Abstract:

Objective To explore the effects of lanthanum carbonate combined with cinacalcet and calcitriol on thyroid hormone ，phosphorus ⁃ calcium metabolism and clinical symptoms in hyperparathyroidism patients undergoing maintenance hemodialysis（MHD）. Methods The clinical data of 90 patients with secondary hyperparathyroidism（SHPT）who underwent MHD in outpatient of the hospital from January 2017 to April 2020 were retrospectively analyzed. According to different administration methods，the 16 patients who were treated with calcitriol were included in group C，36 patients who treated with cinacalcet and calcitriol were included in group B，and 38 patients who treated with lanthanum carbonate combined with calcitriol and cinacalcet were included in group A. The clinical symptoms，levels of serum intact parathyroid hormone（iPHT）and phosphorus ⁃calcium metabolism，and occurrence of adverse reactions were compared among the three groups. Results At 1 month，3 months and 6 months after treatment，level of serum iPHT was the highest in group C，followed by group B and group A（P < 0.05）. At 6 months after treatment，controls rates of iPTH in groups A and B were 94.74% and 83.33%，which were higher than that in group C（56.25%）（P < 0.05）. After treatment，skin itching and bone joint pain in the three groups were improved（P < 0.05）. There was no significant difference in the proportion of patients with skin itching and bone joint pain among the three groups（P > 0.05）. At 1 month，3 months and 6 months after treatment，serum calcium，serum phosphorus and calcium phosphorus product in group A and B were lower than those in group C. The serum phosphorus and calcium phosphorus product in group A were lower than those in group B（P < 0.05）. There was no significant difference in the incidence of adverse reactions during treat⁃ ment among the three groups（P > 0.05）. Conclusion Lanthanum carbonate combined with cinacalcet and cal⁃citriol can effectively improve clinical symptoms of SHPT patients undergoing MHD，reduce iPHT level，and im⁃ prove calcium⁃phosphorus metabolism，with relatively higher medication safety.

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