Kivonat:
BACKGROUND: Achieving target levels of laboratory parameters of
bone and mineral metabolism in chronic kidney disease (CKD)
patients is important but also difficult in those living with
end-stage kidney disease. This study aimed to determine if there
are age-related differences in chronic kidney disease-mineral
and bone disorder (CKD-MBD) characteristics, including treatment
practice in Hungarian dialysis patients. METHODS: Data were
collected retrospectively from a large cohort of dialysis
patients in Hungary. Patients on hemodialysis and peritoneal
dialysis were also included. The enrolled patients were
allocated into two groups based on their age (<65 years and >=65
years). Characteristics of the age groups and differences in
disease-related (epidemiology, laboratory, and treatment
practice) parameters between the groups were analyzed. RESULTS:
A total of 5008 patients were included in the analysis and the
mean age was 63.4+/-14.2 years. A total of 47.2% of patients
were women, 32.8% had diabetes, and 11.4% were on peritoneal
dialysis. Diabetes (37.9% vs 27.3%), bone disease (42.9% vs
34.1%), and soft tissue calcification (56.3% vs 44.7%) were more
prevalent in the older group than the younger group (p<0.001 for
all). We found an inverse relationship between age and
parathyroid hormone (PTH) levels (p<0.001). Serum PTH levels
were lower in patients with diabetes compared with those without
diabetes below 80 years (p<0.001). Diabetes and age were
independently associated with serum PTH levels (interaction:
diabetes x age groups, p=0.138). Older patients were more likely
than younger patients to achieve laboratory target ranges for
each parameter (Ca: 66.9% vs 62.1%, p<0.001; PO4: 52.6% vs
49.2%, p<0.05; and PTH: 50.6% vs 46.6%, p<0.01), and for
combined parameters (19.8% vs 15.8%, p<0.001). Older patients
were less likely to receive related medication than younger
patients (66.9% vs 79.7%, p<0.001). CONCLUSIONS: The achievement
of laboratory target ranges for bone and mineral metabolism and
clinical practice in CKD depends on the age of the patients. A
greater proportion of older patients met target criteria and
received less medication compared with younger patients.
