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DOI: 10.48087/BJMS.2026.130205
Authors: Nouara BENKACIMI1, Saliha LAHFAYA1, Farida AIT MESSAOUD2, Fatima TAOURIRI3, Sabiha BELHAOUA3, Amina MAADADI4, Abdelkader HASROUF4, Mourad KASTALI1
Affiliations: 1-Université Blida 1, Faculté de médecine de Blida et Service de Néphrologie , Etablissement Hospitalier Spécialisé en Transplantation d’Organes et de Tissus de Blida, Algérie. 2- Centre de dialyse LILIA (Blida), Algérie. 3- Centre de dialyse DIAM (Mouzaia), Algérie. 4- Centre de dialyse MITIDIAL(Boufarik), Algérie.
Keywords: Calcium, Phosphate, PTH, Vitamin D, Hemodialysis.
Abstract
Introduction: Mineral and bone disorders related to chronic kidney disease (CKD-MBD) are a major complication in patients on chronic hemodialysis. Their clinical consequences and prognostic impact require regular assessment and close monitoring. The aim of this study was to evaluate adherence to the 2017 KDIGO therapeutic targets in our patients and to describe the main associated factors. Materials and Methods: This was a cross-sectional, descriptive, multicenter study including 218 patients aged 18 years and older who had been on chronic hemodialysis for at least 3 months. We determined the proportion of patients achieving the 2017 KDIGO targets for three biochemical parameters (calcium, phosphate, and PTH), both individually and in combination, and examined factors associated with phosphocalcic control. Results: The mean age of patients was 54.5 ± 14.8 years, with a median hemodialysis duration of 6 years. Individual adherence to KDIGO recommendations was 69.3% for calcium, 54.1% for phosphate, 40.8% for PTH, and 23.4% for vitamin D. Combined parameter analysis showed adherence of 38.5% for the calcium–phosphate pair, while only 13.8% of patients simultaneously met the targets for calcium, phosphate, and PTH. A higher Kt/V was significantly associated with better control of phosphate, PTH, and combined targets. Additionally, higher serum magnesium levels favored achieving calcium targets. Native vitamin D supplementation increased the likelihood of reaching adequate 25(OH)D₃ levels, whereas the use of active vitamin D was associated with lower adherence to calcium and phosphate targets. Conclusion: This cross-sectional study highlights low adherence to KDIGO recommendations (13.8%) and identifies associations between key phosphocalcic parameters (calcium, phosphate, and PTH) and dialysis- and treatment-related factors. Longitudinal studies are needed to further explore these findings.