title: Mineral and bone disorder in Chinese dialysis patients: a multicenter study.
abstract: BACKGROUND
  Mineral 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Total 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.
  
  
  CONCLUSIONS
  Status of MBD is sub-optimal among Chinese patients receiving dialysis. The issue of hyperphosphatemia is prominent and needs further attention.
authors.affiliation: 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.
authors.forename: Xianglei
authors.initials: X
authors.lastname: Kong
authors.forename: Luxia
authors.initials: L
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.forename: Wenhu
authors.initials: W
authors.lastname: Liu
authors.forename: Jianghua
authors.initials: J
authors.lastname: Chen
authors.forename: Liren
authors.initials: L
authors.lastname: Peng
authors.forename: Weijie
authors.initials: W
authors.lastname: Yuan
authors.forename: Hua
authors.initials: H
authors.lastname: Wu
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Minhua
authors.initials: M
authors.lastname: Fan
authors.forename: Liqun
authors.initials: L
authors.lastname: He
authors.forename: Feng
authors.initials: F
authors.lastname: Ding
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Chen
authors.forename: Zuying
authors.initials: Z
authors.lastname: Xiong
authors.forename: Jinyuan
authors.initials: J
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Jia
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Changying
authors.initials: C
authors.lastname: Xing
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Tang
authors.forename: Fanfan
authors.initials: F
authors.lastname: Hou
authors.forename: Guiyang
authors.initials: G
authors.lastname: Shu
authors.forename: Changlin
authors.initials: C
authors.lastname: Mei
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Dongmei
authors.initials: D
authors.lastname: Xu
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
authors.forename: Li
authors.initials: L
authors.lastname: Zuo
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000208:ethnology*; D015415:Biomarkers / Q000097:blood; D001847:Bone Diseases / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D002118:Calcium / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium