Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea

Gheun Ho Kim; Bum Soon Choi; Dae Ryong Cha; Dong Hyun Chee; Eunah Hwang; Hyung Wook Kim; Jae Hyun Chang; Joong Kyung Kim; Jung Woo Noh; Kwon Wook Joo; Sang Choel Lee; Sang Woong Han; Sejoong Kim; Soo Wan Kim; Sug Kyun Shin; Wondo Park; Won Kim; Wooseong Huh; Young Joo Kwon; Young Sun Kang

doi:10.1016/j.krcp.2013.12.003

Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea

Gheun Ho Kim, Bum Soon Choi, Dae Ryong Cha, Dong Hyun Chee, Eunah Hwang, Hyung Wook Kim, Jae Hyun Chang, Joong Kyung Kim, Jung Woo Noh, Kwon Wook Joo, Sang Choel Lee, Sang Woong Han, Sejoong Kim, Soo Wan Kim, Sug Kyun Shin, Wondo Park, Won Kim, Wooseong Huh, Young Joo Kwon, Young Sun Kang

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Background In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients. Methods Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed. Results Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg ²/dL², respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH >300 pg/mL. Conclusion Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca < P product, suggestive of the importance of SHPT management.

Original language	English
Pages (from-to)	52-57
Number of pages	6
Journal	Kidney Research and Clinical Practice
Volume	33
Issue number	1
DOIs	https://doi.org/10.1016/j.krcp.2013.12.003
Publication status	Published - 2014 Mar
Externally published	Yes

Bibliographical note

Funding Information:
GH Kim has received speaker fees from and has been a consultant for AbbVie. GH Kim, BS Choi, DR Cha, EA Hwang, HW Kim, JH Chang, JK Kim, JW Noh, KW Joo, SC Lee, SW Han, SW Kim, SK Shin, WD Park, W Kim, WS Huh, and YJ Kwon have received research funding from AbbVie. DH Chee is an employee of AbbVie, and owns AbbVie Stocks. SJ Kim and YS Kang have nothing to disclose.

Funding Information:
This study was funded by AbbVie. AbbVie led development of the study design in collaboration with academic investigators and analysed the primary data. All authors contributed to design, analysis, and interpretation of these data, and reviewed, approved, and decided to publish the manuscript. The authors thank Dr MiKyung Kim (NaeClear Inc.) and Dr Jiho Kang (AbbVie) for their efforts to prepare the manuscript and Dr Joo-Hark Yi (Hanyang University Guri Hospital) and Dr Tai Yeon Koo (Seoul National University Hospital) for collecting the data for this study.

Keywords

Calcium
Hemodialysis
Intact parathyroid hormone
Phosphorus
Secondary hyperparathyroidism

ASJC Scopus subject areas

Nephrology
Urology

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10.1016/j.krcp.2013.12.003

Cite this

Kim, G. H., Choi, B. S., Cha, D. R., Chee, D. H., Hwang, E., Kim, H. W., Chang, J. H., Kim, J. K., Noh, J. W., Joo, K. W., Lee, S. C., Han, S. W., Kim, S., Kim, S. W., Shin, S. K., Park, W., Kim, W., Huh, W., Kwon, Y. J., & Kang, Y. S. (2014). Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea. Kidney Research and Clinical Practice, 33(1), 52-57. https://doi.org/10.1016/j.krcp.2013.12.003

Kim, GH, Choi, BS, Cha, DR, Chee, DH, Hwang, E, Kim, HW, Chang, JH, Kim, JK, Noh, JW, Joo, KW, Lee, SC, Han, SW, Kim, S, Kim, SW, Shin, SK, Park, W, Kim, W, Huh, W, Kwon, YJ & Kang, YS 2014, 'Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea', Kidney Research and Clinical Practice, vol. 33, no. 1, pp. 52-57. https://doi.org/10.1016/j.krcp.2013.12.003

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title = "Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea",

abstract = "Background In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients. Methods Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed. Results Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg 2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH >300 pg/mL. Conclusion Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca < P product, suggestive of the importance of SHPT management.",

keywords = "Calcium, Hemodialysis, Intact parathyroid hormone, Phosphorus, Secondary hyperparathyroidism",

author = "Kim, {Gheun Ho} and Choi, {Bum Soon} and Cha, {Dae Ryong} and Chee, {Dong Hyun} and Eunah Hwang and Kim, {Hyung Wook} and Chang, {Jae Hyun} and Kim, {Joong Kyung} and Noh, {Jung Woo} and Joo, {Kwon Wook} and Lee, {Sang Choel} and Han, {Sang Woong} and Sejoong Kim and Kim, {Soo Wan} and Shin, {Sug Kyun} and Wondo Park and Won Kim and Wooseong Huh and Kwon, {Young Joo} and Kang, {Young Sun}",

note = "Funding Information: GH Kim has received speaker fees from and has been a consultant for AbbVie. GH Kim, BS Choi, DR Cha, EA Hwang, HW Kim, JH Chang, JK Kim, JW Noh, KW Joo, SC Lee, SW Han, SW Kim, SK Shin, WD Park, W Kim, WS Huh, and YJ Kwon have received research funding from AbbVie. DH Chee is an employee of AbbVie, and owns AbbVie Stocks. SJ Kim and YS Kang have nothing to disclose. Funding Information: This study was funded by AbbVie. AbbVie led development of the study design in collaboration with academic investigators and analysed the primary data. All authors contributed to design, analysis, and interpretation of these data, and reviewed, approved, and decided to publish the manuscript. The authors thank Dr MiKyung Kim (NaeClear Inc.) and Dr Jiho Kang (AbbVie) for their efforts to prepare the manuscript and Dr Joo-Hark Yi (Hanyang University Guri Hospital) and Dr Tai Yeon Koo (Seoul National University Hospital) for collecting the data for this study.",

year = "2014",

month = mar,

doi = "10.1016/j.krcp.2013.12.003",

language = "English",

volume = "33",

pages = "52--57",

journal = "Kidney Research and Clinical Practice",

issn = "2211-9132",

publisher = "The Korean Society of Nephrology",

number = "1",

}

TY - JOUR

T1 - Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis

T2 - A multicentre study in Korea

AU - Kim, Gheun Ho

AU - Choi, Bum Soon

AU - Cha, Dae Ryong

AU - Chee, Dong Hyun

AU - Hwang, Eunah

AU - Kim, Hyung Wook

AU - Chang, Jae Hyun

AU - Kim, Joong Kyung

AU - Noh, Jung Woo

AU - Joo, Kwon Wook

AU - Lee, Sang Choel

AU - Han, Sang Woong

AU - Kim, Sejoong

AU - Kim, Soo Wan

AU - Shin, Sug Kyun

AU - Park, Wondo

AU - Kim, Won

AU - Huh, Wooseong

AU - Kwon, Young Joo

AU - Kang, Young Sun

N1 - Funding Information: GH Kim has received speaker fees from and has been a consultant for AbbVie. GH Kim, BS Choi, DR Cha, EA Hwang, HW Kim, JH Chang, JK Kim, JW Noh, KW Joo, SC Lee, SW Han, SW Kim, SK Shin, WD Park, W Kim, WS Huh, and YJ Kwon have received research funding from AbbVie. DH Chee is an employee of AbbVie, and owns AbbVie Stocks. SJ Kim and YS Kang have nothing to disclose. Funding Information: This study was funded by AbbVie. AbbVie led development of the study design in collaboration with academic investigators and analysed the primary data. All authors contributed to design, analysis, and interpretation of these data, and reviewed, approved, and decided to publish the manuscript. The authors thank Dr MiKyung Kim (NaeClear Inc.) and Dr Jiho Kang (AbbVie) for their efforts to prepare the manuscript and Dr Joo-Hark Yi (Hanyang University Guri Hospital) and Dr Tai Yeon Koo (Seoul National University Hospital) for collecting the data for this study.

PY - 2014/3

Y1 - 2014/3

N2 - Background In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients. Methods Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed. Results Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg 2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH >300 pg/mL. Conclusion Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca < P product, suggestive of the importance of SHPT management.

AB - Background In many countries, nephrologists follow clinical practice guidelines for mineral bone disorders to control secondary hyperparathyroidism (SHPT) associated with abnormal serum calcium (Ca) and phosphorus (P) levels in patients undergoing maintenance hemodialysis (MHD). The Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines have long been used in Korea, and this study was undertaken to investigate the current status of serum Ca and P control in MHD patients. Methods Data were collected from a total of 1,018 patients undergoing MHD without intercurrent illness, in 17 hemodialysis centers throughout the country. Serum levels of Ca, P, and intact parathyroid hormone (iPTH) were measured over 1 year, and the average values were retrospectively analyzed. Results Serum levels of Ca, P, and the Ca×P product were 9.1±0.7 mg/dL, 5.3±1.4 mg/dL, and 48.0±13.6 mg 2/dL2, respectively. However, the percentages of patients with Ca, P, and Ca × P product levels within the KDOQI guideline ranges were 58.7%, 51.0%, and 70.7%, respectively. Of the 1,018 patients, 270 (26.5%) had iPTH >300 pg/mL (uncontrolled SHPT), whereas 435 patients (42.7%) showed iPTH <150 pg/mL. Patients with uncontrolled SHPT had significantly higher values of serum Ca, P, and Ca×P product than those with iPTH >300 pg/mL. Conclusion Despite the current clinical practice guidelines, SHPT seems to be inadequately controlled in many MHD patients. Uncontrolled SHPT was associated with higher levels of serum Ca, P, and Ca < P product, suggestive of the importance of SHPT management.

KW - Calcium

KW - Hemodialysis

KW - Intact parathyroid hormone

KW - Phosphorus

KW - Secondary hyperparathyroidism

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U2 - 10.1016/j.krcp.2013.12.003

DO - 10.1016/j.krcp.2013.12.003

M3 - Article

AN - SCOPUS:84897403111

SN - 2211-9132

VL - 33

SP - 52

EP - 57

JO - Kidney Research and Clinical Practice

JF - Kidney Research and Clinical Practice

IS - 1

ER -

Serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis: A multicentre study in Korea

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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