Kidney Res Clin Pract.
2014 Mar;33(1):52-57.
Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea
- Affiliations
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- 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. kimgh@hanyang.ac.kr
- 2Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 3Department of Nephrology, Korea University Medical College, Ansan, Korea.
- 4AbbVie Ltd., Seoul, Korea.
- 5Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 6Department of Internal Medicine, St.Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
- 7Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
- 8Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea.
- 9Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Korea.
- 10Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 11Department of Internal Medicine, Goodmorning Hospital, Pyeongtaek, Korea.
- 12Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
- 13Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 14Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
- 15Department of Internal Medicine, NHIS Ilsan Hospital, Goyang, Korea.
- 16Department of Internal Medicine, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea.
- 17Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
- 18Department of Internal Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
- 19Division of Nephrology, College of Medicine, Korea University, Guro Hospital, Seoul, Korea.
Abstract
- BACKGROUND
In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients.
METHODS
Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed.
RESULTS
Serum levels of Ca, P, and the CaxP product were 9.1+/-0.7mg/dL, 5.3+/-1.4mg/dL, and 48.0+/-13.6mg2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca x P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and CaxP product than those with iPTH < or =300pg/mL.
CONCLUSION
Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca x P product, suggestive of the importance of SHPT management.
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