Comparable removal effect of six different blood purification treatments on phosphorus and parathyroid hormone of uremic patients

Abstract

Objective To investigate the removal effect of six different blood purification ways on phosphorus and PTH of uremic patients.Methods A total of 200 patients whose hemodialysis phosphorus were greater than 1.70 mmol/L and PTH were greater than 300 pg/ml were selected and were divided randomly into 6 groups:hemodialysis combined with hemoperfusion (HD + HP130) group,HD + HP230 group,hemodiafiltration (HDF) group,hemodialysis (HD) group,continuous veno-venous hemofiltration (CVVH) group and high-flux hemodialysis (HFHD) group.Compare clearance rate of phosphorus and PTH blood with these six groups before and after treatment.Results PTH of HD group decreased after the treatment,but there was no statistically significant difference (P ＞ 0.05) ; while after phosphorus treatment,PTH decreased and there was statistically significant difference (P ＜ 0.05).Both PTH and phosphorus in HDF group and HFHD group decreased after the treatment and there was statistically significant difference (P ＜ 0.05).PTH of CVVH group decreased obviously after the treatment and there was statistically significant difference (P ＜ 0.01),PTH decreased in HD + HP130 and HD + HP230 group after the treatment; There was statistically significant difference (P ＜ 0.05),which was higher than HDF group (P ＜ 0.05) and HFHD group.Moreover,phosphorus decreased and there was statistically significant difference (P ＜ 0.05).Conclusions Hemodialysis combined with hemoperfusion,continuous veno-venous hemofiltration,high-flux hemodialysis and hemodiafiltration can effectively remove phosphorus and PTH.The removal result was CVVH group ＞ HD+ HA230 group ＞ HD+ HA130 group ＞ HDF group ＞ HFHD group.What's more,hemodialysis can effectively remove phosphorus but cannot effectively remove PTH. Key words: Blood purification; Single treatment; Hemodialysis; Phosphorus; Parathyroid hormone; Uremia