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Objective:To investigate the efficacy of hemodiafiltration combined with hemoperfusion in the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing maintenance hemodialysis (MHD).Methods:A total of 40 patients with SHPT undergoing MHD who received treatment at the Blood Purification Center of The First Affiliated Hospital of Anhui University of Science and Technology from February 2021 to March 2023 were included in this prospective cohort study. They were randomly divided into a control group and an observation group ( n = 20/group).The control group received a single high flux hemodialysis, while the observation group used a combination of hemodialysis filtration and hemoperfusion for 3 months. In both groups, the changes in hemoglobin, blood urea nitrogen, serum creatinine, serum calcium, serum phosphorus,and parathyroid hormone levels were compared before and after dialysis. Results:After dialysis, the hemoglobin level in the observation group was (119.45 ± 5.27) g/L, which was significantly higher than (106.30 ± 6.52) g/L in the control group ( t = -7.02, P < 0.001). The serum phosphorus level in the observation group was (1.18 ± 0.17) mmol/L, which was significantly lower than (1.52 ± 0.22) mmol/L in the control group ( t = 5.49, P < 0.001). The parathyroid hormone level in the observation group was (122.14 ± 40.57) ng/L, which was significantly lower than (168.78 ± 78.27) ng/L in the control group ( t = 2.39, P = 0.023). Conclusion:Hemodiafiltration combined with hemoperfusion can reduce clinical symptoms, increase hemoglobin level, and reduce phosphorus and parathyroid hormone levels in patients with SHPT undergoing MHD, which deserves clinical promotion.
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Liver transplant patients require lifelong immunotherapy, and if they are infected by SARS-Cov-2, their immune function will face double whammy. This report described the integrated approach of traditional Chinese and western medicine in the treatment of a liver transplant patient with severe COVID-19. The treatment was involved with western medicine such as antiviral, immunosuppressive, focusing on maintaining immune balance. Traditional Chinese medicine was given based on the differentiation of syndromes, targeting at the core pathogenesis and using methods such as promoting qi circulation, clearing heat and resolving dampness, draining lung and relieving panting. Following the treatment, the patient exhibited notable improvement in clinical symptoms and liver function, leading to the effective cessation of disease progression and a shortened recovery period.
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Chronic kidney disease (CKD) is one of the most urgent problems in global health since its discovery, which is characterized by high prevalence rate, multiple complications and poor long-term prognosis.And hyperphosphatemia, which has not been overcome clinically, is the most common complications of CKD.Keeping blood phosphorus concentrations within a normal range is extremely important for CKD patients, which not only effectively improves their prognosis, but also extends their lifespan.This article will briefly review the progress in the treatment of hyperphosphatemia from the aspects of dietary control, replacement of phosphorus-containing drugs, comparison of phosphorus binders, excretion of urinary phosphorus, and intensification of dialysis and traditional Chinese medicine.