Evaluation of chronic kidney disease-mineral and bone disorder (CKD MBD) among patients on twice weekly hemodialysis in Khartoum teaching hospital, Sudan
المؤلفون المشاركون
Dosogi, Walid Abd al-Raziq
Abd al-Wahhab, Hisham Hasan
al-Shaykh, Maha Ali Hamidah
Mustafa, Alam al-Din Musa
المصدر
العدد
المجلد 44، العدد 2 (30 يونيو/حزيران 2022)، ص ص. 912-917، 6ص.
الناشر
تاريخ النشر
2022-06-30
دولة النشر
البحرين
عدد الصفحات
6
التخصصات الرئيسية
الملخص EN
Background: Many predictors of morbidity and mortality in dialysis patients but bone metabolism remains one of the important factors.
Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in chronic kidney disease (CKD) recommend that, in Stage 5 CKD, the target levels for calcium (Ca) (corrected for serum albumin), phosphate (P), calcium X phosphate (Ca X P) product and parathyroid hormone (PTH) levels should be maintained at 8.4-9.5 mg/dl, 3.5-5.5 mg/dl, < 55 mg2/dl2 and 150-300 pg /ml, respectively.
Objectives: To recognize the effectiveness of twice per week haemodialysis (8 hours per week dialysis) in achieving the control level of calcium, phosphorus, calcium phosphorus products according to K/DOQI guidelines.
Patients & Methods: A prospective observational cross-sectional hospital-based study was conducted on 77 adult patients with End Stage Renal Disease (ESRD) who received complete two sessions of haemodialysis per week equivalent to eight hours/week hemodialysis.
Personal and demographic data was collected together with the data regarding calcium, phosphorus, calcium times phosphorus (ca X po4) product, PTH, Serum Albumin, information of the dialysis session, co-morbidities according to Davis score.
Data was analysed using software program SPSS v 16.
Correlation between control of mineral and bone disorder and co-morbidities was tested using Qui-Square test (α 0.05).
Results: The aetiology of ESRD was not recognized in 33.8% and thirty-two patients (41.6%) were hypertensive prior to initiation of hemodialysis Forty-two patients (54.5%) maintained residual renal function (RRF) as defined 24hours diuresis ≥ 100 ml.
84% of patient (n=65) had their HD sessions through arterio-venous (AVF.) About 88.2% of patients with AVF had mild Davies’s score.
While 20% and 75% of patients with jugular catheter either had moderate or severe score respectively, this relation found to be significant (p= 0.002).
The percentage of patients whose Ca, P, Ca X p product and PTH were within K/DOQI recommended ranges were 43%, 36%, 65% and 21% respectively.
All the patients with target level of phosphorus had target level of ca x po4 product and 75% of patient with phosphorus level above the target had ca x po4 product above the target level also (P=0.0001).
On the other hand, serum calcium had no significant effect on the ca x po4 product (P= 0.24).
We found 85% of our study population used to take the fixed dose of 1500mg caco3 in 3 divided doses per day despite variation in their bone biochemical parameters.
But on the other hand, 88.9% of patients with above target PTH level appropriately prescribed Vitamin D and 37.5% with target level of PTH did not take vitamin D (p=0.04).
Sixty out of the 77 patients in the study (78%) prescribed similar dose of Alfacalcidol (0.25ug/day) regardless of the level of PTH, in the other words this means 26 out of the 34 patients with low PTH (76.4%) were prescribing Alfacalcidol despite their lower level of PTH rendering them to in threat of developing dynamic bone disease.
Conclusion: Current clinical management of chronic kidney disease-metabolic bone disorder CKD-MBD is far from reaching the target set by K/DOQI guidelines not only because of twice weekly HD but also due to inappropriate phosphate binders and vitamin D prescriptions.
Other approach rather than medical intervention such as well-planned parathyroidectomy need to be considered for management of uncontrolled secondary or tertiary hyperparathyroidism.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Dosogi, Walid Abd al-Raziq& Abd al-Wahhab, Hisham Hasan& al-Shaykh, Maha Ali Hamidah& Mustafa, Alam al-Din Musa. 2022. Evaluation of chronic kidney disease-mineral and bone disorder (CKD MBD) among patients on twice weekly hemodialysis in Khartoum teaching hospital, Sudan. Bahrain Medical Bulletin،Vol. 44, no. 2, pp.912-917.
https://search.emarefa.net/detail/BIM-1443319
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Dosogi, Walid Abd al-Raziq…[et al.]. Evaluation of chronic kidney disease-mineral and bone disorder (CKD MBD) among patients on twice weekly hemodialysis in Khartoum teaching hospital, Sudan. Bahrain Medical Bulletin Vol. 44, no. 2 (Jun. 2022), pp.912-917.
https://search.emarefa.net/detail/BIM-1443319
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Dosogi, Walid Abd al-Raziq& Abd al-Wahhab, Hisham Hasan& al-Shaykh, Maha Ali Hamidah& Mustafa, Alam al-Din Musa. Evaluation of chronic kidney disease-mineral and bone disorder (CKD MBD) among patients on twice weekly hemodialysis in Khartoum teaching hospital, Sudan. Bahrain Medical Bulletin. 2022. Vol. 44, no. 2, pp.912-917.
https://search.emarefa.net/detail/BIM-1443319
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references : p. 916-917
رقم السجل
BIM-1443319
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر