Observation on death of MHD patients with different blood phosphorus variation coefficients / 中国综合临床

ABSTRACT

Objective To investigate the death of MHD patients with different blood phosphorus variability.Methods The clinical data of seventy-four cases of MHD patients with more than 3 months dialysis age in the hemodialysis center of Chaozhou Central Hospital from January 2014 to December 2016 were retrospectively analyzed.The general data and laboratory biochemical indexes were collected and according to the difference in coefficient of variation (CV),the patients were divided into two groupshigh blood phosphorus variability group (CV≥0.226 mmol/L) and low blood phosphorus variability group (CV ＜0.226 mmol/L).The relationship between the coefficient of variation and all-cause mortality and cardiovascular mortality in MHD patients was analyzed.Results Among all selected patients,all-cause mortality rate was 22.9％ (17/24),12.2％ (9/74) died of cardiovascular disease,and the all-cause mortality 34.2％ (13/38)in the high blood phosphorus variability group was significantly higher than that in the other one1 1.1％ (4/36) (x2=5.574,P＜0.05);but there was no significant difference between the two groups in cardiovascular disease mortality (X2 =0.962,P＞0.05).And there was no significant difference between the serum phosphorus standard group and the substandard group in the all-cause mortality and the cardiovascular disease mortality (x2 =0.389,0.065,P ＞ 0.05).There was no significant difference in the cumulative survival rate between the patients in the serum phosphorus standard group who experienced all-cause death and cardiovascular disease death and the patients in the substandard group (P＞0.05).In the high blood phosphorus variability group,patients who reached serum phosphorus standard had higher total mortality rate and cardiovascular disease mortality rate,compared with patients who achieved serum phosphorus standard or experienced low phosphorus deficiency in the low blood phosphorus variability group (x2=0.211,0.197,P ＞0.05).Kaplan/Meier analysis showed that the cumulative survival rates of all patients with all-cause death and cardiovascular death in the high blood phosphorus variability group were significantly lower than those in the low level group (P＜ 0.05).Conclusion All-cause mortality and cardiovascular disease mortality are high in MHD patients with large variability in blood phosphorus,and the degree of blood phosphorus variation is helpful to predictthe death of MHD patients.