Effects of lowering dialysate calcium concentration on mineral metabolism and bone turnover in patients with low level of parathyroid hormone on hemodialysis

doi:10.3969/j.issn.1006-7795.2016.02.023

Abstract

Abstract: Objective To observe the effect of dialysate with lowering calcium concentration on mineral metabolism and bone turnover in patients with low level of parathyroid hormone on hemodialysis.Methods Total 70 patients with iPTH<100 pg/mL were treated with DCa-1.25mmol/l dialysate for 1 year. Serum calcium, phosphorus, alkaline phosphatase(ALP) levels were determined by standard method. Their levels of serum intact parathyroid (iPTH), osteocalcin (OC), procollagen type I amino-terminal propeptide (PINP), β-crosslaps (β-CTX) were measured by Chemiluminescence. iPTH, OC, PINP, β-CTX, serum calcium, phosphorus, ALP were measured before and 1, 3, 6, 12 months after the change of dialysate. Results After lowering D-Ca, serum iPTH levels progressively increased at 3 months(P<0.001), and serum OC, PINP, β-CTX levels increased at 1 months(P<0.001). In correlation analyses, the changes in OC and β-CTX correlated positively with baseline iPTH (OC:r=0.673, P=0.037;β-CTX:r=0.651, P=0.020), and correlated negatively with age (OC:r=-0.816, P<0.001;β-CTX:r=-0.718, P<0.001). In Logistic regression analysis, baseline iPTH, diabetes were independent factors of the improvement of iPTH level. Conclusion Dialysate with lowering calcium concentration can improve PTH levels and stimulate bone metabolism.

Key words: bone metabolism, low calcium dialysate, low parathyroid hormone, hemodialysis

CLC Number:

R692

Ma Lijie, Li Zhongxin, Liu Jing, Zhao Sumei. Effects of lowering dialysate calcium concentration on mineral metabolism and bone turnover in patients with low level of parathyroid hormone on hemodialysis[J]. Journal of Capital Medical University, 2016, 37(2): 228-232.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2016.02.023

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2016/V37/I2/228

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