Abstract:

o explore the prevalence and risk factors of the chronic kidney diseasemineral and bone disorder (CKDMBD) in maintenance hemodialysis (MHD) patients in Sichuan province.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 1 150 patients on MHD from 14 hemodialysis centers in Sichuan province were enrolled in this study. Demographic information and laboratory measurements including serum calcium, phosphorus and PTH were collected. Vascular calcification was determined by echocardiogram and plain Xray films of lateral abdomen and frontal pelvis. Serum levels of 25 hydroxyvitamin D(25(OH)D), 25(OH)D3, FGF23 and serum soluble Klotho protein (sKL) was also measured.
Ｒｅｓｕｌｔｓ：Among our patients, 968% patients met the diagnosis criteria of CKDMBD. The prevalence of hypophosphatemia, hyperphosphatemia, hypocalcemia, hypercalcemia, decreased PTH and elevated PTH was 780%, 559%, 314%, 283%, 172% and 583%, respectively. Cardiac valve calcification was found in 169 patients (300%). Xray films showed that abdominal aortic calcification was found in 168 patients (454%), iliac artery and femoral artery calcification was found in 106 patients (275%). The percentage of patients within treatment target of serum calcium, phosphorus and iPTH was 368%, 363% and 245%, respectively. Multivariate logistic regression analyses demonstrated that the risk factors for hyperphosphatemia were systolic pressure, SCr, BUN, HDL and iPTH; for hypocalcemia were dialysis duration, iPTH and FGF23; for higher iPTH were phosphate, ALB and ALP; and those for vascular calcification were age, dialysis duration, pulse pressure, CRP and klotho.
Ｃｏｎｃｌｕｓｉｏｎ：The prevalence of CKDMBD in MHD patients in Sichuan area is high, and the control rate of serum phosphorus, calcium and iPTH is relatively low and attributed to multiple factors.