中国医学创新2025，Vol.22Issue(14)：153-158,6.DOI:10.3969/j.issn.1674-4985.2025.14.034
新余市维持性血液透析慢性肾脏病5期患者CKD-MBD患病及治疗现状调查
Survey on the Prevalence and Treatment Status of CKD-MBD in Patients with Stage 5 Chronic Kidney Disease Undergoing Maintenance Hemodialysis in Xinyu City
摘要
Abstract
Objective:To investigate the prevalence and treatment status of chronic kidney disease mineral bone metabolism disorders(CKD-MBD)in patients with chronic kidney disease(CKD)stage 5 on maintenance hemodialysis(MHD)in Xinyu City.Method:A total of 856 patients with CKD stage 5 who underwent MHD in the blood purification centers of 7 hospitals(including 2 tertiary hospitals and 5 secondary hospitals)in Xinyu City from January 1,2022 to June 30,2024 were selected as the research objects,and the prevalence and treatment status of CKD-MBD in patients were investigated.Result:(1)Among the 856 stage 5 CKD patients undergoing MHD in Xinyu City,654 cases(76.40%)had hyperphosphatemia,392 cases(45.79%)had hypocalcemia,and 539 cases(62.97%)had elevated intact parathyroid hormone(iPTH)levels.(2)According to the Chinese CKD-MBD diagnosis and treatment guidelines and KDIGO guidelines.The compliance rates for correcting calcium,blood phosphorus,and iPTH in stage 5 CKD patients in tertiary hospitals were 50.25%,22.58%,and 16.47%,respectively.The compliance rates in secondary hospitals were 45.69%,15.36%,and 14.61%,respectively.The compliance rate of blood phosphorus in tertiary hospitals was better than that in secondary hospitals,the difference was statistically significant(P<0.05).However,the differences in compliance rates of corrected calcium and iPTH were not statistically significant(P>0.05).(3)The proportion of patients with hypocalcemia in tertiary hospitals who chose Calcium Carbonate was 88.35%,which was much higher than the proportion of patients who choose Calcium Acetate,which was 1.13%.Among patients with hyperphosphatemia,no Calcium-Phosphorus Binders was chosen.56.78%of patients chose Sevelamer,and 43.22%chose Lanthanum Carbonate.The proportion of patients who chose Alfacalcidol,Calcitriol,Paricalcidol and Cinacalcet in the treatment of secondary hyperparathyroidism was 59.78%,1.68%,5.31%and 30.45%,respectively.2.79%of the patients in tertiary hospitals chose PTX surgery for severe secondary hyperparathyroidism.89.68%of hypocalcemia patients chose Calcium Carbonate,which was much higher than 3.17%of Calcium Acetate.Among patients with hyperphosphatemia,4.57%chose Calcium Carbonate,55.71%chose Sevelamer,and 39.73%chose Lanthanum Carbonate.The proportion of Alfacalcidol,Calcitriol,Paricalcitol and Cinacalcet in the treatment of secondary hyperparathyroidism was 67.96%,2.21%,8.29%and 20.44%,respectively.Only 1.10%of the patients in secondary hospitals chose PTX surgery for severe secondary hyperparathyroidism.(4)Based on the Chinese CKD-MBD diagnosis and treatment guidelines and KDIGO guidelines,the rates of inappropriate treatment of low Ca,high P and high iPTH in tertiary hospitals were 24.03%,40.92%and 24.86%,respectively,and those in secondary hospitals were 52.03%,53.42%and 35.91%,respectively.Conclusion:The prevalence of mineral and bone abnormalities in MHD patients in Xinyu City is mainly low calcium,high phosphorus,and high iPTH.Calcium,phosphorus binders and other drugs are used for treatment.The blood phosphorus control rate in tertiary hospitals is better than that in secondary hospitals,but the overall treatment control rate is lower.Further improvement of the treatment regimen is needed to improve the therapeutic effect.关键词
维持性血液透析/慢性肾脏病矿物质骨代谢紊乱/治疗现状/慢性肾脏病Key words
Maintenance hemodialysis/Chronic kidney disease mineral bone metabolism disorders/Treatment status/Chronic kidney disease引用本文复制引用
康文龄,蒋芳,周宝琴,周群,徐磊..新余市维持性血液透析慢性肾脏病5期患者CKD-MBD患病及治疗现状调查[J].中国医学创新,2025,22(14):153-158,6.基金项目
新余市科技计划项目(20223090866) （20223090866）
