STUDY OF DISTURBANCES OF PHOSPHATE AND PARATHYROID HORMON IN THE ELDERLY CHRONIC HEMODIALYSIS PATIENTS

Abstract

Objectives: 1. To identify the prevalence of the elderly chronic hemodialysis patients with dysturbances of Phosphate and PTH. 2. To compare the clinical manifestations and complications of the patients with hyperparathyroidism versus the patients with non-hyperparathyroidism. 3. To compare dysturbances P, PTH in patients dialyzed by high – flux dialyzer versus low-flux. Materials and method: Patients: 53 elderly chronic hemodialysis patients in department of Nephrology and Dialysis, Thong Nhat Hospital. The period of study was Sept 2009 to Sept 2010. The criteria inclusion was patients over 60 years of old, chronic hemodialysis more than 6 months, followed strictly medical treatment of hyperparathyroidism and followed closely prescriptions of hemodialysis. Method: prospective and cross-sectional study. Statistical analysis: SPSS 13.0. Results: The prevalence of elderly chronic hemodialysis with serum phosphate in normal range, mild, moderate and severe increase was 20.8%; 15.1%; 28.3% and 35.8% respectively. The prevalence of those with serum PTH in normal range and hyperparathyroidism was 13.4% and 26.4% respectively. Systolic and diastolic blood pressure in patients with hyperparathyroidism vs non hyperparathyroidism were 144.64±12.32 vs 142.82±15.89 (p>0.05) and 76.07±6.56 vs 76.67±5.77 (p>0.05). The prevalence of those with uremia itching in hyperparathyroidism group vs non hyperparathyroidism was 52.86% vs 38.46% (p>0.05). Hb (g/dl) in patients with hyperparathyroidism vs non hyperparathyroidism was 10.76±2.93 vs 10.89±1.28 (p>0.05). Total cholesterol and triglyceride (mmol/L) in those with hyperparathyroidism vs non hyperparathyroidism were 4.86±0.89 vs 4.78±1.00 (p>0.05) and 2.11±0.91 vs 2.08±1.31 (p>0.05). The prevalence of hyperparathyroiddism in patients dialysed by high-flux dialyzer was 10% vs 36.36% in those dialysed by low-flux dialyzer (p<0.05). Conclusions: The prevalence of the elderly chronic hemodialysis patients with dysturbances of Phosphate and PTH was 79.2% and 86.8% respectivelly. In those, 26.4% patients diagnosed hyperparathyroidism (PTH pre HD ≥ 250pg/ml). The differences of clinical manifestations such as blood pressure, itching, anemia and lipid disorders in patients with hyperparathyroidism versus non – hyperparathyroidism were not recorded. The study also shows that lower rate of hyperparathyroidism in the patients dialysed by high-flux dialyzer versus in those dialyzed by low – flux dialyzer. Key words: chronic hemodialysis; parathyroidism.