Mineral and bone disorders in chronic hemodialysis and evaluation of adherence to the kdigo 2017 recommendation: multicenter study

Sanae Ezzaki

Introduction: Mineral and bone disorders (BMD) are common in chronic hemodialysis, clinical complications and their impact on the prognosis justify prevention and appropriate treatment. The objective of our study is to determine the calcium phosphate status and the prevalence of BMD in our chronic hemodialysis patients and to assess the degree of adherence to recommendations KDIGO 2017

Methods: We conducted a retrospective multicenter study area CASABLANCA-SETTAT, including 658 hemodialysis patients.

Results:The average age of our patients was 49 +/- 14.6 years, with a male predominance, Causal nephropathy was undetermined in 48.3%, diabetes in 19.3% of cases, the average hemodialysis duration was 85 ± 54 month. Bone pain was present in 47.6% of patients. Arthralgia in 43.3% of cases, 15.6% of patients suffering from pruritus, while 24.3% of patients had conjunctivitis. Biologically, the mean serum calcium was 87.77 mg / l, the average phosphatemia was 46.85 mg / l, the average PTH was 489.29 pg / ml. Therapeutically, calcium supplementation was prescribed in 78.8% of the cases, 30.5% of patients received vitamin D derivatives, calcium‐free phosphate binders were prescribed in 15% of patients, 5% of patients were treated with a calcimimetic. And 7% by parathyroidectomy. The 3 targets recommended by KDIGO were achieved in only 29.3% of patients. conclusions: It appears from this multicenter study, that our results are far from the targets recommended by the KDIGOs.