Clinical observation on secondary hyperparathyroidism treated by hemoperfusion combined with calcitriol impact therapy

Objective: To observe the therapeutic effects of hemoperfusion combined with calcitriol impact therapy on secondary hyperparathyroidism( SHPT) of maintenance hemodialysis( MHD) patients. Methods: Seventy patients were randomly divided to Group A( n = 35) and Group B( n = 35). Patients in Group A underwent conventional hemodialysis treatment 2 times and hemodialysis combined with hemoperfusion once a week,while those in group B only underwent conventional hemodialysis treatment 3 times a week. Both Group A and Group B accepted calcitriol impact therapy at the same time. All objects were treated by 12 weeks. Serum calcium( Ca), phosphorus( P) and intact parathyroid hormone( iPTH) were detected and analyzed before and after treatment for 4 weeks,8 weeks and 12 weeks,and changes of clinic symptoms such as ostealgia,myasthenia and skin itch were observed. Results: The serum Ca of both Group A and Group B began to rise after 4 weeks' treatment( P 0. 05) and rose obviously at the end of treatment( P 0. 01). After therapy,Serum P of Group A decreased significantly( P 0. 01),but it had no significant difference in Group B before and after treatment( P 0. 05). After 4 weeks' treatment,serum iPTH of Group A decreased significantly( P 0. 01) and it was lower than that of homochronous Group B after 8 weeks' treatment or 12 weeks' treatment( P 0. 05 or P 0. 01). Clinic symptoms such as ostealgia,myasthenia and skin itch of both Group A and Group B were obviously improved. Conclusion: Hemoperfusion combined with calcitriol impact therapy can effectively control SHPT,obviously reduce serum iPTH and P at the same time of elevated serum calcium,which enhance safety and efficacy of calcitriol impact therapy.