Objective To investigate the effects of different blood purification technologies on bone metabolism in maintenance hemodialysis patients. Methods :A total of 105 patients were randomly divided into 3 groups: HD (hemodialysis), HF (hemodialysis plus hemodiafiltration) and HP (hemodialysis plus hemoperfusion). After 8 months of intervention, bone metabolism biomarkers, such as Ca, P, iPTH, beta-CTX, PINP and FGF23, were detected.Results P[(2.73±0.83) vs (2.27±0.54) mmol/L] and PTH [(453.2±44.2) vs (438.7±41.0) pg/ml] levels significantly elevated in HD group (P<0.05), FGF23 [(410.3±99.5) vs (450.7±88.6) ng/ml] level in HF group markedly decreased (P<0.05), PTH [(370.9±35.5) vs (458.3±49.2) pg/ml]、beta-CTX [(2.01±1.34) vs (2.74±1.26) ng/ml] and FGF23 [(408.7±89.9) vs (459.9±76.1) ng/ml] levels in HP group significantly reduced (P<0.05). Conclusions Combined with hemodiafiltration, especially combined with hemoperfusion are more efficient on improving bone metabolism than hemodialysis alone in maintenance hemodialysis patients.
Key words
hemodialysis /
hemodiafiltration /
hemoperfusion /
bone metabolism
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References
[1] 陶巍巍,朱宁,张枫,等. 维持性血液透析患者成纤维细胞生长因子23水平与骨质疏松及其他骨代谢指标的相关性[J]. 中国老年学杂志, 2016(13):3251-3253.
[2] Simunovic I, Pavlovic D, Kudumija B, et al. Bone fragility fractures in hemodialysis patients: Croatian surveys[J]. Coll Antropol, 2015,39(1):71-74.
[3] 张默,刘林林,王力宁,等. 影响维持性血液透析患者骨密度相关因素分析[J]. 中国骨质疏松杂志, 2016,22(11):1446-1450.
[4] 中华医学会肾脏病学分会. 第三章慢性肾脏病-矿物质和骨异常的预防和治疗[J]. 中华肾脏病杂志, 2014,30(z1):11-36.
[5] Taniguchi M, Fukagawa M, Fujii N, et al. Serum phosphate and calcium should be primarily and consistently controlled in prevalent hemodialysis patients[J]. Ther Apher Dial, 2013,17(2):221-228.
[6] 陶巍巍,朱宁,孙宁爽,等. 脉搏波速度预测维持性血液透析并发骨质疏松的价值[J]. 中国老年学杂志, 2016(14):3522-3524.
[7] Bielesz B O, Hecking M, Plischke M, et al. Correlations and time course of FGF23 and markers of bone metabolism in maintenance hemodialysis patients[J]. Clin Biochem, 2014,47(13-14):1316-1319.
[8] 朱彪,焦婷,赵刚,等. GDF11抑制老龄鼠骨形成的实验研究[J]. 牙体牙髓牙周病学杂志, 2017,27(11):623-628.
[9] Rodriguez-Ortiz M E, Lopez I, Munoz-Castaneda J R, et al. Calcium deficiency reduces circulating levels of FGF23[J]. J Am Soc Nephrol, 2012,23(7):1190-1197.
[10] Koizumi M, Komaba H, Fukagawa M.Parathyroid function in chronic kidney disease: role of FGF23-Klotho axis[J]. Contrib Nephrol, 2013,180:110-123.
[11] 漆映辉,倪兆慧,曲晓璐,等. 不同血液净化技术的联合应用对维持性血液透析患者矿物质和骨异常的影响[J]. 中国血液净化, 2016,15(2):72-76.
[12] Vasikaran S, Cooper C, Eastell R, et al. International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine position on bone marker standards in osteoporosis[J]. Clin Chem Lab Med, 2011,49(8):1271-1274.
