Effect of high-flux hemodialysis combined with hemoperfusion on calcium-phosphorus metabolism in hemodialysis patients
高通量透析联合灌流对血透患者钙磷代谢的影响

摘要

目的 探讨高通量血液透析联合血液灌流对维持性血液透析患者钙磷代谢及相关指标的影响。方法 选取2024年1月至2025年12月在我院血液净化室接受治疗的26例维持性血液透析合并钙磷代谢紊乱患者为研究对象，根据治疗方案分为联合组（高通量血液透析联合血液灌流，n=16）和对照组（单纯高通量血液透析，n=10）。两组均给予基础药物治疗及常规透析护理，连续治疗3个月。比较两组治疗前后钙磷代谢指标、营养及贫血指标、肾功能相关指标，并统计不良反应。结果 治疗后，联合组血磷、钙磷乘积、全段甲状旁腺激素（intact parathyroid hormone,iPTH）水平低于对照组，血钙水平高于对照组（P<0.05）；且联合组血清铁蛋白、血红蛋白（Hemoglobin,Hb）高于对照组，血清肌酐（Serum Creatinine ,Scr）、血尿素氮（Blood Urea Nitrogen, BUN）低于对照组（P<0.05）；两组治疗期间不良反应比较，P>0.05。结论 高通量血液透析联合血液灌流可有效纠正维持性血液透析患者的钙磷代谢紊乱，降低iPTH水平，同时改善患者营养状况、贫血及肾功能，安全性良好。

Abstract

Objective To investigate the effects of high-flux hemodialysis combined with hemoperfusion on calcium-phosphorus metabolism and related indicators in maintenance hemodialysis patients.
Methods A total of 26 maintenance hemodialysis patients with calcium-phosphorus metabolism disorders treated in the Blood Purification Room of our hospital from January 2024 to December 2025 were selected as the study subjects. They were divided into a combination group (high-flux hemodialysis combined with hemoperfusion, n=16) and a control group (high-flux hemodialysis alone, n=10) according to the treatment regimen. Both groups received basic pharmacotherapy and routine dialysis care for three consecutive months. Calcium-phosphorus metabolism indicators, nutritional and anemia indicators, and renal function-related indicators were compared between the two groups before and after treatment, and adverse reactions were recorded.
Results After treatment, the combination group showed lower levels of serum phosphorus, calcium-phosphorus product, and iPTH, and higher serum calcium levels compared with the control group (P<0.05). In addition, the combination group had higher serum ferritin and Hb levels, and lower Scr and BUN levels than the control group (P<0.05). Comparison of adverse reactions during treatment between the two groups showed no significant difference (P>0.05).
Conclusion   High-flux hemodialysis combined with hemoperfusion can effectively correct calcium-phosphorus metabolism disorders in maintenance hemodialysis patients, reduce iPTH levels, and simultaneously improve nutritional status, anemia, and renal function, with good safety.