HYPERPHOSPHATEMIA IN END STAGE RENAL DISEASE: PREVALENCE AND PATIENTS CHARACTERISTICS OF MULTIETHNIC POPULATION OF UNITED ARAB EMIRATES

Syed Arman Rabbani,Sathvik B S,Basset El Essawy,Martin Thomas Kurian,Padma Gm Rao

doi:10.22159/ijpps.2017v9i12.22425

Abstract

Objective: Hyperphosphatemia is significantly associated with increased mortality among end stage renal disease (ESRD) patients on hemodialysis. There is paucity of data on hyperphosphatemia in ESRD patients of the multiethnic population of United Arab Emirates (UAE). The study aimed to investigate the prevalence and characteristics of hyperphosphatemia in ESRD patients of the multiethnic population of UAE undergoing maintenance hemodialysis.Methods: Adults ESRD patients undergoing maintenance hemodialysis for more than six months at the study site were included. Demographic, clinical and biological data of the patients were collected. Patient characteristics were compared as per the serum phosphate level, between patients with or without hyperphosphatemia. Univariate and multivariate logistic regression analyses were carried out to identify the predictors of hyperphosphatemia.Results: Hyperphosphatemia was present in 73.8% of the study population, while 31.3% presented with high calcium-phosphate product. Univariate logistic analysis revealed that hyperphosphatemia was inversely correlated with age, hemoglobin, serum calcium, and hypertensive nephropathy as cause of renal disease, and positively correlated with female gender, expatriate status, body mass index (BMI), higher number of comorbidities, calcium-phosphate product and parathyroid hormone (PTH). Multivariate logistic regression model revealed that only age, BMI, hemoglobin and PTH independently correlated with hyperphosphatemia.Conclusion: We report a high prevalence of hyperphosphatemia in multiethnic study population undergoing maintenance hemodialysis at a secondary care hospital in UAE. In this study population, only age, BMI, hemoglobin and PTH were identified as independent predictors of hyperphosphatemia.

Highlights

Hyperphosphatemia in end-stage renal disease (ESRD) is a common and serious biochemical abnormality linked to vascular calcification, renal osteodystrophy and secondary hyperparathyroidism [1,2,3,4]
Univariate logistic analysis revealed that hyperphosphatemia was inversely correlated with age, hemoglobin, serum calcium and hypertensive nephropathy as cause of renal disease
Multivariate analysis indicated that only age, body mass index (BMI), haemoglobin and parathyroid hormone (PTH) independently correlated with hyperphosphatemia

Summary

Introduction

Hyperphosphatemia in end-stage renal disease (ESRD) is a common and serious biochemical abnormality linked to vascular calcification, renal osteodystrophy and secondary hyperparathyroidism [1,2,3,4]. The abnormality is significantly associated with increased mortality among ESRD patients on hemodialysis [5,6,7]. Studies have shown a strong association of hyperphosphatemia with cardiovascular morbidity and mortality in ESRD patients [8,9,10]. Adequate control of serum phosphate is a critical component in the clinical management of ESRD patients. A number of phosphate binders, each with its own potential advantages and disadvantages, are available for the management of hyperphosphatemia. Non-calcium-based phosphate binders like sevelamer and lanthanum are expensive, and associated with gastrointestinal side effects [11,12]. More recently iron-based phosphate binders have shown to be effective in controlling hyperphosphatemia [13]

Results

Discussion

Conclusion