title: Mineral and bone disease in black african hemodialysis patients: a report from senegal.
abstract: BACKGROUND
  Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in hemodialysis patients. In Senegal, number of dialysis patients is growing but few data are available about their bone disorders.
  
  
  OBJECTIVE
  To describe patterns of CKD-MBD in Senegalese dialysis patients.
  
  
  METHODS
  We performed a cross-sectional study including patients from three dialysis centres in Senegal. Diagnosis of different types of CKD-MBD relied on clinical, biological and radiological data collected from medical records in dialysis.
  
  
  RESULTS
  We included 118 patients and 79 of them presented CKD-BMD (prevalence of was 66.9 %). Mean age of CKD-MBD patients was 47.8 ± 15.7 years (16-81 years) and sex-ratio (Male/Female) was 1.15. Secondary hyperparathyroidism was the most frequent disorder (57 patients) followed by adynamic bone disease (21 patients) and osteomalacia (1 patients). The main clinical manifestations were bone pain (17.5% of cases), pruritus (36.8% of cases) and pathological fractures (2.5% of cases). Bone biopsy was not available. Valvular and peripheral vascular calcification were present in 24.5% and 21.2% of patients respectively. Management of CKD-MBD included optimization of dialysis, calcium bicarbonate, sevelamer, vitamin D analogues and calcimimetics. The NKF/DOQI recommended levels of serum calcium, phosphate and parathormone PTH were not achieved in one third of patients. Six patients presented major cardiovascular events during their dialysis period.
  
  
  CONCLUSIONS
  CKD-MBD are frequent in Senegalese hemodialysis patients and they are dominated by high turn-over disease. Clinical and biological manifestations are unspecific and accurate diagnoses are often difficult in absence of histomorphometry. Treatment is suboptimal for many patients in a context of limited resources.
authors.affiliation: Internal Medicine and Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Saint-Louis, Senegal.
authors.forename: Sidy Mohamed
authors.initials: SM
authors.lastname: Seck
authors.forename: Mohamed
authors.initials: M
authors.lastname: Dahaba
authors.forename: Elhadj Fary
authors.initials: EF
authors.lastname: Ka
authors.forename: Mouhamadou Moustapha
authors.initials: MM
authors.lastname: Cisse
authors.forename: Seigne
authors.initials: S
authors.lastname: Gueye
authors.forename: Ahmet Ould Lemrabott
authors.initials: AO
authors.lastname: Tal
keywords: Hemodialysis; Renal Osteodystrophy; Senegal