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. 2012 Fall;4(4):613-6.
doi: 10.5812/numonthly.4225. Epub 2012 Sep 24.

Mineral and bone disease in black african hemodialysis patients: a report from senegal

Sidy Mohamed Seck  1 , Mohamed Dahaba, Elhadj Fary Ka, Mouhamadou Moustapha Cisse, Seigne Gueye, Ahmet Ould Lemrabott Tal
Affiliations

Mineral and bone disease in black african hemodialysis patients: a report from senegal

Sidy Mohamed Seck et al. Nephrourol Mon. 2012 Fall.

Abstract

Background: Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in hemodialysis patients. In Senegal, number of dialysis patients is growing but few data are available about their bone disorders.

Objectives: To describe patterns of CKD-MBD in Senegalese dialysis patients.

Patients and methods: We performed a cross-sectional study including patients from three dialysis centres in Senegal. Diagnosis of different types of CKD-MBD relied on clinical, biological and radiological data collected from medical records in dialysis.

Results: We included 118 patients and 79 of them presented CKD-BMD (prevalence of was 66.9 %). Mean age of CKD-MBD patients was 47.8 ± 15.7 years (16-81 years) and sex-ratio (Male/Female) was 1.15. Secondary hyperparathyroidism was the most frequent disorder (57 patients) followed by adynamic bone disease (21 patients) and osteomalacia (1 patients). The main clinical manifestations were bone pain (17.5% of cases), pruritus (36.8% of cases) and pathological fractures (2.5% of cases). Bone biopsy was not available. Valvular and peripheral vascular calcification were present in 24.5% and 21.2% of patients respectively. Management of CKD-MBD included optimization of dialysis, calcium bicarbonate, sevelamer, vitamin D analogues and calcimimetics. The NKF/DOQI recommended levels of serum calcium, phosphate and parathormone PTH were not achieved in one third of patients. Six patients presented major cardiovascular events during their dialysis period.

Conclusions: CKD-MBD are frequent in Senegalese hemodialysis patients and they are dominated by high turn-over disease. Clinical and biological manifestations are unspecific and accurate diagnoses are often difficult in absence of histomorphometry. Treatment is suboptimal for many patients in a context of limited resources.

Keywords: Hemodialysis; Renal Osteodystrophy; Senegal.

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Figures

Figure 1
Figure 1. CKD-MBD Subtypes According to Gender
See this image and copyright information in PMC

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