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透析中心夜间血液透析对尿毒症患者血磷代谢的影响 被引量:23

In-center nocturnal hemodialysis on phosphate metabolism in uremic patients
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摘要 目的 观察透析中心夜间长时血液透析(in-center nocturnal hemodialysis,INHD)模式对尿毒症患者高磷血症的疗效.方法 调查INHD时间6个月以上的56例患者进入INHD前l~3个月及进入INHD至2013年5月透析情况、透析前血磷、血钙、血全段甲状旁腺激素(iPTH)检测值,分析血磷变化趋势,统计患者降磷药物服用情况.结果 患者进入INHD前3个月内平均血磷水平变化无统计学差异,进入INHD后1个月平均血磷水平即显著下降(P<0.05),之后持续稳定在<1.67mmol/L水平;进入INHD后,有15例患者的31次(6.5%)检测出现低磷血症,发生过低磷血症的患者年龄更大、体重指数(BMI)更低、接受NHD时间更长(P<0.05):进入INHD后有14例(25%)患者停用降磷药物.结论 INHD能持续、平稳、有效地控制透析患者高磷血症,低磷血症发生率较低. Objective To observe the effect of in-center nocturnal hemodialysis (INHD) on hyperphos- phatemia in uremic patients. Methods Fifty-six patients treated with INHD for more than 6 months were in- vestigated. Serum phosphate, calcium and iPTH before and after entering INHD were collected. The use of phosphate binders was also recorded. Results The average serum phosphate changed insignificantly within the 3 months before 1NHD, but decreased significantly (P 〈0.05) after 1NHD for one month, and maintained less than 1,67 mmol/L thereafter. Hypophosphatemia occurred for 31 times (6.5%) in 15 patients after INHD. Hypophosphatemia was frequently found in patients with older age, lower body mass index, and longer noctur- nal hemodialysis duration (P 〈0.05). After INHD, phosphate binders were discontinued in 14 patients (25%). Conclusion 1NHD can effectively and stably control hyperphosphatemia in dialysis patients, with the lower prevalence of hypophosphatemia.
出处 《中国血液净化》 2014年第3期140-142,160,共4页 Chinese Journal of Blood Purification
基金 国家自然科学基金资助项目(编号:81200542) 上海市重点学科建设项目(编号:B902)
关键词 夜间血液透析 尿毒症 高磷血症 低磷血症 Nocturnal hemodialysis Uremia Hyperphosphatemia Hypophosphatemia
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参考文献16

  • 1G aasbeek A,Meinders E.Hypophosphatemia:An update on its etiology and treatment[J].Am J Med,2005,118:1094-1101.
  • 2Tentori F.Mineral and bone disorder and outcomes in hemodialysis patients:results from the DOPPS[J].Semin Dial,2010,23:10-14.
  • 3Kong X,Zhang L,Zhang L,et al.Mineral and bone disorder in Chinese dialysis patients:a multicenter study[J].BMC Nephrol,2012,21:116.
  • 4Palmer 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,2011,305:1119-1127.
  • 5Floege J,Kim J,Ireland E,et al.Serum iPTH,calcium and phosphate,and the risk of mortality in a European haemodialysis population[J].Nephrol Dial Transplant,2011,26:1948-1955.
  • 6Slatopolsky E,Moe S.50 years of research and discovery in chronic kidney disease and mineral & bone disorder:the central role of phosphate[J].Kidney Int Suppl,2011,121:S1-S2.
  • 7Danese MD,Belozeroff V,Smirnakis K,et al.Consistent control of mineral and bone disorder in incident hemodialysis patients[J].Clin J Am Soc Nephrol,2008,3:1423-1429.
  • 8Kidney Disease:Improving Global Outcomes (KDIGO) CKD-MBD Work Group.KDIGO clinical practice guideline for the diagnosis,evaluation,prevention,and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)[J].Kidney International 2009,76 (Suppl 113):S1-S130.
  • 9Pierratos A.Nocturnal home haemodialysis:an update on a 5-year experience[J].Nephrol Dial Transplant,1999,14:2835-2840.
  • 10Walsh M,Manns BJ,Klarenbach S,et al.The effects of nocturnal compared with conventional hemodialysis on mineral metabolism:A randomized-controlled trial[J].Hemodial Int,2010,14:174-181.

二级参考文献29

  • 1United States Renal Data System-USRDS.2003.Mortality and causes of death.http://www.usrds.org/2002/pdf/h.pdf.
  • 2Ng YH,Meyer KB,Kusek JW,et al.Hemodialysis timing,survival,and cardiovascular outcomes in the Hemodialysis (HEMO) Study.Am J Kidney Dis,2006,47:614-624.
  • 3Pereira BJG,Sayegh MH,Blake PG.Chronic kidney disease,dialysis,and transplantation.In:Pereira BJG,Sayegh MH,Blake PG,eds.A Companion to Brenner and Rector's The Kidney.Philadelphia:Saunders,2005:472-480.
  • 4Buillod RC,Shaldon S.Over-night unattended haemodialysis in the home.Proc EDTA,1965,2:99-109.
  • 5Charra B,Chazot Jean G,Hurot JM,et al.Long 3×8 hr dialysis:A three decade summary.J Nephrol,2003,16Suppl 7:S64-S69.
  • 6Pierratos A,Ouwendyk M,Francoeur R,et al.Nocturnal hemodialysis:Three-year experience.J Am Soc Nephrol,1998,9:859-868.
  • 7Troidle L,Finkelstein F,Hotchkiss M,et al.Enhanced solute removal with intermittent,in-center,8-hour nocturnal hemodialysis.Hemodial Int,2009,13:487-491.
  • 8Bugeja A,Dacouris N,Thomas A,et al.In-center nocturnal hemodialysis:another option in the management of chronic kidney disease.Clin J Am Soc Nephrol,2009,4:778-783.
  • 9Suri R,Depner TA,Blake PG,et al.Adequacy of quotidian hemodialysis.Am J Kidney Dis,2003,42(1 Suppl):42-48.
  • 10Culleton BF,Walsh M,Klarenbach SW,et al.Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life.JAMA,2007,298:1291-1299.

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