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Secondary hyperparathyroidism (SHPT) is the common complication in chronic kidney disease patients,especially in those with hemodialysis,which is associated with cardiovascular events and mortality.Active vitamin D and its analogues are classic treatment for SHPT,but some patients are resistant to active vitamin D,and ablation would be a choice for such cases.The purpose of this review is to provide current progress in ablation for SHPT.
RESUMO
Objective To investigate mineral bone metabolic conditions of pre-dialysis patients with chronic kidney disease (CKD),and obtain useful information about the management and treatment of CKD.Methods The levels of serum calcium,phosphate,25-HydroxyvitaminD [25 (OH) VitD],and intact parathyroid hormone (iPTH) were compared.Then a correlation analysis was performed for 25 (OH)VitD.Results Hypocalcemia,hyperphosphatemia,secondary hyperparathyroidism and inadequate of 25 (OH) VitD appeared early in CKD2.Deficiency of 25 (OH)VitD was widespread in CKD2 ～ 5.Multiple linear regression analysis showed that 25 (OH) VitD was independently associated with adjusted level of calcium (P =0.002),application of calcium carbonate (P =0.038),and application of calcitriol (P =0.049) (R square =0.360,P =0.000).Conclusions Mineral bone disorder emerges early in CKD2.More attention should be paid to the management of 25 (OH)VitD.
RESUMO
Objective To study the effect of long session hemodialysis (LSHD) on the quality of life in maintenance hemodialysis (MHD) patients.Methods A total of 40 MHD patients in our dialysis center were enrolled in the study.Quality of life was investigated by SF-36 table.Sleep questionnaire survey concluded the Athens insomnia scale (AIS),Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS).Clinical data were collected.Forty MHD patients were equally divided into HD and LSHD groups according to clinical data and sleep quality score for prospective study.Hemodialysis dose of HD group was 4 h thrice weekly,and of LSHD group was 8 h thrice weekly.The trial lasted for 6 months.Changes of life quality were compared between two groups.Results As compared to HD group,LSHD group had significant higher Kt/V (1.73±0.36 vs 1.41±0.23,P＜0.05),higher levels of serum hemoglobin [(124.67±9.08) vs (110.55±9.01) g/L,P＜0.01] and albumin [(45.01±2.66) vs (39.28±2.63) g/L,P＜0.01].better sleep quality score (16/20 vs 5/20,P=0.001) and higher blood pressure control proportion (14/20 vs 5/20,P=0.010),higher score of SF-36 (P＜0.05).Conclusion LSHD can improve the life quality of MHD patients by increasing sleep quality and nutrition level.