Objective: To evaluate the effect of different blood purification techniques on serum parathyroid hormone (PTH) level in chronic hemodialysis (HD) patients with renal failure.
Methods: Ninety patients were randomly divided into three groups: absorption (AP) group, hemodiafiltration (HDF) group, and HD group. Patients in AP group received therapy with resin absorptive devices associated with HD, patients in HDF group received HDF, while patients in HD group received HD. Blood routine examination, serum albumin, globulin, blood urea nitrogen, creatinine and PTH were measured before and after these treatments, and vital signs and side effects were recorded during HD. Glomerular filtration rate (GFR) and the length of HD were compared among three group.
Results: (1)Serum PTH in AP group was decrease from (291.7+/-237.5)ng/L to (122.2+/-114.5)ng/L, the difference was statistically significant. The mean single clearance rate was 48.6%+/-55.2%, the rate of relief from skin discomfort was 83.3%e10/12 cases). (2)Serum PTH in HDF group was decreased from(325.9+/-423.1)ng/L to (90.9+/-93.7)ng/L, the difference was statistically significant. The mean single clearance rate was 59.5%+/-22.7%, and the rate of relief from skin discomfort was 50.0%(4/8 cases).(3)Serum PTH in HD group was decreased from (297.7+/-211.3)ng/L to (248.1+/-105.5)ng/L, which showed no statistically significant difference. The mean single clearance rate was 13.1%+/-30.2%, the rate of relief from skin discomfort was 14.3%(1/7 cases).
Conclusion: Resin absorptive devices and HDF can safely and effectively clear PTH, relieve skin discomfort; while hemodialysis alone can not.