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Objective: Clinical observation of of residual renal effects of calcium and phosphorus metabolism in patients on maintenance hemodialysis and left ventricular hypertrophy. Methods: A cross-sectional study of February 2011, Shenzhen Second People's Hospital hemodialysis centers 158 patients on maintenance hemodialysis (Maintenance hemodialysis, MHD) patients. Urea clearance rate estimated glomerular filtration rate (as Glomerular filtration rate, GFR) GFR> 1ml/min/1.73m2 defined as residual renal function (Residual renal function, RRF), and hemodialysis patients were divided into Group A (the the RRF group) and group B (RRF group). The main observation biochemical indicators for serum calcium, phosphorus, calcium-phosphorus product, serum parathyroid hormone (PTH). Ultrasonic measurements of left ventricular posterior wall end-diastolic thickness of the interventricular septum thickness, E / A, ejection fraction (EF), left ventricular mass index (Left ventricular mass index, LVMI) calculated using the Devereux formula. Two sample t test, χ2 test count data, multiple linear regression analysis (Multiple linear \hypertrophy in rats, and analysis of factors associated with residual renal function. Results: (1) A group of patients with 60 cases, accounting for 37.97%, GFR 2.96 ± 1.95ml/min/1.73m2. (2) A group of patients serum phosphorus and parathyroid hormone water were significantly lower than in group B (1.54 ± 0.55 mmol / L vs 2.18 ± 0.67mmol / L, P = 0.036; 356.11 ± 271.15 pg / ml vs 577.68 ± 416.04pg / ml, P = 0.001), serum corrected calcium and calcium-phosphate product difference was not statistically significant (2.26 ± 0.25 mmol / L vs 2.01 ± 0.34 mmol / L, P = 0.091; on vs 4.28 mmol2/L2 3.49 ± 0.51 ± 0.66mmol2 / L 2, P = 0.062). (3) multiple linear regression analysis indicated that the maintenance hemodialysis patients with serum phosphorus levels to their dialysis continuous time (Duration of hemodialysis) (β = 0.32, P = 0.005) and serum albumin concentration (β = 0.15, P = 0.046) was a significant positive correlation, while their GFR was significantly negatively correlated (β = -0.180, P = 0.043). Shows that this group of patients dialysis duration, high serum albumin concentration and GFR reduction is an independent risk factor for hyperphosphatemia. (4) A group of patients with the LVMI significant significantly lower than group B (165.64 ± 57.41 vs 199.15 ± 63.88, P = 0.042); group A ventricular septal thickness and ventricular septal thickening were less than the proportion of patients in group B (11.02 ± 1.98mm vs 12.68 ± 2.33 mm, P = 0.033; 76.67% vs 90.82%, P = 0.040); A group of ejection fraction higher than that in group B (63.34 ± 8.11% vs 52.42 ± 9.01%, P = 0.039); while the left ventricular posterior wall thickness, left ventricular posterior wall thickening proportion of patients and the E / A in the difference between the two groups was not statistically significant (12.31 ± 2.20mm vs 13.56 ± 2.7mm, P = 0.176; 85.00% vs 93.88%, P = 0.098; 0.91 ± 0.29 vs 0.79 ± 0.26, P = 0.087). The results showed that the maintenance hemodialysis patients with left ventricular hypertrophy is a common complication of cardiac ventricular septal thickening is the main characteristics of this group of left ventricular hypertrophy, and RFF significant improvement in left ventricular hypertrophy. (5) Multiple linear regression analysis of the the LVMI impact factors results showed that systolic blood pressure (β = 0.420, P = 0.001), calcium-phosphorus product (β = 0.346, P = 0.017), PTH (β = 0.373, P = 0.040) There was a positive correlation with LVMI into, the GFR its negatively related (β = -0.174, P = 0.042). Arterial systolic blood pressure, and calcium-phosphate product, high PTH hyperlipidemia and GFR decline is an independent risk factor in maintenance hemodialysis patients with left ventricular hypertrophy. (6) Bivariate linear correlation analysis, A group of patients RRF and dialysis duration (Pearson correlation coefficient = -0.481, P = 0.003), serum phosphorus levels (Pearson correlation coefficient = -0.372, P = -0.408) LVMI (Pearson correlation coefficient = -0.408, P = 0.027) were negatively correlated, prompt dialysis duration, serum phosphorus levels and left ventricular hypertrophy is the important factors associated with diminished RRF. (7) Multiple linear regression analysis showed that the A-group of patients RRF and dialysis duration and serum phosphorus level was negatively correlated (P = 0.001, P = 0.045), duration of dialysis hyperphosphatemia prompt patients affect MHD patients RRF decline an independent risk factor. Conclusion: (1) high phosphorus and PTH hyperlipidemia is a common manifestation of this group in maintenance hemodialysis patients, dialysis duration, high serum albumin concentration and glomerular filtration rate decline this group of patients with high phosphorus and high PTH hyperinsulinemia is an independent risk factor. (2) left ventricular hypertrophy is a common cardiac complications in this group of patients, ventricular septal thickening of the main characteristics of this group of left ventricular hypertrophy. Arterial systolic blood pressure, and calcium-phosphate product, PTH acidosis and glomerular filtration rate decline is an independent risk factor for this group of patients with left ventricular hypertrophy. (3) the loss of residual renal function is an important clinical characteristics of the majority of patients in this group; dialysis duration, serum phosphorus levels and left ventricular hypertrophy RRF important factors associated with diminished in this group of patients, and dialysis duration and hyperphosphatemia is an independent risk factor for this group of patients RRF decline. (4) RRF may significantly improve hyperphosphatemia and high PTH hyperlipidemia, has important clinical significance in the prevention and treatment of this group of patients with secondary hyperparathyroidism. (5) RRF can significantly mitigate this group of patients with left ventricular hypertrophy, results suggest that the protection of RRF on the prevention and control of maintenance hemodialysis patients with cardiovascular complications, and improve patients' quality of life and prolong the survival time of patients with a very important clinical significance.
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