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Abstract：
The aim of the study was to analyze the change trend of serum ALP over time and identify factors influencing its levels in peritoneal dialysis patients. Then to investigate the impact of serum ALP changes on calcium and phosphorus metabolism in single peritoneal dialysis center utilizing repeated measurement data. A retrospective cohort study was conducted with a total follow-up duration of 30 months. Serum ALP and other biomarkers, including calcium (Ca), phosphorus (P), 25(OH)D, intact parathyroid hormone (iPTH), albumin(ALB), and hemoglobin(Hb) were measured every 3 months. The generalized estimation equation (GEE) was utilized to analyze the change trend of serum ALP over time, and to assess whether there were differences in changes over time between different genders and different primary disease groups. Additionally, factors influencing serum ALP levels were analyzed, and the impact of serum ALP changes on calcium and phosphorus metabolism was also explored. A total of 34 patients were included in the study. Serum ALP and other indicators were measured repeatedly, with a maximum of 8 times and a minimum of 4 times. The median of serum ALP values at all measurement times for all selected patients was 89 U/L. The GEE analysis revealed that serum ALP gradually increased with time, and patients in diabetes group increased faster than those in non-diabetes group. A positive correlation was observed between serum ALP and dialysis duration, also between serum ALP and hemoglobin. However, variations in serum ALP did not significantly affect serum corrected calcium, phosphorus, or iPTH concentrations. The serum ALP levels of peritoneal dialysis patients increase gradually over time, and the concentrations are influenced by dialysis duration. The changes in serum ALP values do not have a significant impact on serum calcium, phosphorus, and iPTH levels.
摘要：
本研究的目的是分析腹膜透析患者血清ALP随时间的变化趋势，并确定影响其水平的因素。然后利用重复测量数据探讨单个腹膜透析中心血清ALP变化对钙磷代谢的影响。进行了一项回顾性队列研究，总随访时间为30个月。血清ALP和其他生物标志物，包括钙（Ca），磷（P），25(OH)D,完整的甲状旁腺激素（iPTH），白蛋白（ALB），每3个月测量血红蛋白（Hb）。利用广义估计方程(GEE)分析血清ALP随时间的变化趋势,并评估不同性别和不同原发疾病组之间随时间的变化是否存在差异。此外,分析影响血清ALP水平的因素,并探讨血清ALP变化对钙磷代谢的影响。共有34名患者被纳入研究。反复测定血清ALP等指标,最多8次，最少4次。所有选定患者在所有测量时间的血清ALP值的中位数为89U/L。GEE分析显示血清ALP随时间逐渐升高,糖尿病组患者的增长速度高于非糖尿病组。血清ALP与透析时间呈正相关,也在血清ALP和血红蛋白之间。然而,血清ALP的变化没有显著影响血清校正钙，磷，或iPTH浓度。腹膜透析患者血清ALP水平随时间逐渐升高,浓度受透析持续时间的影响。血清ALP值的变化对血清钙没有显著影响,磷，和iPTH水平。
