Mineral and bone disorder in Chinese dialysis patients: a multicenter study.
Mineral and bone disorder in Chinese dialysis patients: a multicenter study.
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DOI：
10.1186/1471-2369-13-116
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发表时间：
2012-09-21
期刊：
影响因子：
2.3
通讯作者：
Wang H
中科院分区：
文献类型：
--
作者：
Kong X;Zhang L;Zhang L;Chen N;Gu Y;Yu X;Liu W;Chen J;Peng L;Yuan W;Wu H;Chen W;Fan M;He L;Ding F;Chen X;Xiong Z;Zhang J;Jia Q;Shi W;Xing C;Tang X;Hou F;Shu G;Mei C;Wang L;Xu D;Ni Z;Zuo L;Wang M;Wang H
慢性肾脏病患者的矿物质和骨紊乱（MBD）与发病率和死亡率增加相关。关于发展中国家，尤其是中国透析患者MBD治疗状况的研究非常有限。一项横断面研究纳入了1711例血液透析（HD）患者和363例腹膜透析（PD）患者。分析与MBD相关的血清磷（P）、钙（Ca）、全段甲状旁腺激素（iPTH）等指标。将MBD目标的实现与透析结局和实践研究（DOPPS）3和DOPPS 4的结果进行了比较。与高磷血症相关的因素进行了检查。共有来自28家医院的2074名透析患者参与了这项研究。只有38.5%、39.6%和26.6%的患者达到肾脏疾病结局质量倡议（K/DOQI）规定的血清P、Ca和iPTH水平目标。血磷和钙水平HD组分别为（6.3 ± 2.1）mg/dL和（9.3 ± 1.1）mg/dL，PD组分别为（5.7 ± 2.0）mg/dL和（9.2 ± 1.1）mg/dL，差异有统计学意义（P < 0.05）。PD组iPTH水平明显高于HD组（P = 0.03）。达到P的K/DOQI目标的患者百分比（37.6%vs49.8%vs54.5%，P < 0.01），Ca与DOPPS 3和DOPPS 4的数据相比，HD患者的PTH（38.6% vs 50.4% vs 56.0%，P < 0.01）和iPTH（26.5% vs 31.4% vs 32.1%，P < 0.01）较低。血磷水平高于5.5 mg/dL的患者比例在HD患者中为57.4%，在PD患者中为47.4%。年龄、透析模式和居住地区与高磷血症独立相关。接受透析的中国患者的MBD状况不佳。高磷血症问题突出，需要进一步关注。
Mineral and bone disorder (MBD) in patients with chronic kidney disease is associated with increased morbidity and mortality. Studies regarding the status of MBD treatment in developing countries, especially in Chinese dialysis patients are extremely limited. A cross-sectional study of 1711 haemodialysis (HD) patients and 363 peritoneal dialysis (PD) patients were enrolled. Parameters related to MBD, including serum phosphorus (P), calcium (Ca), intact parathyroid hormone (iPTH) were analyzed. The achievement of MBD targets was compared with the results from the Dialysis Outcomes and Practice Study (DOPPS) 3 and DOPPS 4. Factors associated with hyperphosphatemia were examined. Total 2074 dialysis patients from 28 hospitals were involved in this study. Only 38.5%, 39.6% and 26.6% of them met the Kidney Disease Outcomes Quality Initiative (K/DOQI) defined targets for serum P, Ca and iPTH levels. Serum P and Ca levels were statistically higher (P < 0.05) in the HD patients compared with those of PD patients, which was (6.3 ± 2.1) mg/dL vs (5.7 ± 2.0) mg/dL and (9.3 ± 1.1) mg/dL vs (9.2 ± 1.1) mg/dL, respectively. Serum iPTH level were statistically higher in the PD patients compared with those of HD patients (P = 0.03). The percentage of patients reached the K/DOQI targets for P (37.6% vs 49.8% vs 54.5%, P < 0.01), Ca (38.6% vs 50.4% vs 56.0%, P < 0.01) and iPTH (26.5% vs 31.4% vs 32.1%, P < 0.01) were lower among HD patients, compared with the data from DOPPS 3 and DOPPS 4. The percentage of patients with serum phosphorus level above 5.5 mg/dL was 57.4% in HD patients and 47.4% in PD patients. Age, dialysis patterns and region of residency were independently associated with hyperphosphatemia. Status of MBD is sub-optimal among Chinese patients receiving dialysis. The issue of hyperphosphatemia is prominent and needs further attention.