WCN25-197 MINERAL AND BONE DISEASE IN CHRONIC HEMODIALYSIS PATIENTS: INSIGHTS FROM A SATELLITE HEMODIALYSIS UNIT IN KENYA

Introduction: Patients with end-stage renal disease (ESRD) on maintenance haemodialysis (HD) are at an increased risk of developing chronic kidney disease mineral bone disorder (CKD -MBD).Routine evaluation is recommended to ensure timely diagnosis thereby avoiding long term complications.In Kenya, the number of patients on dialysis is growing but there isn't enough data available about HD patients mineral bone disorders.Methods: This was a retrospective study conducted between 1st January 2023 to 1st January 2024 at parklands kidney centre renal unit, Nairobi.The study population was adults aged 18 years and above who were undergoing maintenance haemodialysis.We evaluated the serum/ plasma intact parathyroid hormone (iPTH), corrected calcium, phosphate, total alkaline phosphatase (TALP) and 25 -[OH] vitamin D levels of one hundred and eighteen patients.Results: A hundred and eighteen patients (118) on maintenance haemodialysis were evaluated (78 men, 40 women) they had a mean age of 61.7AE15.3years and a mean kt/V of 1.49AE0.39.The prevalence of hyperparathyroidism (iPTH >150 pg/ml), hyperphosphataemia (> 1.45 mmol/L), hypocalcaemia (< 2.1 mmol/L) and 25-OH vitamin D deficiency (<30 ng/ml) was 87.3%, 55.9%, 28.8% and 73.7 % respectively.The combination of markers of bone turnover (iPTH >150pg/ml and TALP> 120 U/L) suggestive of high turnover bone disease, was present in 58.5 % of the study population.In logistic regression analysis for predictors of hyperparathyroidism only age 1.0 (0.9 -1.0) 0.025 was statistically significant.Fifty-three (44.9%) of patients had iPTH (150 -600 pg/ml) within the recommended kidney disease improving global outcome (KDIGO) guidelines.Conclusions: The overall prevalence of hyperparathyroidism (>150pg/ ml), hyperphosphatemia (1.45 mmol/L), hypocalcaemia (2.1 mmol/L) and 25-OH vitamin D deficiency (<30 ng/ml) was 87.3%, 55.9%, 28.8% and 73.7 % respectively.The combination of markers of bone turnover (>150pg/ml and TALP> 120 IU/L) suggestive of high turnover bone disease, was present in 58.5 % of the study population.Patients within KDIGO-recommended targets for calcium, phosphate and PTH were 59.3%, 37.3 %, and 44.9% respectively.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.