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

BMC Nephrology

Research Article

Liren Peng¹  Wenhu Liu²  Hua Wu³  Changlin Mei⁴  Ling Zhang⁵  Guiyang Shu⁶  Wei Shi⁷  Feng Ding⁸  Fanfan Hou⁹  Minhua Fan^1,10  Dongmei Xu^1,11  Nan Chen^1,12  Weijie Yuan^1,13  Liqun He^1,14  Li Wang^1,15  Jinyuan Zhang^1,16  Xiangmei Chen^1,17  Wei Chen^1,18  Qiang Jia^1,19  Xueqing Yu^2,20  Xiaoling Tang^2,21  Jianghua Chen^2,22  Haiyan Wang^2,23  Li Zuo^2,23  Luxia Zhang^2,23  Mei Wang^2,24  Xianglei Kong^2,25  Zuying Xiong^2,26  Changying Xing^2,27  Zhaohui Ni^2,28  Yong Gu^2,29 

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

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

DOI  :  10.1186/1471-2369-13-116

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

来源: Springer

【 摘 要 】

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

【 授权许可】

Unknown   
© Kong et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.