혈액투석 환자의 고인산혈증 관련요인

Abstract

Purpose: The purpose of this study was to identify factors affecting hyperphosphatemia in hemodialysis patients.

Methods: The participants of the study were 129 patients who had been diagnosed with end-stage renal disease and received hemodialysis. Data were collected from June 15 to August 15, 2017, and analyzed with frequency, percentage, average, standard deviation, independent t-test, x2 test, and logistic regression using SPSS/WIN 24.0 version.

Results: Out of the 129 hemodialysis patients, 71 (55%) had hyperphosphatemia. There were significant differences between healthy group and hyperphosphatemia group in terms of age (p=.048), BMI (Body Mass Index) (p=.004), causative disease of chronic renal failure (p=.026), frequency of hemodialysis per week (p=.024), nutritional status (p<.001), weight gain on maintenance hemodialysis (p=.001), TIBC(Total Iron Binding Capacity) (p=.035), Ca (Calcium) × P (Phosphorus) (p<.001), BUN(Blood Urea Nitrogen) (p<.001), creatine (p=.012), and diet factors of self-care (p=.035). Results of the analysis of factors affecting hyperphosphatemia in hemodialysis patients indicated an increased risk of hyperphosphatemia with diabetes (Odds Ratio [OR]=21.45, 95% Confidence Interval [CI]=1.38~333.47), hypertension (OR=14.41, 95% CI=1.15~180.12), nutritional status (OR=9.37, 95% CI=1.36~64.18), weight gain on maintenance hemodialysis (OR=4.86, 95% CI=1.18~20.05), and BUN (OR=1.07, 95% CI=1.01~1.14).

Conclusion: Based on the results of this study, it is imperative to manage diabetes and hypertension of hemodialysis patients to prevent hyperphosphatemia. Additionally, it is necessary to not only regularly monitor patients’ nutritional conditions and results of blood tests, but also develop and provide an individualized nursing intervention that reflects individual nutritional conditions and biochemical results.