Mineral and Bone Disease in Black African Hemodialysis Patients: A Report From Senegal
| Autor: | Sidy Mohamed Seck, Seigne Gueye, Ahmet Ould Lemrabott Tal, Elhadj Fary Ka, Mohamed Dahaba, Mouhamadou Moustapha Cisse |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Osteomalacia
medicine.medical_specialty Pathology Bone disease business.industry Urology medicine.medical_treatment Renal Osteodystrophy medicine.disease Senegal Internal medicine Hemodialysis medicine Renal osteodystrophy Secondary hyperparathyroidism Original Article medicine.symptom Bone pain business Dialysis Kidney disease |
| Zdroj: | Nephro-urology monthly |
| ISSN: | 2251-7014 2251-7006 |
| Popis: | Background Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in hemodialysis patients. In Senegal, number of dialysis patients is growing but few data are available about their bone disorders. Objectives To describe patterns of CKD-MBD in Senegalese dialysis patients. Patients and methods We performed a cross-sectional study including patients from three dialysis centres in Senegal. Diagnosis of different types of CKD-MBD relied on clinical, biological and radiological data collected from medical records in dialysis. Results We included 118 patients and 79 of them presented CKD-BMD (prevalence of was 66.9 %). Mean age of CKD-MBD patients was 47.8 ± 15.7 years (16-81 years) and sex-ratio (Male/Female) was 1.15. Secondary hyperparathyroidism was the most frequent disorder (57 patients) followed by adynamic bone disease (21 patients) and osteomalacia (1 patients). The main clinical manifestations were bone pain (17.5% of cases), pruritus (36.8% of cases) and pathological fractures (2.5% of cases). Bone biopsy was not available. Valvular and peripheral vascular calcification were present in 24.5% and 21.2% of patients respectively. Management of CKD-MBD included optimization of dialysis, calcium bicarbonate, sevelamer, vitamin D analogues and calcimimetics. The NKF/DOQI recommended levels of serum calcium, phosphate and parathormone PTH were not achieved in one third of patients. Six patients presented major cardiovascular events during their dialysis period. Conclusions CKD-MBD are frequent in Senegalese hemodialysis patients and they are dominated by high turn-over disease. Clinical and biological manifestations are unspecific and accurate diagnoses are often difficult in absence of histomorphometry. Treatment is suboptimal for many patients in a context of limited resources. |
| Databáze: | OpenAIRE |
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