The study of the effect of low calcium dialysate on calcium phosphate metabolism and left ventricular function in CAPD patients

HU Tinghai; et al

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The study of the effect of low calcium dialysate on calcium phosphate metabolism and left ventricular function in CAPD patients

更新时间：2024-01-17

- The study of the effect of low calcium dialysate on calcium phosphate metabolism and left ventricular function in CAPD patients
- Journal of Chongqing Medical University Issue 9, Pages: 980-983(2007)
- 作者机构：
  
  1. 重庆医科大学附属第二医院肾内科
  2. 重庆市南岸区人民医院急诊科
  3. 重庆医科大学附属第二医院肾内科,重庆,400010
  4. ,重庆,400061
- 作者简介：
- 基金信息：
- DOI：
  CLC： R692.5
- Published：2007，
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[1]胡廷海,王蜀湘,张玲.低钙腹透液对CAPD患者钙磷代谢及左心功能影响的临床研究[J].重庆医科大学学报,2007(09):980-983+993.

HU Tinghai, et al. The study of the effect of low calcium dialysate on calcium phosphate metabolism and left ventricular function in CAPD patients. [J]. Journal of Chongqing Medical University (9):980-983(2007)
[1]胡廷海,王蜀湘,张玲.低钙腹透液对CAPD患者钙磷代谢及左心功能影响的临床研究[J].重庆医科大学学报,2007(09):980-983+993. DOI：

HU Tinghai, et al. The study of the effect of low calcium dialysate on calcium phosphate metabolism and left ventricular function in CAPD patients. [J]. Journal of Chongqing Medical University (9):980-983(2007) DOI：

摘要

目的:观察低钙透析液（生理钙）对持续非卧床腹膜透析（CAPD）患者的钙磷代谢及左心功能的影响

为寻求较适宜的治疗方案提供临床依据。方法:在规律性随访的腹透患者中选择校正的血清总钙>2.12 mmol/L、iPTH<150pg/ml的患者33例

改用百特PD4腹透液（钙1.25mmol/L

其余成分相同）

继续口服碳酸钙3g/天。使用低钙透析液期间的第0

8周检测血总钙、血磷、白蛋白、碱性磷酸酶、钠、钾、肌酐、尿素氮、血红蛋白、血iPTH等实验室指标。使用低钙透析液期间的第0

8周采用彩色多普勒超声仪测量左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、射血分数（EF）、短轴缩短分数（FS）、左心室等容舒张时间（IVRT）、舒张早期最大血流速（Emax）、舒张晚期最大血流速（Amax）、及舒张早期最大血流速与舒张晚期最大血流速之比（E/Amax）。结果:在改用低钙透析液随访期间

血钙值有明显下降（P<0.05）

但仍基本维持在正常水平。iPTH值有明显升高（P<0.05）

而血磷、血清白蛋白、碱性磷酸酶、钠、钾、肌酐、尿素氮等指标差异无统计学意义。IVRT、E/Amax在随访期间的变化有统计学意义（P<0.05）

而LVEDD、LVESD、EF、FS在随访期间的变化则无统计学意义。相关性分析发现只有血钙变化（第0

8周）与E/Amax的变化呈负相关（r=-0.39

P<0.05）

与IVRT变化呈正相关（r=0.46

P<0.05）

其它各项临床和实验室观察指标的变化与超声指标的变化均不存在相关性（P>0.05）。结论:低钙腹透液有助于高血钙或正常血钙的部分腹膜透析患者左心室舒张功能的好转。而这一作用可能与低钙透析液改善了部分腹膜透析患者的钙磷代谢和钙负荷过重的情况有关。

Abstract

Objective: To investigate the effect of low calcium dialysate on calcium phosphate metabolism

left ventricular function in continuous ambulatory peritoneal dialysis(CAPD) patients.We wish to provide more clinical support for a more optimal cure.Method: Thirty-three CAPD patients(Serum calcium>2.12 mmol/L、iPTH<150pg/ml) were selected in this study.Standard calcium dialysate solution(1.75mmol/L) was changed to lower calcium dialysate(Baxter PD4 with calcium concentration 1.25mmol/L).Calcium carbonate(3g/d) was used at the meantime.Serum calcium

phosphate

albumin

alkaline phosphatease

natrium

kalium

serum creatinine(Scr)

blood urea nitrogen(BUN)

hemachrome

intact parathyroid hormone(iPTH) were detected periodically(0

4th

8th week).The left ventricu1ar function were echocardiographically examined at the beginning and the end of this study

respectively.Results: After changing to PD4

serum calcium concentration decreased

and iPTH increased significantly.The changes in E/Amax

isovolumic relaxation time were statistically significant.The change in serum calcium(0

8th week) was the only variab1e correlating independently with the changes in E/Amax(r=0.39

P<0.05)

IVRT(r=0.46

P<0.05).Conclusion: There were favorable changes in left ventricular function after treatment with low calcium dialysate.These changes may be associated with the ameliorate of calcium phosphate metabolism and calcium overload.

关键词

慢性肾功能不全腹膜透析钙超声心动图

Keywords

Chronic rena1 failureperitoneal dialysiscalciumechocardiography

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