title: CKD-MBD spectrum at the time of initiation of hemodialysis in Pakistani chronic kidney disease patients.
abstract: Chronic kidney disease (CKD) is associated with mineral and bone disorder (MBD), which results in significant morbidity and mortality. To determine the spectrum of CKD- MBD in the Pakistani population, we performed a retrospective review of the medical records of 63 native Pakistani CKD stage-5 patients at our unit at the initiation of hemodialysis from March 2009 to September 2011. The cohort included 28 males and 35 females, with an age range of 18- 87 years (mean age 51 years). We reviewed the serum parathormone (PTH) levels along with other serum biochemical markers according to the KDIGO 2009 guidelines. There were 25 (40%) patients who had PTH <150 pmol/L, 15 (22%) patients who had PTH from 150 to 300 pmol/L and 24 (38%) patients who had PTH >300 pmol/L. Subgroup analysis and follow-up of patients with initial PTH >300 pmol/L (n = 24) showed treatment response in nine patients (38%). We conclude that at initiation of hemodialysis, a significant number of patients had low PTH and a similar percentage of high PTH in our population states. Therefore, we recommend early assessment of renal bone disease spectrum to prevent morbidity and mortality associated with mineral bone disorder in CKD patients.
authors.forename: Ehtesham
authors.initials: E
authors.lastname: Hafeez
authors.forename: Hammad
authors.initials: H
authors.lastname: Raza
authors.affiliation: Nephrology and Dialysis Unit, Department of Medicine, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad, Pakistan.
authors.forename: Rahmat Ullah
authors.initials: RU
authors.lastname: Khan
authors.forename: Muhammad Asim
authors.initials: MA
authors.lastname: Anwar
authors.forename: Tariq
authors.initials: T
authors.lastname: Hussain
authors.forename: Muhammad Atif
authors.initials: MA
authors.lastname: Beg