ABSTRACT
Objective To investigate the present state of mineral metabolism and its related factors in elderly patients with maintenance hemodialysis (MHD),in order to improve the quality of life and survival rate in elderly patients with MHD in Xinxiang.Methods Clinical data of 466 patients with treatment of MHD for over 3 months in 4 hospitals in Xinxiang district were enrolled from January 2012 to August 2013 in this study,and the patients were divided into the elderly group (n=159,aged ≥ 60 years) and the non-elderly group (n =307,aged ＜ 60 years).The evaluation indexes for mineral metabolism were determinated,such as serum levels of calcium,phosphorus,intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP).The present state of mineral metabolism and its relationships with anemia,dialysis ages,adequacy of dialysis,malnutrition and inflammatory factors were analyzed in elderly patients with MHD.Results Among 466 patients,the serum levels of calcium,phosphorus and iPTH in MHD patients were (1.95 ± 0.34) mmol/L,(2.54±1.38) mmol/L and (409.5±345.6) ng/L respectively,and their control rates were 34.3％,20.4％ and 25.5％ respectively.And in patients with hemodialysis three times a week,the control rates were 50.8％,31.4％ and 32.2％ respectively.The serum levels of phosphorus,iPTH,ALP,albumin and transferrin saturation were lower in elderly group than in non-elderly group (all P＜0.01),and the serum levels of pre-albumin,hemoglobin and feritin were lower in elderly group than in non-elderly group (all P＜0.05).But the serum levels of calcium and C-reactive protein (CRP)were higher in elderly group than in non-elderly group (all P＜0.05).Conclusions The elderly patients with MHD exhibit unique clinical manifestations of abnormal mineral metabolism,and low bone transformation osteopathy is the main manifestation.The micro-inflammation,malnutrition and anemia are more severe in elderly patients than in non elderly patients.