Mineral and bone disorder in Chinese dialysis patients: a multicenter study

• Main Authors: Kong Xianglei, Zhang Luxia, Zhang Ling, Chen Nan, Gu Yong, Yu Xueqing, Liu Wenhu, Chen Jianghua, Peng Liren, Yuan Weijie, Wu Hua, Chen Wei, Fan Minhua, He Liqun, Ding Feng, Chen Xiangmei, Xiong Zuying, Zhang Jinyuan, Jia Qiang, Shi Wei, Xing Changying, Tang Xiaoling, Hou Fanfan, Shu Guiyang, Mei Changlin, Wang Li, Xu Dongmei, Ni Zhaohui, Zuo Li, Wang Mei, Wang Haiyan
• Format: Article
• Language: English
• Published: BMC 2012-09-01
• Series: BMC Nephrology
• Subjects: End stage renal disease; Mineral and bone disorder; Epidemiology
• Online Access: http://www.biomedcentral.com/1471-2369/13/116

<p>Abstract</p> <p>Background</p> <p>Mineral and bone disorder (MBD) in patients with chronic kidney disease is associated with increased morbidity and mortality. Studies regarding the status of MBD treatment in developing countries, especially in Chinese dialysis patients are extremely limited.</p> <p>Methods</p> <p>A cross-sectional study of 1711 haemodialysis (HD) patients and 363 peritoneal dialysis (PD) patients were enrolled. Parameters related to MBD, including serum phosphorus (P), calcium (Ca), intact parathyroid hormone (iPTH) were analyzed. The achievement of MBD targets was compared with the results from the Dialysis Outcomes and Practice Study (DOPPS) 3 and DOPPS 4. Factors associated with hyperphosphatemia were examined.</p> <p>Results</p> <p>Total 2074 dialysis patients from 28 hospitals were involved in this study. Only 38.5%, 39.6% and 26.6% of them met the Kidney Disease Outcomes Quality Initiative (K/DOQI) defined targets for serum P, Ca and iPTH levels. Serum P and Ca levels were statistically higher (P < 0.05) in the HD patients compared with those of PD patients, which was (6.3 ± 2.1) mg/dL vs (5.7 ± 2.0) mg/dL and (9.3 ± 1.1) mg/dL vs (9.2 ± 1.1) mg/dL, respectively. Serum iPTH level were statistically higher in the PD patients compared with those of HD patients (P = 0.03). The percentage of patients reached the K/DOQI targets for P (37.6% vs 49.8% vs 54.5%, P < 0.01), Ca (38.6% vs 50.4% vs 56.0%, P < 0.01) and iPTH (26.5% vs 31.4% vs 32.1%, P < 0.01) were lower among HD patients, compared with the data from DOPPS 3 and DOPPS 4. The percentage of patients with serum phosphorus level above 5.5 mg/dL was 57.4% in HD patients and 47.4% in PD patients. Age, dialysis patterns and region of residency were independently associated with hyperphosphatemia.</p> <p>Conclusions</p> <p>Status of MBD is sub-optimal among Chinese patients receiving dialysis. The issue of hyperphosphatemia is prominent and needs further attention.</p>