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目的慢性肾脏病矿物质与骨异常(CKD-MBD)是CKD患者的常见并发症。关于CKD-MBD的现有数据重点关注血液透析(HD)患者。关于中国腹膜透析(PD)患者中CKD-MBD的研究极少,尤其缺乏大样本对比性研究。我们希望明确与CKD-MBD相关参数有关的潜在影响因素。方法收集本单位定期PD患者的人口统计学资料。采集空腹血标本及前一天全部尿液和透析液。测定血清标本的生化全套。测定24小时尿量以及腹透液与24小时尿液中肌酐(Cr)与尿素氮(BUN)浓度。根据公式计算周Kt/V、残余肾功能(RRF)和周肌酐清除率(Ccr)。研究血清钙(Ca)、磷(P)和全段甲状旁腺激素(i PTH)的可能相关因素。结果入选140例PD患者,其中男76例,女64例。具有更好残余肾功能的患者血P控制更佳。相关性分析表明血清钙与RRF、透析时间以及SCr和白蛋白(ALB)水平显著相关;血清P与RRF、Kt/V、周Ccr、BUN、透析时间以及SCr和ALB水平显著相关;血清i PTH与RRF、周Ccr、年龄、透析时间以及SCr和ALB水平显著相关。结论本研究结果表明以RRF和24小时尿量作为残余肾功能评价指标时,具有更好残余肾功能的PD患者血清P、ALP和i PTH控制更好。因此保护残余肾功能对ESRD人群有重要意义。
Purpose Chronic kidney disease (MDD-MBD) is a common complication of CKD. The available data on CKD-MBD focuses on hemodialysis (HD) patients. There are few studies on CKD-MBD in Chinese patients with peritoneal dialysis (PD), especially the lack of large sample comparative studies. We hope to clarify the potential impact factors associated with CKD-MBD-related parameters. Methods We collected the demographic data of regular PD patients in our hospital. Fasting blood samples and urine and dialysis fluid were collected the day before. Determination of serum samples of a full set of biochemistry. Determination of 24-hour urine output and dialysate and 24-hour urine creatinine (Cr) and urea nitrogen (BUN) concentrations. Weekly Kt / V, residual renal function (RRF), and creatinine clearance (Ccr) were calculated according to the formula. To study the possible related factors of serum Ca, P and whole PTH. Results A total of 140 PD patients were selected, including 76 males and 64 females. Patients with better residual renal function have better blood P control. Correlation analysis showed that serum calcium was significantly correlated with RRF, dialysis time, and levels of SCr and albumin (ALB); serum P was significantly correlated with RRF, Kt / V, Ccr, BUN, dialysis time and SCr and ALB levels; serum i PTH Significantly correlated with RRF, Ccr, age, dialysis duration, and SCr and ALB levels. CONCLUSIONS: The results of this study suggest that the control of serum P, ALP, and i PTH in patients with PD with better residual renal function is better when RRF and 24-hour urine output are used as indicators of residual renal function. Therefore, the protection of residual renal function in ESRD population is of great significance.