title: Prevalence of chronic kidney disease-mineral and bone disorder in incident peritoneal dialysis patients and its association with short-term outcomes.
abstract: BACKGROUND
  A complex relationship exists between chronic kidney disease-mineral and bone disorder (CKD-MBD) and adverse outcomes among dialysis patients. This study aimed to report the prevalence of CKD-MBD and examine the impact of achieving target CKD-MBD parameters on morbidity and mortality one year after peritoneal dialysis (PD) initiation.
  
  
  METHODS
  In this retrospective cohort study, patients electively initiated on PD were followed up for one year. Laboratory parameters were collected and the prevalence of CKD-MBD 4-6 months after PD initiation was determined based on the Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Linear regression and Cox proportional hazards model were used to evaluate the effects of achieving CKD-MBD targets 4-6 months after PD initiation on hospitalisation, the incidence of peritonitis or exit-site infections (ESIs), and mortality at one year.
  
  
  RESULTS
  The prevalence of CKD-MBD among the 86 patients in this study was 86.0% (KDOQI) and 54.7% (KDIGO). There was no significant difference in hospitalisation duration between patients who achieved targets and those who did not. Patients who failed to meet all the KDIGO CKD-MBD or calcium serum targets had a higher incidence of peritonitis or ESI. A trend toward shorter time to death was observed among patients who failed to meet the KDIGO phosphorus serum targets.
  
  
  CONCLUSIONS
  There was moderate (KDIGO) to high prevalence (KDOQI) of CKD-MBD among the patients. Achievement of all the KDIGO CKD-MBD or calcium serum targets was associated with reduced peritonitis or ESI, while achievement of the KDIGO phosphorus serum targets was associated with improved survival.
authors.affiliation: Department of Pharmacy, Tan Tock Seng Hospital, Singapore.
authors.forename: Shen Hui
authors.initials: SH
authors.lastname: Chuang
authors.affiliation: Biostatistics Unit, Dean's Office, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Hung Chew
authors.initials: HC
authors.lastname: Wong
authors.affiliation: Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
authors.forename: Anantharaman
authors.initials: A
authors.lastname: Vathsala
authors.affiliation: Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
authors.forename: Evan
authors.initials: E
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Medicine, National University Hospital, Singapore.|Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Priscilla Pei Ching
authors.initials: PP
authors.lastname: How
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D015995:Prevalence; D016016:Proportional Hazards Models; D011786:Quality Control; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: incident; mineral and bone disorder; outcomes; peritoneal dialysis; short-term