Ruiz de Arechavaleta Andrea, Quintero Nerio, Parra E U Daniela, Jara Aquiles, Russo Moisés, Zitko Pedro, Pefaur Jacqueline
Rev Med Chil. 2015 Feb;143(2):168-74. doi: 10.4067/S0034-98872015000200003.
Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a condition of dialysis patients associated with both morbidity and mortality. Management is based on clinical guidelines with goals that are hard to comply with.
To describe and compare biochemical variables associated with this disorder in two different time periods.
Revision of medical records of 814 patients (49% females) dialyzed during 2009 and 1018 patients (48% females), dialyzed during 2012 in Southern Metropolitan Santiago. Information about serum calcium, phosphorus, parathyroid hormone (PTH) and albumin was retrieved.
Median PTH values in 2009 and 2012 were 222.5 and 353.5 pg/ml respectively (p < 0.05). The figures for serum calcium corrected by albumin were 9.0 and 8.5 mg/dl respectively (p < 0.05). The figures for phosphorus were 4.7 and 5.0 mg/dl respectively (p < 0.05). The Calcium x Phosphorus product was 41.4 and 42.5 mg²/dl² (p < 0.05). Of note, the proportion patients with serum calcium below recommended levels (< 8.4 mg/dl) increased from 16% to 40% from 2009 to 2012. The proportion of patients with biochemical variables within recommended ranges was lower in 2012 than in 2009.
There was a low proportion of patients with bone metabolism parameters within ranges recommended by clinical guidelines. These parameters were worst in 2012.
慢性肾脏病-矿物质和骨异常（CKD-MBD）是一种与透析患者发病率和死亡率相关的病症。其管理基于临床指南，而这些指南的目标难以遵循。
描述并比较两个不同时间段与该病症相关的生化变量。
回顾了2009年在圣地亚哥南部接受透析的814例患者（49%为女性）以及2012年接受透析的1018例患者（48%为女性）的病历。获取了血清钙、磷、甲状旁腺激素（PTH）和白蛋白的信息。
2009年和2012年PTH的中位数分别为222.5和353.5 pg/ml（p < 0.05）。经白蛋白校正后的血清钙数值分别为9.0和8.5 mg/dl（p < 0.05）。磷的数值分别为4.7和5.0 mg/dl（p < 0.05）。钙磷乘积分别为41.4和42.5 mg²/dl²（p < 0.05）。值得注意的是，血清钙低于推荐水平（< 8.4 mg/dl）的患者比例从2009年的16%增至2012年的40%。2012年生化变量在推荐范围内的患者比例低于2009年。
骨代谢参数在临床指南推荐范围内的患者比例较低。2012年这些参数情况更差。
