Mineral and Bone Disease in Black African Hemodialysis Patients: A Report From Senegal

Background: chronic kidney disease related mineral and bone disease (ckd-mbd) is a worldwide challenge in hemodialysis patients. in senegal, number of dialysis patients is growing but few data are available about their bone disorders. objectives: to describe patterns of ckd-mbd in senegalese dialysis patients. patients and methods: we performed a cross-sectional study including patients from three dialysis centres in senegal. diagnosis of different types of ckd-mbd relied on clinical, biological and radiological data collected from medical records in dialysis. results: we included 118 patients and 79 of them presented ckd-bmd (prevalence of was 66.9 %). mean age of ckd-mbd patients was 47.8 ± 15.7 years (16-81 years) and sex-ratio (male/female) was 1.15. secondary hyperparathyroidism was the most frequent disorder (57 patients) followed by adynamic bone disease (21 patients) and osteomalacia (1 patients). the main clinical manifestations were bone pain (17.5% of cases), pruritus (36.8% of cases) and pathological fractures (2.5% of cases). bone biopsy was not available. valvular and peripheral vascular calcification were present in 24.5% and 21.2% of patients respectively. management of ckd-mbd included optimization of dialysis, calcium bicarbonate, sevelamer, vitamin d analogues and calcimimetics. the nkf/doqi recommended levels of serum calcium, phosphate and parathormone pth were not achieved in one third of patients. six patients presented major cardiovascular events during their dialysis period. conclusions: ckd-mbd are frequent in senegalese hemodialysis patients and they are dominated by high turn-over disease. clinical and biological manifestations are unspecific and accurate diagnoses are often difficult in absence of histomorphometry. treatment is suboptimal for many patients in a context of limited resources.