低钙透析液对腹膜透析患者透析效果及生存质量的影响

目的：观察长期使用低钙透析液进行腹膜透析患者的透析效果及生存质量。方法选择2009年6月至2012年5月在新华医院崇明分院肾脏内科开始进行持续性不卧床腹膜透析患者160例，按照透析液含钙量的不同分为低钙透析液组（低钙组，透析液钙浓度1．25 mmol／L）83例和标准钙透析液组（标准钙组，透析液钙浓度1．75 mmol／L）77例，随访3年，观察透析第1年末、第3年末时2组患者生存率、透析效果及生存质量的比较。结果随访至第1年末时，2组患者生存率及退出腹膜透析的个案数量差异无统计学意义（P＞0．05），继续进行腹膜透析的患者之间生存质量、透析一般情况、血管钙化、心血管事件差异无统计学意义（P＞0．05），低钙组患者的血钙高于甲状旁腺激素低于标准钙组，差异有统计学意义（P＜0．05）。随访至第3年末时，低钙组患者生存率更高，退出腹膜透析的个案数量则明显低于标准钙组，继续进行腹膜透析的患者之间透析一般情况差异无统计学意义（P＞0．05），低钙组患者的血钙高于、甲状旁腺激素低于标准钙组，血管钙化、心血管事件发生更少，生存质量更高，差异有统计学意义（P＜0．05）。结论患者长期使用低钙透析液进行腹膜透析对钙磷代谢存在有利影响，患者的长期生存质量要好于标准钙透析液进行透析的患者。

Effects of prolonged use of low calcium dialysis solution on the patients with peritoneal dialysis and the impact on the life quality of survivors

Objective To observe the effects of prolonged use of low calcium dialysis solution on the patients with peritoneal dialysis and the impact on the life quality of survivors.Methods One hundred and sixty ambulatory patients who underwent persistent peritoneal dialysis from June 2009 to May 2012 in the Department of Nephrology, Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiaotong University, were chosen for the study.In accordance with the calcium level in the dialysate, the patients were divided into the low calcium dialysate group ( dialysate calcium level of 1.25 mmol/L) (83 cases) and standard calcium dialysate group ( dialy-sate calcium level of 1.75 mmol/L)(77 cases).All the patients had medical follow-ups for 3 years.At the end of the first year and third year, survival rates, dialytic effects and their life quality were observed and compared between the 2 groups.Results Medical fol-low-up at the end of the first year showed that no significant differences could be seen in survival rate and the number of patients with-drawing from the treatment of dialysis, when comparisons were made between the 2 groups.Significant differences could neither be seen in the life quality, general conditions of dialysis, vascular calcification, as well as cardiovascular events in those persistent dialytic pa-tients.Serum calcium of the low calcium dialysate group was higher than that of the standard calcium dialysate group.Medical follow-up to the end of the third year further indicated that the survival rate of the low calcium dialysate group was higher, and the number of pa-tients withdrawing from dialysis treatment was significantly less than that of the standard calcium dialysate group.No significant differences could be noted in the general conditions of the patients that had persistent dialysis.Serum calcium of the low calcium dialysate group was higher than that of the standard calcium dialysate group.And there were less cases of vascular calcification and cardiovascular events and their life quality was obviously better.Statistical significance could be noted, when comparisons were made between the 2 groups ( P<0.05).Conclusion Prolonged use of low calcium dialysis solution was beneficial to calcium metabolism of the patients with peritoneal di-alysis.The life quality of the patients, in the long run, was better than that of the patients with standard calcium dialysate dialysis.