Phospho-Calcic Phenotypes in Chronic Hemodialysis Patients and Associated Mortality Risk: A Single-Center Retrospective Study

Background: Mineral and bone disorder (MBD) is a major contributor to cardiovascular mortality in end-stage kidney disease (ESKD). Classifying hemodialysis patients into phospho-calcic phenotypes may help identify those at highest risk. Methods: A retrospective single-center study of 54 chronic hemodialysis patients at CHU Ibn Rochd (Casablanca), conducted over 12 months (January–December 2023). Patients were classified into 12 groups (36 phenotypes) based on averaged calcium, phosphorus, and PTH levels. Logistic regression was used to assess phenotype-mortality associations. Results: Mean age was 46.9 years; mean HD vintage 13.31 years. Mean PTH was markedly elevated at 774.9 pg/mL. The largest group (38%) was Group 2 (high PTH, normal calcium, variable phosphorus). Six deaths occurred (11.1%), distributed across six different groups. No statistically significant association was found between phospho-calcic phenotype and mortality. Conclusion: The limited sample size precluded the detection of a significant phenotype-mortality relationship. Larger multicenter studies are warranted to validate a phenotypic classification approach to MBD-related mortality risk in hemodialysis.