Management of Calcium and Phosphorus Metabolism in Hemodialysis Patients in Tehran Province, Iran

Authors

  • Mitra Mahdavi-Mazdeh Department of Nephrology, Tehran University of Medical Sciences, Tehran, Iran Author
  • Mahnaz Zamyadi Management Center of Transplantation and Special Diseases, Ministry of Health, Iran Author
  • Shahram Norouzi Management Center of Transplantation and Special Diseases, Ministry of Health, Iran Author
  • Alireza Heidary Rouchi Management Center of Transplantation and Special Diseases, Ministry of Health, Iran Author

Abstract

Introduction. Our aim was to evaluate the degree of achievement of the recommended values in National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI) guidelines for the laboratory indicators of bone metabolism in patients undergoing hemodialysis (HD) in Tehran province.

Materials and Methods. We evaluated the laboratory information of 2630 HD patients in Tehran province. Demographic data of the patients and the clinical information including the duration of dialysis session, dialysate calcium concentration, Kt/V, and serum values of calcium, phosphorus, and intact parathyroid hormone (PTH) were recorded. The laboratory values were compared to the recommended ranges by the K/DOQI work group in patients with end-stage renal disease.

Results. Only 1.8% of the patients could enjoy a successful management according to the K/DOQI recommendations for the 4 target laboratory tests of serum calcium, phosphorus, intact parathyroid hormone, and calcium-phosphorus product. Hypocalcemia was diagnosed in 33.2% of the patients, whereas 13.6% were diagnosed with hypercalcemia. Hypophosphatemia and secondary hyperparathyroidism were diagnosed in 6.8% and 24.2% of the patients, respectively.

Conclusions. Our findings proved that complying with the recommendations established by the K/DOQI work group in the clinical management of mineral metabolism is very demanding. Phosphate binders frequently lead to untoward toxicities and imbalance in bone metabolism of patients on HD, warranting new cost-effective therapies with fewer side effects. It would be of great interest to analyze, in the future, the benefits derived from the effect of new therapies such as calcimimetics or new phosphate binders regarding the achievement of the K/DOQI guidelines.

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Published

2009-04-08

Issue

Section

ORIGINAL | Dialysis

How to Cite

Management of Calcium and Phosphorus Metabolism in Hemodialysis Patients in Tehran Province, Iran. (2009). Iranian Journal of Kidney Diseases, 1(1), 25-28. https://ijkd.org/index.php/ijkd/article/view/39

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