Epidemiology investigation of mineral and bone disorder among maintenance hemodialysis patients in Shanxi Province

Abstract

Objective To observe the monitor and control situation of calcium and phosphorus metabolic disorder among maintenance hemodialysis (MHD) patients in Shanxi Province from 2012 to 2015, so as to provide data support for the continual improvement of hemodialysis. Methods Retrospective analysis of MHD patients′ clinical data directly reported online by all medical institutions carrying out blood purification therapy from 2012 to 2015 in Shanxi Province. The main collection includes patients′ demographic data, blood calcium, blood phosphorus, blood intact parathyroid hormone(iPTH), and so on. The collection of various related data was completed through the National Blood Purification Registration System. The data collected were then used in Excell2003 to establish a database for analysis. Results The detection rates of serum calcium and serum phosphorus in MHD patients were both lower from 2012 to 2015, and were 35.7%-45.9% and about 40% in recent years, respectively. The detection rate of iPTH was even lower, but has an upward trend, and has reached 21.2% from 8.9%. According to the guidelines for diagnosis and treatment of chronic kidney disease-mineral bone disease (CKD-MBD) of Chinese Society of Nephrology, during 2012-2015, the yearly rates of standard-reaching MHD patients in blood phosphorus (1.13-1.78 mmol/L) accounted for 41.6%, 39.8%, 40.7%, and 39.4%, respectively. The control of phosphorus in both female group and aged-over-50 group was better than in male group and in the aged-less-than-50 group. The yearly standard-reaching rate of calcium (2.10-2.54 mmol/L) among MHD patients from 2012 to 2015 was 42.3%, 49.8%, 55.4%, and 56.4%, respectively. The control of phosphorus was better in female group, aged 30-39 group, aged 50-59 group, and aged-over-70 group. The yearly rates of standard-reaching MHD patients with serum iPTH ranging 150-600 pg/ml were 58.3%, 52.6%, 51.2%, and 54.6%, respectively, from 2012 to 2015. Conclusions The rates of MHD patients receiving detection of calcium, phosphorus, and iPTH in Shanxi Province were low. The standard-reaching rate of blood phosphorus was not increased significantly in recent years, while the standard-reaching rate of blood calcium has been gradually improved in recent years. Key words: Hemodialysis; Mineral and bone disorder; Epidemiology