Comparison of calcium-phosphorus metabolism between peritoneal dialysis and hemodialysis patients and analysis of influencing factors

Objective To compare the effects of peritoneal dialysis(PD)and hemodialysis(HD)on calcium-phosphorous metabolism in uremic patients,and to analyze the related influencing factors so as to provide basis and improvement measures for the clinical treatment.Methods The clinical data of PD and HD patients undergoing maintenance PD and HD in our hospital from October 1^st,2018 to October 1^st,2019 were collected and analyzed retrospectively.The serum calcium,phosphorus and intact parathyroid hormone were collected and compared between the patients with PD and HD at 0,3,6 and 12 months of dialysis.Multivariate linear regression was used to analyze the related influencing factors of calcium-phosphorus metabolism abnormality.Results (1)The levels of serum phosphorus at 3(t=-4.044,P<0.001),6(t=-5.886,P<0.001)and 12(t=-7.808,P<0.001)months of dialysis in the HD group were all higher than those in the PD group.The levels of serum calcium at 6(t=6.521,P<0.001)and 12(t=6.841,P<0.001)moths of dialysis were lower than those in the PD group,and the level of calcium-phosphorus product at 12 months(t=-2.080,P=0.038)was higher than that in the PD group.(2).After 12 months of dialysis,the compliance rates of serum phosphorus(χ²=4.329,P=0.037),serum calcium(χ²=5.587,P=0.018)and calcium-phosphorus product(χ²=5.750,P=0.016)in the PD group were significantly higher than those in the HD group.(3)The multivariate linear regression analysis of the factors that may influence the calcium-phosphorous metabolism in dialysis patients showed that the dialysis modality(B=-0.287,P=0.005),age(B=-0.010,P=0.005),dialysis duration(B=-0.010,P=0.027),and sodium(Na)(B=-0.026,P=0.033)were the independent influencing factors of the level of serum phosphorus,with negative correlation.Conclusions Compared with HD,the levels of serum phosphorus and calcium can be controlled better by PD.Low age,low dialysis age and low sodium were independent influencing factors of increase blood phosphorus level.