title: Assessment of bone mineral metabolism derangements by K/DOQI guidelines in haemodialysis patients at Rawalpindi.
abstract: 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.
authors.affiliation: Department of Pathology, Army Medical College, National University of Sciences and Technology, Rawalpindi.
authors.forename: Dilshad Ahmad
authors.initials: DA
authors.lastname: Khan
authors.lastname: Fatima-Tuz-Zuhra
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Khan
authors.forename: Imran
authors.initials: I
authors.lastname: Saif
mesh_terms: 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
chemical_list: D000085:Acetates; D017610:Calcium Compounds; D010281:Parathyroid Hormone; D010710:Phosphates; D002119:Calcium Carbonate; D002118:Calcium; C120662:calcium acetate