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Evaluation of Phospho-calcic Profile of Dakar Chronic Hemodialysis and Comparison with KDIGO Recommendations

The bone and mineral disorders related to chronic kidney disease (BM-CKD) are common among chronic hemodialysis patients with increased overall mortality due to secondary hyperparathyroidism and vascular calcifications. Patients and method: This is a retrospective, descriptive and analytical multicenter study made in the hemodialysis unit of the Aristide Le Dantec hospital in Dakar and 2 private hemodialysis units concerned with 135 patients. The objective of the study was to determine the epidemiological, clinical and laboratory phosphocalcic disorders of chronic hemodialysis patients in Dakar. Then these data were compared with the latest targets KDIGO 2009 to make recommendations for good practice against doctors. Results: The average age was 50 years with a sex ratio of 1.04. Average time in hemodialysis patients was 47 months. The dialysis medium frequency per week was 2.86 per week. The average duration of dialysis was 4.1 hours. All centers used dialysate bath at 1.5 mmol/l calcium. The main causal nephropathy was represented by the common nephroangiosclerosis (51.1%), nephropathy indeterminate (14.8%) and chronic glomerulonephritis (10.4%). The overall prevalence of calcium phosphate disorders was 23% for hypocalcemia, hyperphosphatemia for 30.8%, 42.6% for hyperparathyroidism, 16.3% for the decline in reserves of native vitamin D and 8.1% for high total alkaline phosphatase (TAP). The average frequency of dosing of these different parameters calcium phosphate was 4.1 months for serum calcium and phosphate, 11.4 months for PTH, 19.7 months for the 25OH Vitamin D and 46.2 months for Total alkaline phosphatase. Regarding the percentage of patients who were in the KDIGO standards, there was 63.7% for serum calcium; 60.9% for phosphate; 44.7% for iPTH; 21.5% for the 25OH Vitamin D and 9.6% for total alkaline phosphatase. Phosphate binders were prescribed in 28.1% of cases for the calcium carbonate and in 11.9% of cases for sevelamer. Oral vitamin D was prescribed in 15.6% of cases, calcitriol in 17% of cases and cinacalcet in 7.4% of cases. Parathyroidectomy was performed in 4.4% of cases. Control status phosphocalcic of chronic hemodialysis is a hot topic. Its complications are responsible for a global and cardiovascular morbidity and mortality. Preventing BM-CKD requires good control of hyperphosphatemia and secondary hyperparathyroidism.

Auteur(s) : Mahamat Abderraman G1,*, Elhadji Fary KA2, Muhammadu Moustapha Cisse2, Ahmed Tall Lemrabott2, Maria Faye2, Abdou Niang2, and Boucar Diouf2
Pages : 1-5
Année de publication : 2015
Revue : International Journal of Nephrology and Kidney Failure
N° de volume : 1.1
Type : Article
Mise en ligne par : KA El Hadji Fary