| Title | Are CSN and NKF-K/DOQI mineral metabolism guidelines for hemodialysis patients achievable? Results from a provincial renal program. | | Author(s) | Wazny LD, Raymond CB, Lesperance EM, Bernstein KN | | Institution | Department of Pharmaceutical Services, Health Sciences Centre, Winnipeg, MB. Lwazny@hsc.mb.ca | | Source | CANNT J 2008 Apr-Jun; 18(2):36-41, 44-50; quiz 42-3, 51-2. | | Abstract | BACKGROUND: The calcium, phosphorus, and parathyroid hormone targets recommended by the Canadian Society of Nephrology (CSN) encompass a wider range of values as compared to the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) guidelines. We sought to compare mineral metabolism parameters within the Manitoba Renal Program (MRP) to the CSN and NKF-K/DOQI guidelines. Medication use was also examined.
METHODS: All hemodialysis patients in Manitoba were evaluated. Values for serum albumin, phosphorus, calcium, intact parathyroid hormone (PTH) and pertinent medications were collected.
RESULTS: Five hundred and forty-six patients were included in the analysis. Fifty-three per cent to 81% of MRP patients met individual CSN targets. However, only 26% of patients achieved all targets, despite high usage of phosphate (85.5% calcium carbonate, 16.1% sevelamer, 1.3% aluminum) and PTH-lowering drug therapies (30.2% calcitriol, 2.7% cinacalcet).
CONCLUSION: Only a small proportion of patients were able to achieve all three CSN mineral metabolism targets simultaneously. The majority of outliers presented with hyperphosphatemia or hypoparathyroidism. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 18669010 |
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