alexa Mineral and Bone Status in Tunisian Maintenance Hemodialysis Patients: The National Bone and Mineral Metabolism Observatory
ISSN: 2161-0959

Journal of Nephrology & Therapeutics
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Research Article

Mineral and Bone Status in Tunisian Maintenance Hemodialysis Patients: The National Bone and Mineral Metabolism Observatory

Fethi Ben Hamida*, Samia Barbouche, Imed Helal, Ounissi Mondher, Lilia Ben Fatma, Wided Smaoui, Chams Gharbi, Cyrine Karoui, Adel Kheder, Hedi Ben Maiz and Taieb Ben Abdallah

Department of Nephrology, Charles Nicolle Hospital, Laboratory of Kidney Pathology (LR00SP01), France

*Corresponding Author:
Fethi Ben Hamida
Department of Nephrology
Charles Nicolle Hospital
Laboratory of Kidney Pathology (LR00SP01), France
Tel: + (216)98330598
E-mail: [email protected]

Received Date: May 10, 2017; Accepted Date: May 28, 2017; Published Date: June 04, 2017

Citation: Hamida FB, Barbouche S, Helal I, Mondher O, Fatma LB, et al. (2017) Mineral and Bone Status in Tunisian Maintenance Hemodialysis Patients: The National Bone and Mineral Metabolism Observatory. J Nephrol Ther 7: 295. doi:10.4172/2161-0959.1000295

Copyright: © 2017 Hamida FB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



In Tunisia, data assessing the status of mineral and bone disorders (MBD) among dialysis patients is scarce. In order to address this gap in the literature, we sought to conduct this observational study including 4868 patients from 108 hemodialysis facilities nationwide, aiming to: (i) report parameters of MBD during the first quarter 2006, (ii) determine the levels of compliance with the recommendations of the Kidney Disease Outcome Quality Initiative (K/ DOQI), and (iii) compare these levels of compliance with those of Dialysis Outcomes and Practice Patterns Study (DOPPS). Mean serum phosphorus, calcium, calcium- phosphorus product and intact parathyroid hormone (iPTH) concentrations were respectively 1.74 mmol/L, 2.28 mmol/L, 3.95 mmol²/l² and 254 pg/ml. MBD’s measures were met the K/DOQI’s guidelines in 44.1% of cases for serum phosphorus, 42.5% of cases for serum calcium, 68.6% of the cases for calcium phosphorus product, 20.2% of cases for iPTH and 3.3% of cases for these four parameters taken together. These results were comparable to those observed in the DOPPS study. The most phosphate binder prescribed was calcium carbonate (91.2% of cases) with high average daily dose (superior to 1500 mg in 45.8% of cases). Sevelamer and aluminum salt were prescribed respectively in 0.5% and 0.10% of patients. The only active vitamin D available in Tunisia was alfacalcidol; it was prescribed in 49.7% of patients with a mean weekly dose of 4.04 μg. A calcium dialysate bath of 1.75; 1.50 and 1.25 mmol/L were prescribed respectively in 80.2%, 14.7% and 5.1% of cases. This is the first exhaustive study reporting MBD abnormalities in Tunisia and, to our knowledge, in Africa. A second study was stated in January


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