Effect of hemodiafiltration combined with low dose calcitriol on high turnover osteodystrophy in maintenance hemodialysis patients / 重庆医学

ABSTRACT

Objective To compare the clinic efficacy and safety of renal osteodystrophy between hemodiafiltration (HDF)com-bined low dose calcitriol and high flux hemodialysis combined high dose Calcitriol .Methods 25 patients ,who were in accordance with the inclusion criteria ,were randomly divided into HDF combined low dose Calcitriol group (group HDF) (n=13) and high flux hemodialysis combined high dose Calcitriol (group VitD)(n=12) .Patients in group HDF took Calcitriol for 0 .5μg after every dialysis session ,while those in group VitD took it for 1 .0 μg after dialysis at first ,then the dose would be adjusted every 4 weeks according to the level of blood Calcium .The intervention continued for 16 weeks in total .Then detecting the levels of intact parathy-roid hormone (iPTH) ,bone alkaline phosphatase (BAP) ,serum calcium (Ca) ,serum phosphorus (P) ,and calculating Ca × P sedi-mentation and clinical symptom score .Results he level of Ca in group HDF and group VitD increased significantly after interven-tion (P= 0 .000) .No difference was no statistically significant between the two groups (P= 0 .141) .The P ,iPTH ,BAP of two groups were significantly decreased (P<0 .05) .P in group HDF decreased more significantly(P=0 .003) .iPTH and BAP in group VitD decreased more significantly (P=0 .034 ,0 .046);Ca × P in group HDF decreased significantly (P=0 .031) ,but increased obvi-ously in group VitD(P=0 .037) ,which was much higher than group HDF(P=0 .001) .Clinical symptom in the two groups im-proved significantly after intervention(P<0 .05) ,There were no significant difference between the two groups(P=0 .632) .Conclu-sion The clinic efficacy of HDF combined low dose calcitriol is same as that of high flux hemodialysis combined high dose calcitri-ol .It could also reduce calcitriol side-effect ,which is an effective theraphy for high turnover osteodystrophy .