Effect of hemoperfusion on phosphorus metabolism in patients on maintenance hemodialysis

Objective To study the effect of hemoperfusion(HP) on phosphorus metabolism in patients on maintenance hemodialysis(MHD)and its possible mechanism.Methods Sixty-five MHD patients were divided into three groups.Conventional hemodialysis(HD),hemoperfusion(HP) and hemodiafiltration(HDF) were performed in 20 patients,25 patients and 20 patients for 24 weeks as a course,respectively.Twenty healthy people were served as controls.Serum levels of fibroblast growth factor 23(FGF-23),intact parathyroid hormone(iPTH),blood urea nitrogen(BUN),phosphorus,calcium and creatinine(Scr) were measured before and at 12th,24th week of treatment.Results Serum levels of FGF-23,iPTH,BUN,Scr and phosphorus were significantly higher(P0.05) and serum calcium was significantly lower(P0.05) in MHD patients than in control group.At 12th week of treatment,serum level of FGF-23 in HP group decreased markedly(P0.05).At 24th week of treatment,serum levels of iPTH,FGF-23 and phosphorus in HP group decreased markedly(P0.05) and the serum level of FGF-23 was significantly lower than that of HDF and HD groups(P0.01) and level of phosphorus significantly lower than that of HD group(P0.01).Differences of other parameters were not significant(P0.05).Conclusions Higher levels of serum FGF-23 or iPTH are universally found in MHD patients.Hemoperfusion can effectively decrease FGF-23 and blood phosphorus,and this may be related to the adsorption of FGF-23 and decrease of iPTH by hemoperfusion.