Assessment of bone mineral metabolism derangements by K/DOQI guidelines in haemodialysis patients at Rawalpindi.
OBJECTIVE
To assess serum calcium, phosphorus and PTH levels with reference to K/DOQI targets in haemodialysis patients at Rawalpindi. Further more efficacy of calcium carbonate (CaCO3) was compared with calcium acetate (CaAc) for maintaining serum P and Ca levels in our ESRD patients.


METHODS
One hundred and ninety patients on haemodialysis receiving calcium phosphate binders (CaCO3 n = 128 and CaAc n = 62) were selected from a tertiary care hospital at Rawalpindi, Pakistan. Serum Ca and P were assayed on chemistry analyzer. PTH was measured on immulite-1000. Data were compared with K/DOQI targets and analysed by using SPSS-15.


RESULTS
The patients had mean serum Ca 2.34 +/- 0.29 mmol/L, Phosphorus 1.76 +/- 0.43 mmol/L and Parathyroid hormone (PTH) 38.7 +/- 35.6 nmol/L. The patients had achieved K/DOQI target ranges of Ca, P, PTH and Ca x P product in 37.9%, 41.1%, 22.6% and 61.5% respectively. Patients on CaCO3 had significantly higher serum Ca 2.38 +/- 0.31 mmol/L than those on CaAc therapy 2.26 +/- 0.22 mmol/L.


CONCLUSIONS
Most of patients on maintenance haemodialysis at Rawalpindi, did not achieve the recommended K/DOQI target ranges. Appropriate phosphate binders are required for improvement of mineral metabolism and medical outcome in our patients.
Khan
Dilshad Ahmad
DA
Department of Pathology, Army Medical College, National University of Sciences and Technology, Rawalpindi.
Fatima-Tuz-Zuhra
Khan
Farooq Ahmad
FA
Saif
Imran
I
D000085:Acetates; D000328:Adult; D000368:Aged; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000517:prevention & control; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D002119:Calcium Carbonate; D017610:Calcium Compounds; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism*; D010710:Phosphates / Q000097:blood / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects* / Q000592:standards
D000085:Acetates; D017610:Calcium Compounds; D010281:Parathyroid Hormone; D010710:Phosphates; D002119:Calcium Carbonate; D002118:Calcium; C120662:calcium acetate