Hyperphosphatemia in Dialysis Patients National Multicenter Study

Abstract

Introduction: Hyperphosphatemia (HPFT) is a complication that is exacerbated proportionally to the degree of kidney damage, and leads to vascular calcification and increased cardiovascular risk. The objective of the present study is to determine the frequency of hyperphosphatemia in patients with chronic dialysis treatment. Material and methods: This is a cross-sectional, observational, retrospective and analytical study. Real-life national multicenter study, conducted from January 1 to March 31, 2022. It includes subjects with chronic dialysis (>3 months stay), >16 years, from the public and private sectors. Does not include patients treated with phosphate binders or vitamin D receptor analogs; only treated with calcium derivatives in different formulations. Gender, age, causes of kidney failure, serum phosphorus values (mg/dL), calcium (mg/dL) and parathyroid hormone (pg/mL) are identified. Results: 2,176 subjects, 1,205 from the public sector (55%) and 971 private (45%). 1,063 (49%) male and 1,113 female (51%), with a mean age of 51.4 years (range 16-88). 794 with diabetes (36%), 559 arterial hypertension (26%) and 823 unknown (38%). The mean serum calcium values were 8.75 mg/dL (SD ± 1.01; range: 6.1-12.7) and phosphorus 5.15 mg/dL (SD ± 3.04; range: 2.5-18.1). 1,435 subjects presented HPFT (66%), 903 mild (41%), 450 moderate (21%, mean 5.7 mg/dL) and 82 severe (4%, mean: 9.2 mg/dL). Parathyroid hormone was determined in 33% (mean 614.87 pg/ mL, SD 628.64; range: 53.3 -3,803). Conclusions: HPFT is frequent in patients with chronic dialysis, it affects regardless of gender, age, primary cause of kidney disease and even after receiving adequate dialysis treatment. Significant increase in HPFT was observed in peritoneal dialysis patients.