Phenotypes of Mineral Bone Disorder in Chronic Kidney Disease in a Dialysis Population

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Enrique Rojas-Campos , Neri Ruvalcaba-Contreras , Alejandro Campos-Mariz , Arantxa Aguilar-Campos , Jorge Andrade-Sierra , José Ignacio Cerrillos-Gutiérrez , Miguel Medina-Pérez , Luis Evangelista-Carrillo , Adriana Banda , Alfonso M. Cueto-Manzano
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引用次数: 0

Abstract

Background

Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is associated with clinical outcomes. It is necessary to identify the phenotype to make clinical decisions that optimize resources and follow-up.

Objective

To determine the frequency of the CKD-MBD phenotype in dialysis patients and the associated factors.

Methods

Cross-sectional study in 440 patients, evaluated for CKD-MBD. Phenotypes show frequency of high, low or on target levels of PTH, vitamin D and phosphorus. The most common phenotype was used for comparisons.

Results

Age was 37.5 ± 15.8 years, 53% male, 28% were diabetic, 60% on peritoneal dialysis (PD), dialysis vintage was 12.0 months (IQR 3.0–34.3). High PTH was 58%, low vitamin D 82%, high phosphorus 39%, low calcium 50%, and vascular calcification 55%. The combination of high PTH and low vitamin D and high on-target phosphorus was 39%. Those with high PTH and low vitamin D were more likely to use PD (71 vs 51%; p <0.0001), had higher lipids: total cholesterol (159 vs. 152; p = 0.002) and triglycerides (137 vs. 123; p = 0.02), higher potassium (4.7 ± 0.7 vs. 4.9 ± 0.9 mg/dL; p = 0.04), and higher serum creatinine (11.9 ± 4.4 vs. 10.6 ± 3.7 mg/dL; p = 0.01). Predictors of the most common phenotypes were PD use, total cholesterol, and serum creatinine.

Conclusions

More than one third (38%) of our sample of patients had high PTH and low vitamin D with either high or normal phosphorus. Patients with these phenotypes more frequently used PD, had higher lipids and low potassium. PD use, total cholesterol and serum creatinine were significantly associated with these phenotypes.

透析人群中慢性肾脏病矿物质骨紊乱的表型。
背景:慢性肾脏病-矿物质和骨质紊乱(CKD-MBD)与临床结果相关。有必要确定表型,以便做出优化资源和随访的临床决策:确定透析患者中出现 CKD-MBD 表型的频率及相关因素:方法:对 440 名接受 CKD-MBD 评估的患者进行横断面研究。表型显示 PTH、维生素 D 和磷的高水平、低水平或达标水平的频率。最常见的表型用于比较:年龄为 37.5 ± 15.8 岁,53% 为男性,28% 为糖尿病患者,60% 接受腹膜透析(PD),透析时间为 12.0 个月(IQR 3.0-34.3)。PTH高的占58%,维生素D低的占82%,磷高的占39%,钙低的占50%,血管钙化的占55%。高 PTH、低维生素 D 和高目标磷的组合占 39%。高 PTH 和低维生素 D 患者更有可能使用 PD(71% 对 51%;P 结论:高 PTH 和低维生素 D 患者更有可能使用 PD:在我们的样本中,超过三分之一(38%)的患者存在高 PTH 和低维生素 D,同时血磷偏高或正常。具有这些表型的患者更经常使用促肾上腺皮质激素,血脂更高,血钾更低。使用 PD、总胆固醇和血清肌酐与这些表型有显著相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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