title: Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea.
abstract: BACKGROUND
  In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients.
  
  
  METHODS
  Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed.
  
  
  RESULTS
  Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg(2)/dL(2), respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH ≤300 pg/mL.
  
  
  CONCLUSIONS
  Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca × P product, suggestive of the importance of SHPT management.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Gheun-Ho
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan, Korea.
authors.forename: Dae Ryong
authors.initials: DR
authors.lastname: Cha
authors.affiliation: AbbVie Ltd., Seoul, Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Chee
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Eunah
authors.initials: E
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, St. Vincent׳s Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea.
authors.forename: Joong-Kyung
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Noh
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kwon Wook
authors.initials: KW
authors.lastname: Joo
authors.affiliation: Department of Internal Medicine, Goodmorning Hospital, Pyeongtaek, Korea.
authors.forename: Sang Choel
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Sang-Woong
authors.initials: SW
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, NHIS Ilsan Hospital, Goyang, Korea.
authors.forename: Sug-Kyun
authors.initials: SK
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Wondo
authors.initials: W
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Wooseong
authors.initials: W
authors.lastname: Huh
authors.affiliation: Division of Nephrology, College of Medicine, Korea University, Guro Hospital, Seoul, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan, Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kang
keywords: Calcium; Hemodialysis; Intact parathyroid hormone; Phosphorus; Secondary hyperparathyroidism