文虎. 血液透析濾過在維持性透析患者中的臨床應用[J].首都醫科大學學報，2009, 30(2): 154-160.
8.	Davenport A, Gardner C, Delaney M, et al. The effect of dialysis modality on phosphate control: haemodialysis compared to haemodiafiltration. The Pan Thames Renal Audit[J]. Nephrol Dial Transplant, 2010, 25(3): 897-901.
9.	王秀玲, 劉健, 桑小紅, 等．HA型大孔樹脂血液灌流治療慢性腎功能衰竭的臨床觀察[J]. 中華腎臟病雜志, 2000, 16(2): 97-99.
10.	唐萬欣，陶冶，付平，等. 連續性靜脈-靜脈血液濾過中低磷血癥防治及危重評分相關性研究[J]. 華西醫學, 2007, 22(1): 40-41.
11.	張景紅, 宦紅娣. 維持性血液透析患者高磷血癥的控制[J]. 中國血液凈化, 2009, 8(10): 533-535.
12.	李海明, 顧勇, 薛駿，等. 甲狀旁腺全切除加前臂移植治療尿毒癥繼發性甲狀旁腺功能亢進[J]. 中華腎臟病雜志, 2006,22(4): 197-200.

1. 　Melamed ML, Eustace JA, Plantinga L, et al. Changes in serum cal-cium, phosphate, and PTH and the risk of death in incident dialysis patients: a longitudinal study[J]. Kidney Int, 2006, 70(2): 351-357.
2. 　張建榮，張凌. 慢性腎臟病繼發性甲旁亢[M]. 北京: 人民軍醫出版社，2010: 85-92.
3. 　Palmer SC, Hayen A, Macaskill P, et al. Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis[J]. JAMA, 2011, 305(11): 1119-1127.
4. 　張凌. 重視慢性腎衰竭患者高磷血癥的處理[J]. 中國血液凈化，2004，3 (4)：181-183.
5. 　Block GA, Spiegel DM, Ehrlich J, et al. Effects of sevelamer and calcium on coronary artery calcification in patients new to henodialysis[J]. Kidney Int, 2005, 68(4): 1815-1824.
6. 　Sprague SM, Abboud H, Qin P, et al. Lanthanum carbonate reduces phosphorus burder in patients with CKD stage 3 and 4: a randomized trial[J]. Clin J Am Soc Nephrol, 2009, 4(1): 178-185.
7. 　尹道馨，張東亮，劉文虎. 血液透析濾過在維持性透析患者中的臨床應用[J].首都醫科大學學報，2009, 30(2): 154-160.
8. 　Davenport A, Gardner C, Delaney M, et al. The effect of dialysis modality on phosphate control: haemodialysis compared to haemodiafiltration. The Pan Thames Renal Audit[J]. Nephrol Dial Transplant, 2010, 25(3): 897-901.
9. 　王秀玲, 劉健, 桑小紅, 等．HA型大孔樹脂血液灌流治療慢性腎功能衰竭的臨床觀察[J]. 中華腎臟病雜志, 2000, 16(2): 97-99.
10. 　唐萬欣，陶冶，付平，等. 連續性靜脈-靜脈血液濾過中低磷血癥防治及危重評分相關性研究[J]. 華西醫學, 2007, 22(1): 40-41.
11. 　張景紅, 宦紅娣. 維持性血液透析患者高磷血癥的控制[J]. 中國血液凈化, 2009, 8(10): 533-535.
12. 　李海明, 顧勇, 薛駿，等. 甲狀旁腺全切除加前臂移植治療尿毒癥繼發性甲狀旁腺功能亢進[J]. 中華腎臟病雜志, 2006,22(4): 197-200.

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West China Medical Journal

Clinical Study of Three Different Modes of Blood Purification for Clearance of Serum Phosphate in Maintenance Hemodialysis Patients

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