Intensified treatment of hyperphosphatemia associated with reduction in parathyroid hormone in patients on maintenance hemodialysis

摘要

Abstract Background: This study investigated the therapeutic effect of intensive phosphorus-lowering therapy on intact-parathyroid hormone (iPTH) levels in hemodialysis patients. Methods: Ninety-five hemodialysis patients with serum phosphorus ≥1.78?mmol/L and iPTH ≥300?pg/dL were apportioned to either the treatment or control group (n?=?43 and 52, respectively) based on patient commitment to treatment. The treatment group was given phosphorus-lowering therapies with phosphate binders (lanthanum, sevelamer or/and calcium reagent) combined with dietary phosphate restriction and intensified hemodialysis. The control individuals were given low doses of calcium agents, if serum calcium was 20% decrease in serum phosphorus, the patients in the treatment group were further stratified as rapid responders (≤2?months; 27 patients) or slow responders (>2?months; 16 patients) and percent changes in iPTH were compared. Results: Serum phosphorus and iPTH levels decreased from baseline in the treatment group (?24.08?±?1.93% and ?9.92?±?3.70%, respectively) but increased in the control group (22.00?±?3.63% and 104.21?±?23.89%; both p?p?