Samuel Mbadu Lelo1,2, François-Pantaléon Musungayi Kajingulu1,3,4, Jean-Robert Makulo 1,2,
Yannick Mayamba Nlandu1,5, Justine Busanga Bukabau1,5, Pierre Koso Mbulupasu1,6, Augustin Luzayadio Longo1,
Jeanine Nina Losa Luse7, Vieux Momeme Mokoli1,2, Ernest Kiswaya Sumaili1, Nazaire Mangani Nseka1
1Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo; 2Hemodialysis Center,
Ngaliema Medical Center, Kinshasa, Democratic Republic of the Congo; 3Dialysis Center, HJ Hospital, Kinshasa, Democratic Republic of the Congo;
4Department of Internal Medicine, Saint-Joseph Hospital, Kinshasa, Democratic Republic of the Congo; 5Hemodialysis Center, Centre Médical de
Kinshasa, Kinshasa, Democratic Republic of the Congo; 6Department of Internal Medicine, Clinique Ngaliema, Kinshasa, Democratic Republic of the
Congo; 7Hemodialysis Center, Hôpital Général de Référence de Kinshasa, Kinshasa, Democratic Republic of the Congo
Correspondence: Jean-Robert Makulo, Email jrmakulo2016@gmail.com
Background: Data on 25 [OH] vitamin D and intact parathyroid hormone [iPTH] in hemodialysis patients are very limited in sub-Saharan African countries. The present study aimed to assess the magnitude of hypovitaminosis D, and to evaluate the achievement of iPTH KDIGO 2017 targets among chronic hemodialysis patients followed in Kinshasa.
Methods: We conducted a multicenter cross-sectional study in 6 hospitals in Kinshasa. All patients followed on hemodialysis for more than 3 months were included. Hypovitaminosis D was defined as <30 ng/mL (insufficiency = 20–29 ng/mL; deficiency if <20 ng/mL) and the targets for iPTH values were based on the 2017 KDIGO guidelines. The determinants for hypovitaminosis D were evaluated by logistic regression.
Results: 251 patients [mean age 56 ± 14 years, 72.5% men, 63% hypertensive, 31% diabetic, 100% supplemented with native 25 [OH] vitamin D + CaCO3 were included. Hypovitaminosis D was found in 79.7% (deficiency 47.4%) and was associated with the male gender aOR 2.7 [1.4–5.2], p = 0.004, the low-permeability dialyzer 2.2 [1.1–4.2], p = 0.025 and anemia 3.9 [1.2–12.7], p = 0.022.
Only 40% of patients with 25 [OH] vitamin D deficiency had iPTH according to KDIGO targets vs 6% of patients with severe hyperparathyroidism (iPTH > 600 pg/mL), 45% with levels between 16 and 150 pg/mL and 9% a iPTH ≤ 15 pg/mL.
Conclusion: Despite a sunny environment, a large proportion of Congolese hemodialysis patients have hypovitaminosis D, in particular a deficiency. Among them, less than half have target iPTH values. These results show the benefit of regular monitoring of these parameters in order to optimize treatment.
Keywords: KDIGO targets, hemodialysis, hypovitaminosis D, iPTH
International Journal of Nephrology and Renovascular Disease
open access to scientific and medical research
International Journal of Nephrology and Renovascular Disease 2024:17 71–79