Clinical Practices and Therapeutic Management of Mineral and Bone Disorders in Chronic Kidney Disease 4, 5 and 5D: The OCEANOS Study in Iran

Nafar, Mohsen; Rashid-Farokhi, Farin; Zeraati, Abbas Ali; Ossareh, Shahrzad; Atapour, Abdolah; Nemati, Eghlim; Gholi, Fatemeh Poor reza; Sagheb, Mohammad Mahdi; Hakemi, Monir Sadat; Argani, Hassan; Tara, Ahmad; Afshar, Reza; Ahmadi, Javad Mohamd Reza; Karimi, Nadia; Mamdouhi, Fereshteh; Mahdavi‐Mazdeh, Mitra; Sabaghian, Tahereh

doi:10.5812/numonthly.61632

Cited by 1 publication

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“…In the DOPPS study, 43% of patients with PTH of < 150 pg/mL were treated with vitamin D analogs (16). Moreover, in a multicenter study that was recently conducted in Iran, 70% of the hemodialysis patients had been receiving this group of drugs (43). In our study, 9.3% of the patients had PTH of > 600 pg/mL; the low cost and high intake of vitamin D analogs could explain this low percentage.…”

Section: Discussionmentioning

confidence: 47%

Serum Calcium and Phosphorus Levels in Hemodialysis Patients: A Large Population-Based Multicenter Study

Nafar

Sabaghian

Khoshdel

et al. 2019

Iran Red Crescent Med J

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Background: Mineral bone disorder is one of the major factors affecting mortality and morbidity in dialysis patients, which is called chronic kidney disease-mineral and bone disorder (CKD-MBD). Objectives: This study aimed to evaluate the laboratory parameters of mineral bone disorder in hemodialysis patients in Iran and their relationship with malnutrition and inflammation. Methods: This multicenter observational study was conducted in 2016 in 58 dialysis centers in Iran. Data of a total number of 7191 chronic hemodialysis patients aged older than 18 years with a dialysis duration of > 3 months were collected. Idiopathic hypercalcemia and history of parathyroidectomy were considered as the exclusion criteria. The serum levels of calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) were measured over a period of three months, and the findings were compared with the K/DOQI (National Kidney Foundation Dialysis Outcomes Quality Initiative) guidelines. Moreover, the serum level of C-reactive protein (CRP) and nutritional status based on geriatric nutritional risk index (GNRI) were assessed. Results: The percentage of the patients who had a serum iPTH level of < 150 pg/mL was 46% while that of patients with iPTH of > 300 pg/mL was 29.3%. Hypercalcemia and hyperphosphatemia were observed in 20.6% and 34.2% of the patients, respectively. Moreover, 51.7%, 61.3%, 24.7%, and 84.7% of the patients, respectively, reached the K/DOQI target range of Ca, P, iPTH, and Ca × P product. The percentages of mild-to-severe malnutrition based on GNRI in patients whose iPTH level was within, below, and above the recommended range of K/DOQI guidelines were 30.7%, 34.1%, and 25.9%, respectively (P < 0.001). Furthermore, the serum level of CRP was significantly higher in low-serum PTH patients than in the other two groups. In total, only could 8.3% of the patients reach the four KDOQI target levels of CKD-MBD. Conclusions: The findings showed a significant percentage of patients had a low serum PTH level, which might be attributed to inflammatory and nutritional factors. Only had a small percentage of patients reached all the K/DOQI targets. Therefore, the effects of inflammatory and nutritional factors should also be considered, particularly in developing countries.

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Section: Discussionmentioning

confidence: 47%

Serum Calcium and Phosphorus Levels in Hemodialysis Patients: A Large Population-Based Multicenter Study

Nafar

Sabaghian

Khoshdel

et al. 2019

Iran Red Crescent Med J

Self Cite

View full text Add to dashboard Cite

show abstract

Clinical Practices and Therapeutic Management of Mineral and Bone Disorders in Chronic Kidney Disease 4, 5 and 5D: The OCEANOS Study in Iran

Abstract: Background: The aim of this study was to evaluate the management of mineral and bone disorders (MBD) in patients with chronic kidney disease (CKD) in Iran and the extent to which KDIGO goals were met.

Cited by 1 publication

References 28 publications

Serum Calcium and Phosphorus Levels in Hemodialysis Patients: A Large Population-Based Multicenter Study

Serum Calcium and Phosphorus Levels in Hemodialysis Patients: A Large Population-Based Multicenter Study

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