Serum Calcium and Phosphorus Levels in Patients Undergoing Maintenance Hemodialysis: A Multicentre Study in Korea

Overview

Journal Kidney Res Clin Pract

Specialty Nephrology

Date 2016 Feb 16

PMID 26877950

Citations 14

Authors

Gheun-Ho Kim

Bum Soon Choi

Dae Ryong Cha

Dong Hyun Chee

Eunah Hwang

Hyung Wook Kim

Jae Hyun Chang

Joong-Kyung Kim

Jung Woo Noh

Kwon Wook Joo

Sang Choel Lee

Sang-Woong Han

Sejoong Kim

Soo Wan Kim

Sug-Kyun Shin

Wondo Park

Won Kim

Wooseong Huh

Young Joo Kwon

Young Sun Kang

Affiliations

Soon will be listed here.

Abstract

Background: In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients.

Methods: Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed.

Results: Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg(2)/dL(2), respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH ≤300 pg/mL.

Conclusion: Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca × P product, suggestive of the importance of SHPT management.

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