Mineral and bone disorder in Chinese dialysis patients: a multicenter study

BMC Nephrology

Haiyan Wang⁵  Mei Wang^2,20  Li Zuo⁵  Zhaohui Ni^2,21  Dongmei Xu^1,16  Li Wang^1,14  Changlin Mei^1,17  Guiyang Shu⁷  Fanfan Hou⁸  Xiaoling Tang^2,26  Changying Xing⁴  Wei Shi^1,13  Qiang Jia^2,22  Jinyuan Zhang^2,23  Zuying Xiong⁶  Xiangmei Chen^2,27  Feng Ding^1,18  Liqun He^1,19  Minhua Fan^2,24  Wei Chen^1,15  Hua Wu^2,25  Weijie Yuan^2,28  Liren Peng³  Jianghua Chen^1,12  Wenhu Liu^1,10  Xueqing Yu⁹  Yong Gu¹  Nan Chen²  Ling Zhang^1,11  Luxia Zhang⁵  Xianglei Kong^1,16 

[1] Renal Division, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China;Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China;Department of Nephrology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China;Renal Division, Jiangsu Provincial Hospital, Nanjing, China;Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China;Renal Division, Hospital Peking of Shenzhen, Shenzhen, China;Department of Nephrology, Fujian Provincial Hospital, Fuzhou, China;Department of Nephrology, Nanfang Hospital, The Southern Medical University, Guangzhou, China;Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China;Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China;Department of Nephrology, China-Japan Friendship Hospital, Beijing, China;Kidney Diseases Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;Department of Nephrology, Guangdong General Hospital, Guangzhou, China;Department of Nephrology, Sichuan Provincial People’ s Hospital, Chengdu, China;Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, China;Department of Nephrology, Qianfoshan Hospital, Shandong University, Jinan, China;Department of Nephrology, Changzheng Hospital, Second Military Medical University, Shanghai, China;Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China;Department of Nephrology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China;Institute of Nephrology and Division of Nephrology, and Key Laboratory of Ministry of Health, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China;Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China;Department of Nephrology, The 455th Hospital of PLA, Shanghai, China;Department of Nephrology, Peking University Third Hospital, Beijing, China;Department of Nephrology, Beijing Hospital, Beijing, China;Department of internal medicine, Shantou Central Hospital, Shantou, China;Department of Nephrology, The General Hospital of the People's Liberation Army, Beijing, China;Department of Nephrology, Shanghai First People s Hospital, Shanghai Jiaotong University, Shanghai, China

关键词: Epidemiology;    Mineral and bone disorder;    End stage renal disease;   

Others  :  1083095
DOI  :  10.1186/1471-2369-13-116

 received in 2011-12-13, accepted in 2012-09-14,  发布年份 2012

【 摘 要 】

Background

Mineral and bone disorder (MBD) in patients with chronic kidney disease is associated with increased morbidity and mortality. Studies regarding the status of MBD treatment in developing countries, especially in Chinese dialysis patients are extremely limited.

Methods

A cross-sectional study of 1711 haemodialysis (HD) patients and 363 peritoneal dialysis (PD) patients were enrolled. Parameters related to MBD, including serum phosphorus (P), calcium (Ca), intact parathyroid hormone (iPTH) were analyzed. The achievement of MBD targets was compared with the results from the Dialysis Outcomes and Practice Study (DOPPS) 3 and DOPPS 4. Factors associated with hyperphosphatemia were examined.

Results

Total 2074 dialysis patients from 28 hospitals were involved in this study. Only 38.5%, 39.6% and 26.6% of them met the Kidney Disease Outcomes Quality Initiative (K/DOQI) defined targets for serum P, Ca and iPTH levels. Serum P and Ca levels were statistically higher (P < 0.05) in the HD patients compared with those of PD patients, which was (6.3 ± 2.1) mg/dL vs (5.7 ± 2.0) mg/dL and (9.3 ± 1.1) mg/dL vs (9.2 ± 1.1) mg/dL, respectively. Serum iPTH level were statistically higher in the PD patients compared with those of HD patients (P = 0.03). The percentage of patients reached the K/DOQI targets for P (37.6% vs 49.8% vs 54.5%, P < 0.01), Ca (38.6% vs 50.4% vs 56.0%, P < 0.01) and iPTH (26.5% vs 31.4% vs 32.1%, P < 0.01) were lower among HD patients, compared with the data from DOPPS 3 and DOPPS 4. The percentage of patients with serum phosphorus level above 5.5 mg/dL was 57.4% in HD patients and 47.4% in PD patients. Age, dialysis patterns and region of residency were independently associated with hyperphosphatemia.

Conclusions

Status of MBD is sub-optimal among Chinese patients receiving dialysis. The issue of hyperphosphatemia is prominent and needs further attention.

【 授权许可】

   
2012 Kong et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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