Biological profile of secondary hyperparathyroidism in chronic renal failure

Introduction: Secondary hyperparathyroidism (SHPT) is a frequent complication of chronic renal failure and is associated with high morbidity and mortality. Our goal is to study the average time of development of SHPT, and the biological profile in accordance with recommended standards.

Patients and methods: Retrospective descriptive study, including 134 chronically hemo-dialysed patients. Demographic, clinical, phosphocalcic and therapeutic data were analyzed. The phosphocalcic parameters were defined by KDOQI 2003 and KDIGO 2009 recommendations.

Results: The average time to onset of SHPT is 3.15 ± 4.02 years according to KDOQI standards and 4.6 ± 4.3 years according to KDIGO standards. The most commonly administered SHPT treatments are calcium salt and Vitamin D active. At the end of the study, 73.9% for KDOQI and 46.3% for KDIGO had hyperparathyroidism. The rates of compliance of the phosphocalcic indicators were higher with the KDIGO than with KDOQI recommendations for serum calcium, phosphate and parathyroid hormone (PTH).

Discussion: We noted a significant improvement between the two initial and recent periods concerning phosphocalcic parameters in general and hyperparathyroidism in particular. We found that the delay in the diagnosis of CKD, the duration of dialysis, the cost and availability of treatments, and the minimal frequency of kidney transplant in our country make it difficult to get the biological parameters to the recommended targets,

 Conclusion: It is necessary to underline the interest of a good biological monitoring to ensure a good evaluation of the therapeutic conduct, and a better prevention against the serious complications of SHPT.