Mineralo-bone disorders in peritoneal dialysis patients in senegal (west africa)

Abstract

The chronic kidney disease associated with bone and mineral disorders is a cause of significant morbidity and mortality in patients with chronic renal failure. We carried on this study in the only one Peritoneal Dialysis Unit (DP) with the purpose of determining the CKD-MBD’s prevalence in chronic peritoneal dialysis patients (CPD) and to analyse the clinical, biological, therapeutic and evolutionary mineral-bone disorders in these patients. This is a descriptive monocentric retrospective study from 01 January 2012 to 31 December 2016. Were included in our study all peritoneal dialysis patients’ records for a minimum of 3 months’ duration and having performed a phospho-calcium balance containing at least: intact parathyroid hormone (PTHi), calcemia and the phosphatemia. Thirty-two peritoneal dialysis patients’ records were collected. Thirteen patients, 40.62%, had mineralo-bone disorders. The first causative nephropathy was nephroangiosclerosis (NAS) found in 43.8% of cases and 18.8% of patients had indeterminate nephropathy. The average dialysis’ seniority was 24.59 ± 19.33 months. In the study, twelve patients were in continuous ambulatory peritoneal dialysis (CAPD) (96.9%) and only one in automated peritoneal dialysis (APD) (3.1%). Nine patients, 90.6% of them, benefited from 4 exchanges per day. Six patients (46.2%) had secondary hyperparathyroidism. Seven patients (53.8%) had osteomalacia. None of them had adynamic osteopathy (AO). Only one patient (6.7%) had valvular calcifications (aortic sigmoid valves). The MBD’s profile changed significantly over time due to the use of new biomarkers and new therapies.