关键词: 血液透析 , 血液透析滤过 , 肾性骨病 , 骨钙素 , ß, -I型胶原C-末端肽 , I型前胶原氨基端前肽 , 甲状旁腺激素

Abstract:

Objective：To study the different clinical parameters of bone metabolism between hemodialysis and hemofiltration patients.  Methodology: Thirty uremic patients with maintenance hemodialysis were randomly divided into hemodialysis group (HD group, n = 15) and hemodiafiltration group (HDF group, n = 15), 15 cases of healthy persons as control group. After 10 months of dialysis, the levels of serum osteocalcin (BGP), β-I collagen C-terminal peptide (β-CTX), I procollagen amino-terminal propeptide (PINP), and parathyroid hormone (PTH) levels and changes were compared between two groups before and after dialysis. Results: All patients showed increased baseline mean values of BGP, β-CTX, PINP, and PTH (P<0.001). In HD group, all these bone metabolism markers were higher than that in HDF group (P<0.05).  The levels of serum BGP, β-CTX were decreased significantly after a single HD (P<0.05), but serum PTH was no significant difference. In HDF Group, the levels of serum BGP, β-CTX, PTH were significantly reduced at the end of the session (P<0.01), and declined more than that in HD group. However, the levels of serum PINP did not change significantly in both groups.  Conclusion: Hemodiafiltration might decrease bone turnover, and improve renal osteodystrophy in patients with maintenance hemodialysis, especially for high-turnover renal osteodystrophy.

Key words: hemodialysis , hemodiafiltration , renal osteodystrophy , osteocalcin , β-I collagen Cross-linked C-telopeptide , procollagen type I amino-terminal peptide , parathyroid hormone