Abstract
IntroductionThere is a great scarcity of literature in Pakistan investigating the proportion of end stage renal disease (ESRD) patients undergoing hemodialysis (HD) who meet the recommended kidney diseases outcome quality initiative (K/DOQI) guidelines for serum calcium (Ca), phosphorus (P), calcium phosphorus product (Ca x P) and parathyroid hormone (PTH) levels. Our study aimed to determine frequencies of patients who met the K/DOQI targets for these minerals at a tertiary care hospital's dialysis unit.Methods111 ESRD patients on maintenance HD were selected from a tertiary care hospital. Serum Ca and P were assayed on chemistry analyser. PTH was measured through electrochemiluminescence sandwich method. Data were compared with K/DOQI targets and analysed using SPSS-21.ResultsThe mean age of patients was 55.85 years (SD ± 13.95). Gender distribution was almost equal with 49.5% males and 50.5% females. The patients had mean corrected serum Calcium 9.12 ± 0.64 mg/dL, Phosphorus 4.57 ± 1.54 mg/dL and Parathyroid hormone 333.8 ± 278.4 pg/mL. The patients had achieved K/DOQI target ranges of Ca, P, PTH, Ca x P product and all 4 criteria in 63.1%, 47.6%, 38.7%, 84.7% and 10.8% respectively.ConclusionMajority of patients on maintenance HD at our institution did not achieve the recommended K/DOQI target ranges. Further studies pertaining to the Asian subcontinent will prove resourceful for comparison of mineral metabolism and dialysis outcome of ESRD patients.
Highlights
IntroductionEpidemiological data shows that about 10% of the worldwide population is affected by chronic kidney disease (CKD) and millions die each year since they cannot access affordable treatment [1]
The purpose of this study was to determine the frequency of end stage renal disease (ESRD) patients undergoing Maintenance HD at our institution who met the kidney diseases outcome quality initiative (K/DOQI) Criteria for serum Ca, serum P, Ca x P product and parathyroid hormone (PTH) levels
We found that majority hyper-phosphatemic patients (55%) had higher PTH levels
Summary
Epidemiological data shows that about 10% of the worldwide population is affected by chronic kidney disease (CKD) and millions die each year since they cannot access affordable treatment [1]. Maintenance dialysis is of utmost importance for end stage renal disease (ESRD) patients [6] Their serum Calcium (Ca), Phosphorus (P) levels and Calcium-Phosphorus product (Ca x P) are essential indicators for monitoring bone mineral disease. The Kidney Diseases Outcome Quality Initiative (KDOQI) clinical guidelines for hemodialysis (HD) are a useful criteria which help to monitor serum Ca, P and parathyroid hormone (PTH) levels in CKD patients [7]. Asiatic [8,9], local [10] and various international studies [11,12,13,14,15,16] have been conducted in different countries to assess mineral metabolism abnormalities in ESRD patients receiving hemodialysis in concordance with the K/DOQI guidelines [7]. The purpose of this study was to determine the frequency of ESRD patients undergoing Maintenance HD at our institution who met the K/DOQI Criteria for serum Ca, serum P, Ca x P product and PTH levels
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