Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea.
- Author:
Gheun Ho KIM
1
;
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
;
Se Joong KIM
;
Soo Wan KIM
;
Sug Kyun SHIN
;
Wondo PARK
;
Won KIM
;
Wooseong HUH
;
Young Joo KWON
;
Young Sun KANG
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. kimgh@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Calcium;
Hemodialysis;
Intact parathyroidhormone;
Phosphorus;
Secondary hyperparathyroidism
- MeSH:
Calcium*;
Humans;
Hyperparathyroidism, Secondary;
Kidney Diseases;
Korea;
Parathyroid Hormone;
Phosphorus*;
Renal Dialysis*;
Retrospective Studies
- From:Kidney Research and Clinical Practice
2014;33(1):52-57
- CountryRepublic of Korea
- Language:English
-
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 CaxP product were 9.1+/-0.7mg/dL, 5.3+/-1.4mg/dL, and 48.0+/-13.6mg2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca x 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 >300pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and CaxP product than those with iPTH < or =300pg/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 x P product, suggestive of the importance of SHPT management.
