CHRONIC KIDNEY DISEASE MINERAL AND BONE DISORDER MARKERS IN SCREENING STUDY AMONG DIALYSIS PATIENTS IN NORTH-WEST FEDERAL REGION OF RUSSIA

AIM: to assess the prevalence of chronic kidney disease mineral and bone disorder (CKD-MBD) markers among dialysis patients in North-West Region of Russia and to evaluate its links with clinical and demographical features of dialysis population. PATIENTS AND METHOD: In 1594 patients from 19 dialysis centers in North-West of Russia and Burjatia Republic we assessed serum total calcium, phosphate, parathyroid hormone and 25(OH)D3 levels in central laboratory; ultrasound neck examination was performed by portable scanner. RESULTS: the prevalence categories of calciemia, phosphatemia, PTH levels according to K/DOQI, KDIGO and Russian national ckd-mbd recommendations is presented; hypercalciemia revealed in 6-20% of patients, hypocalciemia - in 38-42%, hyperphosphatemia - in 67% (KDIGO) and 44% by K/DOQI; PTH above 300 pg/ml was found in 60% of cases, above 600 pg/ml - in 29%; PTH level below 150 pg/ml was seen in 24% of patients. We found PTH level in target range in 16% (K/DOQI) or 47% (KDIGO). The prevalence of categories markedly differed by regions; the share of patients in upper category increased with dialysis vintage and was higher in patients with vitamin D insufficiency/deficit. Ultrasound examination revealed one/two/ three/four enlarged parathyroid glands in 17%, 7%, 3% and 3%, accordingly; in parallel, PTH levels increased. 25(OH)D3 level in normal range was found only in 9% of patients. CONCLUSION: The prevalence of hyperphosphatemia, hyperparathyroidism, hypoparathyroidism as well as hypocalciemia and vitamin D insufficiency/deficit are high but rather different in the regions of one area, that presumes the improvement possibilities using the available resourses.

dialysis, ckd-mbd, hyperparathyroidism, hyperphosphatemia, hypocalciemia, hypercalciemia, vitamin D, screening

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