45 th EDTNA/ERCA International Conference – Valencia, September 17-20, 2016 Introduction Secondary hyperparathyroidism (SHPT) is a serious complication for patients with chronic kidney disease (CKD) which affects the bones and cardiovascular system. Patients with CKD have progressive disorder of calcium- phosphorus metabolism due to decreased kidney function. Hypophosphatemia it is a decreased synthesis of active vitamin D that cause many complications, including a reduction of calcium absorption and increasing the production of parathyroid hormone (PTH). Figure 2: Osteoporosis. Figure 3: Patient education. Objectives To determine the influence of dialysis duration on the progress of SHPT. Methods 240 patients were divided into the following groups: group 1: 143 patients on dialysis for up to 5 years; group 2: 63 patients on dialysis for 5-10 years; group 3: 34 patients on dialysis for more than 10 years. The groups were compared in terms of: age, gender, effective treatment time, Kt/V and blood biochemical parameters (Fig.1). Results Results did not show any influence in terms of age and gender on the development of SHPT. Effective treatment time and Kt/V in all groups were adequate, meaning that we cannot evaluate their adverse effects. Calcium was >2.5mmol/L in 17.6% of the patients in group 3 versus 2.7% of the patients in group 1 and 6.3% of the patients in group 2 (Fig.1). Phosphate was >1.78 mmol/L in 36.3% of the patients in group 1 versus 31% of the patients in group 2 and 20.5% of the patients in group 3 (Fig.1). Parathyroid hormone was >600 pg/ml in 44% of the patients in group 3 versus 34.9% of the patients in group 2 and 18% of patients in group 1. Conclusion The study shows that the duration of dialysis has a direct impact on the development of SHPT, which is a serious complication of CKD, requiring constant vigilance of clinic staff, regular examination of patients and preventive and therapeutic measures using up-to-date approach to prevent and slow down the development and the progression of the disease. Nurses should work with their patients regularly to ensure that they stick to a low-phosphate diet, use phosphate binders and take vitamin D. This may delay the disease development and improve the patients’ quality of life. References 1. Handbook of Dialysis, John Daugirdas, Peter G. Blake, Todd S. Ing, 2006. 2. K/DOQI Clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003 3. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. 2009 Influence of dialysis duration on the progress of secondary hyperparathyroidism Evgeniya Volodina 1 , Tatyana Glushenkova 2 , Maria Teresa Parisotto 3 1 Fresenius Medical Care, Fresenius NephroCare Dialysis Centre, Saratov – Russia 2 Fresenius Medical Care, Fresenius NephroCare Dialysis Centre, Ulyanovsk – Russia 3 Fresenius Medical Care, Nursing Care Coordination, Bad Homburg – Germany Figure 1: 2015, blood biochemical values.

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Page 1: RUS EDTNA 2016 Poster Influence of dialysis duration on the progress … 012... · 2018. 6. 15. · 45th EDTNA/ERCA International Conference – Valencia, September 17 -20, 2016 Introduction

45th EDTNA/ERCA International Conference – Valencia, September 17-20, 2016

IntroductionSecondary hyperparathyroidism (SHPT) is a seriouscomplication for patients with chronic kidney disease (CKD)which affects the bones and cardiovascular system.Patients with CKD have progressive disorder of calcium-phosphorus metabolism due to decreased kidney function.Hypophosphatemia it is a decreased synthesis of activevitamin D that cause many complications, including areduction of calcium absorption and increasing the productionof parathyroid hormone (PTH).

Figure 2: Osteoporosis.

Figure 3: Patient education.

ObjectivesTo determine the influence of dialysis duration on the progressof SHPT.

Methods240 patients were divided into the following groups:group 1: 143 patients on dialysis for up to 5 years;group 2: 63 patients on dialysis for 5-10 years;group 3: 34 patients on dialysis for more than 10 years.The groups were compared in terms of: age, gender, effectivetreatment time, Kt/V and blood biochemical parameters(Fig.1).

ResultsResults did not show any influence in terms of age and genderon the development of SHPT. Effective treatment time andKt/V in all groups were adequate, meaning that we cannotevaluate their adverse effects.Calcium was >2.5mmol/L in 17.6% of the patients in group 3versus 2.7% of the patients in group 1 and 6.3% of thepatients in group 2 (Fig.1).Phosphate was >1.78 mmol/L in 36.3% of the patients ingroup 1 versus 31% of the patients in group 2 and 20.5% ofthe patients in group 3 (Fig.1).Parathyroid hormone was >600 pg/ml in 44% of the patientsin group 3 versus 34.9% of the patients in group 2 and 18% ofpatients in group 1.

ConclusionThe study shows that the duration of dialysis has a directimpact on the development of SHPT, which is a seriouscomplication of CKD, requiring constant vigilance of clinic staff,regular examination of patients and preventive and therapeuticmeasures using up-to-date approach to prevent and slowdown the development and the progression of the disease.Nurses should work with their patients regularly to ensure thatthey stick to a low-phosphate diet, use phosphate binders andtake vitamin D. This may delay the disease development andimprove the patients’ quality of life.

References1. Handbook of Dialysis, John Daugirdas, Peter G. Blake, Todd S. Ing, 2006.2. K/DOQI Clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 20033. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. 2009

Influence of dialysis duration on the progress of secondary hyperparathyroidismEvgeniya Volodina1, Tatyana Glushenkova2, Maria Teresa Parisotto3

1Fresenius Medical Care, Fresenius NephroCare Dialysis Centre, Saratov – Russia2Fresenius Medical Care, Fresenius NephroCare Dialysis Centre, Ulyanovsk – Russia3Fresenius Medical Care, Nursing Care Coordination, Bad Homburg – Germany

Figure 1: 2015, blood biochemical values.