[Bone mineral metabolism in patients with chronic kidney disease on dialysis in Southern Metropolitan Santiago]

Rev Med Chil. 2015 Feb;143(2):168-74. doi: 10.4067/S0034-98872015000200003.
[Article in Spanish]

Abstract

Background: Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a condition of dialysis patients associated with both morbidity and mortality. Management is based on clinical guidelines with goals that are hard to comply with.

Aim: To describe and compare biochemical variables associated with this disorder in two different time periods.

Material and methods: Revision of medical records of 814 patients (49% females) dialyzed during 2009 and 1018 patients (48% females), dialyzed during 2012 in Southern Metropolitan Santiago. Information about serum calcium, phosphorus, parathyroid hormone (PTH) and albumin was retrieved.

Results: Median PTH values in 2009 and 2012 were 222.5 and 353.5 pg/ml respectively (p < 0.05). The figures for serum calcium corrected by albumin were 9.0 and 8.5 mg/dl respectively (p < 0.05). The figures for phosphorus were 4.7 and 5.0 mg/dl respectively (p < 0.05). The Calcium x Phosphorus product was 41.4 and 42.5 mg²/dl² (p < 0.05). Of note, the proportion patients with serum calcium below recommended levels (< 8.4 mg/dl) increased from 16% to 40% from 2009 to 2012. The proportion of patients with biochemical variables within recommended ranges was lower in 2012 than in 2009.

Conclusions: There was a low proportion of patients with bone metabolism parameters within ranges recommended by clinical guidelines. These parameters were worst in 2012.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Aged
  • Bone Diseases, Metabolic / etiology
  • Bone Diseases, Metabolic / metabolism
  • Bone and Bones / metabolism*
  • Calcium / blood
  • Chile
  • Cohort Studies
  • Female
  • Guideline Adherence
  • Humans
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood
  • Phosphorus / blood
  • Renal Dialysis* / adverse effects
  • Renal Insufficiency, Chronic / metabolism*
  • Retrospective Studies
  • Serum Albumin / analysis
  • Time Factors

Substances

  • Parathyroid Hormone
  • Serum Albumin
  • Phosphorus
  • Calcium