Dilshad Ahmad Khan, Fatima, Farooq Ahmad Khan, Imran Saif.
Assessment of bone mineral metabolism derangements by K/DOQI guidelines in haemodialysis patients at Rawalpindi.
J Pak Med Assoc Jan ;59(2):59-64.

To assess serum calcium, phosphorus and PTH levels with reference to K/DOQI targets in haemodialysis patients at Rawalpindi. Further more efficacy of calcium carbonate (CaCO3) was compared with calcium acetate (CaAc) for maintaining serum P and Ca levels in our ESRD patients. Methods: One hundred and ninety patients on haemodialysis receiving calcium phosphate binders (CaCO3 n=128 and CaAc n=62) were selected from a tertiary care hospital at Rawalpindi`. Serum Ca and P were assayed on chemistry analyzer. PTH was measured on immulite-1000. Data were compared with K/DOQI targets and analysed by using SPSS-15. Results: The patients had mean serum Ca 2.34 ± 0.29 mmol/L, Phosphorus 1.76 ± 0.43 mmol/L and Parathyroid hormone (PTH) 38.7 ± 35.6 nmol/L. The patients had achieved K/DOQI target ranges of Ca, P, PTH and Ca x P product in 37.9%, 41.1%, 22.6% and 61.5 % respectively. Patients on CaCO3 had significantly higher serum Ca 2.38 ± 0.31 mmol/L than those on CaAc therapy 2.26±0.22 mmol/L. Conclusion: Most of patients on maintenance haemodialysis at Rawalpindi, did not achieve the recommended K/DOQI target ranges. Appropriate phosphate binders are required for improvement of mineral metabolism and medical outcome in our patients

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