Study of calcium-phosphorous metabolism and intact parathyroid hormone levels in end stage renal disease patients

To investigate the state of calcium-phosphorus metabolism and serum intact parathyroid hormone (iPTH) levels in end stage renal disease (ESRD) patients, to analyze clinical characters, and to provide scientific basis for clinical treatment.The data of 100 ESRD patients who received hemodialysis in Peking University First Hospital from January 2000 to July 2003 were analyzed retrospectively.(1) The levels of serum total calcium were adjusted by serum albumin. There were 15 patients with hypocalcemia and 85 patients with normocalcemia or hypercalcemia. 31.8% of the latter took calcium-containing phosphate binders or/and vitamin D. In the 14 patients with hypocalcemia and 58 patients without low serum calcium who did not take calcium-containing phosphate binders or/and vitamin D, we found the levels of carbon dioxide combining power (CO(2)CP) were lower in the group of hypocalcemia (P<0.05), at the same time, there were no significant differences in age and the levels of serum phosphorous, creatinine and iPTH between the two groups. (2) Hyperphosphataemia occurred in 81 patients (81%). (3) The levels of serum iPTH were lower than 100 ng/L in 18 patients (18%) and higher than 300 ng/L in 46 patients (46%), the most common cause of the former was chronic tubular-interstitial nephropathy and that of the latter was chronic glomerulonephritis, excluding the patients who took calcium-containing phosphate binders or/and vitamin D. There were no significant differences in age and the levels of serum calcium, phosphorous and CO(2)CP between the two groups. Multiple regression analyses indicated the levels of serum calcium were in negative correlation with the levels of serum iPTH (r=-0.275, P=0.006).Hyperphosphataemia is one of the outstanding characters in ESRD patients and nearly 50% of all the patients develop secondary hyperparathyroidism. The serum calcium levels are correlative with acidosis besides calcium-containing phosphate binders or/and vitamin D.PubMed02147-503