CHAPTER 9 Chronic Kidney Disease – Mineral and Bone Disorder

CHAPTER 9Chronic Kidney Disease – Mineral and Bone Disorder

Fan Kin SingRozina GhazalliChing Chen HuaLiew Yew Fong

Source: 20th MDTR Report 2012, NRR

Table 9.1.1: Phosphate Binder in HD patients, 1997-2012

Year Number ofpatients

Calcium Carbonate

Aluminium Hydroxide Lanthanum Sevelamer HcI

n % n % n % n %1997 1695 1543 91 417 25 0 0 0 01998 2141 1956 91 343 16 0 0 0 01999 2996 2693 90 244 8 0 0 0 02000 4390 3975 91 239 5 0 0 0 02001 5194 4810 93 145 3 0 0 0 02002 6108 5536 91 171 3 0 0 0 02003 7018 6425 92 118 2 0 0 0 02004 8155 7408 91 106 1 0 0 0 02005 9349 8568 92 98 1 0 0 0 02006 11682 10776 92 71 1 15 0 0 02007 12907 11868 92 57 0 37 0 1 02008 15388 14130 92 72 0 86 1 3 02009 17968 16445 92 34 0 247 1 0 02010 19509 17805 91 27 0 377 2 6 02011 22778 20886 92 35 0 514 2 88 02012 25800 23750 92 13 0 638 2 102 0


Table 9.1.2: Phosphate Binder in PD patients, 1997-2012

Year Number ofpatients

Calcium Carbonate

Aluminium Hydroxide Lanthanum Sevelamer HcI

n % n % n % n %1997 476 393 83 57 12 0 0 0 01998 541 425 79 46 9 0 0 0 01999 610 450 74 36 6 0 0 0 02000 662 522 79 15 2 0 0 0 02001 781 588 75 5 1 0 0 0 02002 891 713 80 6 1 0 0 0 02003 1543 1306 85 15 1 0 0 0 02004 1842 1552 84 24 1 0 0 0 02005 2207 1862 84 21 1 0 0 0 02006 2787 2373 85 14 1 5 0 2 02007 3577 3142 88 8 0 22 1 1 02008 4044 3495 86 14 0 42 1 0 02009 3482 2945 85 12 0 78 2 1 02010 3844 3391 88 4 0 93 2 2 02011 5087 4376 86 8 0 176 3 42 12012 5858 4952 85 6 0 202 3 62 1


Table 9.1.3: Phosphate Binders by Sector in HD patients

Table 9.2.1: Distribution of corrected serum calcium, HD patients, 1997-2012

Year Number of patients Mean SD Median LQ UQ % patients ≥2.1 & ≤2.37

mmol/L1997 1633 2.3 0.3 2.3 2.2 2.5 401998 2060 2.3 0.3 2.3 2.2 2.5 441999 2732 2.3 0.3 2.3 2.2 2.5 392000 3701 2.4 0.3 2.3 2.2 2.5 422001 4618 2.4 0.2 2.4 2.2 2.5 402002 5485 2.3 0.3 2.3 2.2 2.5 432003 6466 2.3 0.2 2.3 2.2 2.4 462004 7536 2.3 0.2 2.3 2.2 2.4 472005 8630 2.3 0.2 2.3 2.2 2.4 492006 10881 2.3 0.2 2.3 2.1 2.4 502007 12275 2.2 0.2 2.2 2.1 2.4 522008 14478 2.3 0.2 2.3 2.1 2.4 532009 16850 2.3 0.2 2.3 2.2 2.4 522010 18655 2.3 0.2 2.3 2.2 2.4 522011 21733 2.3 0.2 2.3 2.1 2.4 532012 24679 2.3 0.2 2.3 2.1 2.4 54


Figure 9.2.1: Cumulative distribution of corrected serum calcium, HD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

1.8 1.9 2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8Corrected serum calcium (mmol/L)

1997 2000 20042008 2012

Table 9.2.2: Distribution of corrected serum calcium, PD patients, 1997-2012

Year Number of patients Mean SD Median LQ UQ %patients ≥2.1 &

≤2.37mmol/L1997 469 2.5 0.3 2.5 2.3 2.6 251998 535 2.4 0.3 2.4 2.3 2.6 301999 593 2.5 0.2 2.5 2.3 2.6 252000 635 2.5 0.2 2.5 2.3 2.6 252001 744 2.5 0.3 2.5 2.4 2.7 222002 859 2.5 0.2 2.5 2.3 2.6 242003 1167 2.4 0.2 2.5 2.3 2.6 272004 1276 2.5 0.2 2.5 2.3 2.6 232005 1338 2.4 0.2 2.4 2.3 2.6 302006 1495 2.4 0.2 2.4 2.3 2.5 382007 1748 2.4 0.2 2.4 2.2 2.5 422008 2017 2.4 0.2 2.4 2.3 2.5 382009 2135 2.4 0.2 2.4 2.2 2.5 392010 2301 2.4 0.2 2.4 2.3 2.5 372011 2506 2.4 0.2 2.4 2.3 2.5 382012 2848 2.4 0.2 2.4 2.2 2.5 42


Figure 9.2.2: Cumulative distribution of corrected serum calcium, PD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9Corrected serum calcium (mmol/L)

1997 2000 20042008 2012

Table 9.2.3: Distribution of serum phosphate, HD patients, 1997-2012

YearNumber

ofpatients

mean SD Median LQ UQ

Percent patients with serum phosphate (mmol/L)

<0.8 ≥0.8 &<1.3 ≥1.3 &<1.8 ≥1.8 &<2.2 >2.2

1997 1649 1.9 0.5 1.9 1.6 2.3 1 10 33 27 291998 2051 1.9 0.5 1.9 1.6 2.2 1 9 31 33 271999 2861 1.9 0.5 1.9 1.5 2.2 1 12 32 28 272000 4078 1.9 0.6 1.8 1.5 2.2 1 12 34 29 242001 4765 1.9 0.5 1.8 1.5 2.2 1 13 35 27 242002 5679 1.9 0.5 1.8 1.5 2.2 1 12 34 27 262003 6588 1.8 0.5 1.8 1.5 2.2 2 13 36 26 242004 7620 1.8 0.5 1.8 1.5 2.2 1 14 37 25 232005 8834 1.8 0.5 1.7 1.4 2.1 2 16 38 25 192006 11129 1.8 0.5 1.7 1.4 2.1 1 17 39 25 182007 12424 1.8 0.5 1.7 1.4 2.1 1 16 40 25 182008 14874 1.7 0.5 1.7 1.4 2 1 17 41 24 172009 17246 1.8 0.5 1.7 1.4 2.1 1 15 40 26 182010 18880 1.8 0.5 1.7 1.4 2.1 1 15 40 26 192011 22164 1.8 0.5 1.7 1.4 2.1 1 15 40 26 182012 25134 1.8 0.5 1.7 1.4 2 1 15 41 25 17


Figure 9.2.3: Cumulative distribution of serum phosphate, HD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

1 1.2 1.4 1.6 1.8 2 2.2 2.4 2.6 2.8 3Serum phosphate (mmol/L)

1997 2000 20042008 2012

Table 9.2.4: Distribution of serum phosphate, PD patients, 1997-2012

YearNumber

ofpatients

mean SD Median LQ UQ

Percent patients with serum phosphate (mmol/L)

<0.8 ≥0.8 &<1.3 ≥1.3 &<1.8 ≥1.8 &<2.2 >2.2

1997 470 1.6 0.4 1.5 1.3 1.8 1 28 44 20 81998 537 1.6 0.5 1.6 1.3 1.9 1 23 44 20 121999 583 1.6 0.5 1.6 1.3 1.9 2 21 45 22 102000 633 1.5 0.5 1.5 1.3 1.8 4 26 43 19 82001 732 1.5 0.5 1.5 1.2 1.8 3 32 40 17 72002 862 1.5 0.5 1.5 1.2 1.8 3 30 42 16 92003 1173 1.6 0.5 1.5 1.2 1.9 2 29 40 19 102004 1278 1.6 0.5 1.6 1.3 1.9 2 27 39 20 112005 1343 1.6 0.5 1.6 1.3 1.9 2 26 40 20 122006 1511 1.6 0.5 1.6 1.3 1.9 2 24 43 19 122007 1757 1.6 0.5 1.6 1.3 1.9 2 23 44 18 132008 2022 1.6 0.5 1.5 1.3 1.9 2 27 42 17 122009 2147 1.6 0.5 1.5 1.2 1.9 2 27 41 18 122010 2303 1.6 0.5 1.5 1.2 1.9 2 28 40 18 112011 2535 1.6 0.5 1.5 1.3 1.9 2 27 41 19 122012 2859 1.6 0.5 1.5 1.3 1.9 2 27 41 18 12


Figure 9.2.4: Cumulative distribution of serum phosphate, PD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

.8 1 1.2 1.4 1.6 1.8 2 2.2 2.4 2.6Serum phosphate (mmol/L)

1997 2000 20042008 2012

Table 9.2.5: Distribution of corrected calcium x phosphate product, HD patients 1997-2012

Year Number of patients Mean SD Median LQ UQ

Percent patients with calcium phosphate product (mmol2/L2)

<3.5 3.5 & <4.5 4.5 & <5.5 5.5

1997 1615 4.5 1.3 4.5 3.6 5.3 23 28 29 201998 2020 4.5 1.2 4.4 3.7 5.2 21 32 28 191999 2698 4.4 1.3 4.3 3.4 5.2 27 29 26 182000 3648 4.4 1.3 4.3 3.5 5.2 25 31 25 182001 4555 4.3 1.3 4.2 3.4 5.2 27 31 24 182002 5403 4.4 1.3 4.3 3.4 5.2 27 31 24 192003 6383 4.2 1.3 4.1 3.3 5.1 30 31 23 162004 7414 4.2 1.3 4.1 3.3 5 32 32 22 152005 8496 4 1.3 3.9 3.2 4.8 36 32 20 122006 10758 4 1.2 3.8 3.1 4.7 38 32 19 112007 12172 3.9 1.2 3.8 3.1 4.6 38 33 19 102008 14360 3.9 1.2 3.8 3.1 4.6 39 33 19 92009 16713 4 1.2 3.9 3.2 4.7 36 34 20 112010 18535 4 1.2 3.9 3.2 4.8 34 34 21 112011 21580 4 1.2 3.9 3.2 4.7 36 34 20 112012 24461 4 1.1 3.8 3.2 4.7 37 34 19 10Source: 20th MDTR Report 2012, NRR

Figure 9.2.5: Cumulative distribution of corrected calcium x phosphate product, HD patients 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

2 2.5 3 3.5 4 4.5 5 5.5 6 6.5 7Corrected calcium x phosphate product (mmol2/L2)

1997 2000 20042008 2012

Table 9.2.6: Distribution of corrected calcium x phosphate product, PD patients 1997-2012

Year Number ofpatients mean SD Median LQ UQ

Percent patients with calcium phosphate product (mmol2/L2)

<3.5 3.5 & <4.5 4.5 & <5.5 5.5

1997 468 3.9 1.1 3.7 3.1 4.5 40 35 17 71998 533 4 1.1 3.8 3.2 4.6 38 35 16 111999 580 4 1.2 3.8 3.2 4.8 36 33 22 102000 621 3.8 1.1 3.7 3.1 4.5 44 31 17 82001 723 3.8 1.1 3.6 2.9 4.5 46 30 18 72002 856 3.8 1.2 3.6 2.9 4.5 45 29 18 82003 1162 3.9 1.2 3.7 3 4.6 43 29 17 102004 1274 4 1.2 3.8 3 4.7 41 30 18 122005 1333 3.9 1.3 3.7 3 4.6 43 29 17 112006 1494 3.9 1.2 3.7 3.1 4.6 43 31 17 92007 1745 3.8 1.2 3.6 3 4.5 46 29 15 102008 2009 3.8 1.2 3.6 3 4.5 47 28 15 102009 2130 3.8 1.2 3.6 2.9 4.5 46 29 15 112010 2289 3.8 1.2 3.6 2.9 4.5 47 29 15 102011 2499 3.8 1.2 3.6 3 4.6 45 28 17 92012 2839 3.8 1.2 3.6 2.9 4.4 47 29 15 9Source: 20th MDTR Report 2012, NRR

Figure 9.2.6: Cumulative distribution of corrected calcium x phosphate product, PD patients 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

2 2.5 3 3.5 4 4.5 5 5.5 6 6.5Corrected calcium x phosphate product (mmol2/L2)

1997 2000 20042008 2012

Table 9.2.7(a): Variation in corrected median serum calcium level among HD centres 1997-2012

Year Number of centres Min 5th Centile LQ Median UQ 95th Centile Max

1997 45 2.1 2.1 2.3 2.3 2.4 2.5 2.51998 49 2 2.1 2.3 2.3 2.4 2.5 2.51999 66 1.9 2 2.3 2.3 2.4 2.5 2.62000 90 2 2.1 2.3 2.3 2.4 2.6 3.22001 115 2 2.1 2.3 2.3 2.4 2.5 2.62002 138 1.9 2.1 2.2 2.3 2.4 2.5 2.62003 169 2 2.1 2.2 2.3 2.4 2.5 2.52004 205 1.9 2.1 2.2 2.3 2.4 2.4 2.52005 232 1.8 2 2.2 2.3 2.4 2.4 2.52006 277 1.9 2.1 2.2 2.3 2.3 2.4 2.52007 313 1.8 2 2.2 2.3 2.3 2.4 2.52008 364 1.8 2.1 2.2 2.3 2.3 2.4 2.62009 406 1.5 2.1 2.2 2.3 2.3 2.4 2.52010 439 1.8 2.2 2.2 2.3 2.3 2.4 2.52011 505 1.6 2.1 2.2 2.3 2.3 2.4 2.62012 552 2 2.1 2.2 2.3 2.3 2.4 2.6


Figure 9.2.7(a): Variation in median serum calcium among HD patients, HD centres, 2012


1.4

1.6

1.8

2

2.2

2.4

2.6

2.8

Seru

m c

alc

ium

, m

mol/L

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower quartile, upper quartile)Median serum calcium

Table 9.2.8(a): Variation in corrected median serum calcium level among PD centres 1997-2012


1997 7 2.1 2.1 2.4 2.4 2.5 2.6 2.61998 9 2.3 2.3 2.3 2.4 2.4 2.6 2.61999 10 2.4 2.4 2.4 2.5 2.5 2.6 2.62000 11 2.4 2.4 2.4 2.5 2.5 2.6 2.62001 12 2.3 2.3 2.4 2.5 2.5 2.6 2.62002 15 2.4 2.4 2.4 2.5 2.5 2.6 2.62003 18 2.2 2.2 2.4 2.4 2.5 2.6 2.62004 18 2.3 2.3 2.4 2.4 2.5 2.5 2.52005 19 2.2 2.2 2.4 2.4 2.5 2.6 2.62006 22 2.2 2.2 2.3 2.4 2.4 2.5 2.62007 22 2.2 2.2 2.3 2.3 2.4 2.4 2.52008 24 2.2 2.2 2.3 2.4 2.5 2.6 2.62009 25 2.2 2.3 2.3 2.3 2.4 2.5 2.62010 26 2.2 2.3 2.3 2.4 2.4 2.5 2.52011 28 2.1 2.3 2.3 2.4 2.4 2.5 2.62012 28 2.2 2.2 2.3 2.3 2.4 2.5 2.6


Figure 9.2.8(a): Variation in median serum calcium level among PD patients, PD centres, 2012


2

2.1

2.2

2.3

2.4

2.5

2.6

2.7

2.8

Ser

um c

alci

um, m

mol

/L

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre

(lower quartile, upper quartile)Median serum calcium

Table 9.2.7(b): Proportion of patients with serum calcium 2.1 to 2.37 mmol/L, HD centres, 1997-2012


1997 45 6 16 31 40 47 66 801998 49 12 21 38 43 50 71 781999 66 0 11 24 39 48 58 802000 90 0 16 30 40 50 64 982001 115 8 12 30 40 50 65 872002 138 5 17 33 43 53 69 822003 169 11 24 35 45 56 70 912004 205 8 22 38 47 58 72 832005 232 0 21 39.5 49 57 70 912006 277 13 31 42 50 59 71 902007 313 9 29 44 52 61 71 932008 364 8 29 46.5 54 60 73 902009 406 0 29 44 53 61 72 862010 439 0 32 45 53 62 73 932011 505 0 32 46 55 63 74 912012 552 8 33 47 55 63.5 75 100


Figure 9.2.7(b): Variation in proportion of patients with serum calcium 2.1 to 2.37 mmol/L, HD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower 95% CI, upper 95% CI)% with serum calcium 2.1-2.37 mmol/L

Table 9.2.8(b): Proportion of patients with serum calcium 2.1 to 2.37 mmol/L, PD centres


1997 7 10 10 18 26 29 53 531998 9 13 13 23 38 40 60 601999 10 5 5 22 28.5 31 42 422000 11 14 14 18 24 33 46 462001 12 12 12 17 23 35.5 38 382002 15 12 12 20 25 34 41 412003 18 9 9 19 32 39 58 582004 18 11 11 17 24.5 31 53 532005 19 17 17 25 35 43 51 512006 22 16 25 33 44.5 49 60 762007 22 19 24 33 45.5 50 62 632008 24 5 15 31.5 41 50 58 652009 25 13 13 29 40 52 58 632010 26 13 16 27 34.5 50 57 572011 28 0 13 31.5 37.5 45.5 58 622012 28 7 9 32 42.5 51 60 71


Figure 9.2.8(b): Variation in proportion of patients with serum calcium 2.1 to 2.37 mmol/L, PD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre

(lower 95% CI, upper 95% CI)% with serum calcium 2.1-2.37 mmol/L

Table 9.2.9(a): Variation in median serum phosphate level among HD centres, 2002- 2012


1997 45 1.3 1.5 1.7 1.9 2 2.3 2.81998 49 1.5 1.5 1.8 2 2 2.2 2.61999 68 1.1 1.6 1.8 1.9 2 2.1 2.52000 101 1.4 1.6 1.7 1.9 1.9 2.2 3.72001 118 1.3 1.5 1.7 1.8 1.9 2.1 2.42002 145 1.3 1.5 1.8 1.9 2 2.2 2.42003 175 0.9 1.5 1.7 1.8 1.9 2.2 2.42004 210 1.4 1.5 1.7 1.8 1.9 2.1 2.42005 233 0.8 1.4 1.6 1.7 1.8 2 2.42006 283 1 1.5 1.6 1.7 1.8 2 2.32007 314 1.1 1.4 1.6 1.7 1.8 2 2.32008 370 1.1 1.4 1.6 1.7 1.8 2 2.52009 411 1.1 1.5 1.6 1.7 1.8 2 2.32010 446 1.3 1.5 1.6 1.7 1.9 2 2.82011 507 1 1.5 1.6 1.8 1.8 2 2.52012 560 1.1 1.5 1.6 1.7 1.8 2 2.6


Figure 9.2.9(a): Variation in median serum phosphate level among HD patients, HD centres, 2012


1

1.2

1.4

1.6

1.8

2

2.2

2.4

2.6

2.8

3

3.2

3.4

Seru

m p

hosp

hate

, m

mol/L

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower quartile, upper quartile)Median serum phosphate

Table 9.2.10(a): Variation in median serum phosphate levels among PD centres 1997-2012


1997 7 1.4 1.4 1.5 1.5 1.6 1.7 1.71998 9 1.4 1.4 1.5 1.6 1.6 1.8 1.81999 9 1.5 1.5 1.5 1.6 1.6 1.7 1.72000 11 1.3 1.3 1.4 1.5 1.6 1.7 1.72001 12 1.3 1.3 1.4 1.5 1.7 1.9 1.92002 15 1.4 1.4 1.4 1.5 1.6 2.1 2.12003 18 1.3 1.3 1.5 1.5 1.6 1.7 1.72004 18 1.3 1.3 1.5 1.5 1.7 1.8 1.82005 19 1.4 1.4 1.5 1.5 1.7 1.9 1.92006 22 1.3 1.4 1.5 1.6 1.7 1.8 1.92007 22 1.3 1.4 1.5 1.6 1.7 1.8 1.82008 24 1.2 1.3 1.5 1.6 1.8 1.9 2.12009 25 1.3 1.4 1.5 1.6 1.7 1.9 2.22010 26 1.3 1.3 1.4 1.6 1.7 1.9 1.92011 28 1.3 1.3 1.5 1.6 1.7 1.9 1.92012 28 1.3 1.4 1.5 1.6 1.7 1.8 1.9


Figure 9.2.10(a): Variation in median serum phosphate level among PD patients, PD centres 2012


11.11.21.31.41.51.61.71.81.9

22.12.22.32.42.5

Ser

um p

hosp

hate

, mm

ol/L

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre

(lower quartile, upper quartile)Median serum phosphate

Table 9.2.9(b): Proportion of patients with serum phosphate 1.13-1.78 mmol/L, HD centres, 1997-2012


1997 45 7 18 29 39 45 59 681998 49 8 20 30 35 44 63 701999 68 0 14 25.5 34.5 44 60 652000 101 7 17 29 36 44 57 732001 118 0 21 32 38.5 47 62 672002 145 10 17 30 37 46 66 902003 175 9 19 31 40 48 64 922004 210 0 18 31 40 50 68 922005 233 12 25 37 44 53 71 902006 283 14 25 38 46 54 70 872007 314 19 27 39 47 54 67 922008 370 10 28 40 48 56 67 872009 411 7 27 39 47 53 67 802010 446 4 24 37 46 54 64 772011 507 0 27 38 47 54 67 942012 560 6 29 39 48 55 67 87


Figure 9.2.9(b): Variation in proportion of patients with serum phosphate 1.13-1.78 mmol/L, HD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower 95% CI, upper 95% CI)% with serum phosphate 1.13-1.78 mmol/L

Table 9.2.10(b): Proportion of patients with serum phosphate 1.13-1.78 mmol/L, PD centres 1997-2012


1997 7 53 53 54 58 66 76 761998 9 43 43 54 60 61 80 801999 9 43 43 51 58 66 68 682000 11 41 41 50 53 61 64 642001 12 43 43 48.5 54 58 77 772002 15 43 43 47 53 60 83 832003 18 44 44 50 54 58 77 772004 18 39 39 49 52 60 76 762005 19 38 38 46 52 58 76 762006 22 41 44 48 52 58 66 682007 22 40 43 48 54 56 73 782008 24 30 39 47.5 52.5 59 65 712009 25 20 40 49 52 58 62 732010 26 34 38 45 50.5 59 67 682011 28 34 39 46.5 51.5 58.5 75 812012 28 26 33 48 51.5 59 63 73


Figure 9.2.10(b): Variation in proportion of patients with serum phosphate 1.13-1.78 mmol/L, PD centres 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre


Table 9.2.9(c): Proportion of patients with serum phosphate 0.8-1.3 mmol/L, HD centres, 2012


1997 45 0 0 5 9 14 28 501998 49 0 0 5 8 10 22 381999 68 0 0 5 10 14 42 542000 101 0 0 7 11 17 26 372001 118 0 2 7 11.5 18 27 532002 145 0 0 6 12 18 28 602003 175 0 0 6 12 18 31 452004 210 0 0 7 12.5 19 29 462005 233 0 0 9 15 20 32 522006 283 0 3 9 15 22 33 502007 314 0 3 10 16 21 31 472008 370 0 2 9 15 22 35 602009 411 0 0 9 14 20 32 422010 446 0 0 8 14 19 29 502011 507 0 2 9 14 20 30 832012 560 0 3 8.5 14 20 31 43


Figure 9.2.9(c): Variation in proportion of patients with serum phosphate 0.8-1.3 mmol/L, HD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 50 100 150 200 250 300 350 400 450 500 550Centre


Table 9.2.10(c): Proportion of patients with serum phosphate 0.8-1.3 mmol/L, PD centres, 2012


1997 7 12 12 18 27 34 35 351998 9 7 7 16 20 29 31 311999 9 6 6 14 18 22 26 262000 11 4 4 18 24 33 36 362001 12 0 0 14.5 32 38 43 432002 15 0 0 18 30 36 50 502003 18 12 12 23 28.5 34 42 422004 18 8 8 19 25.5 32 48 482005 19 8 8 16 25 29 45 452006 22 0 0 16 19 25 35 542007 22 4 5 15 20.5 25 34 432008 24 4 7 17 23 30.5 47 732009 25 4 10 19 25 30 42 472010 26 0 4 15 24.5 32 42 462011 28 0 0 15 22 32 44 462012 28 3 4 15.5 21.5 31.5 34 47


Figure 9.2.10(c): Variation in proportion of patients with serum phosphate 0.8-1.3 mmol/L, PD centres 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre


Table 9.2.11(a): Variation in corrected median calcium x phosphate product HD centres 1997-2012


1997 45 2.9 3.6 4.1 4.3 4.8 5.3 6.21998 49 3.2 3.4 4.1 4.5 4.7 5.2 5.41999 65 2.3 3.2 4 4.3 4.7 5.2 5.62000 89 3.1 3.5 4 4.3 4.6 5.1 6.22001 113 2.9 3.6 3.9 4.2 4.6 5.2 62002 138 2.9 3.5 4 4.3 4.6 5.1 62003 169 2.2 3.3 3.9 4.1 4.5 4.9 5.52004 204 2.9 3.3 3.8 4.1 4.4 4.9 5.62005 225 2.1 3.2 3.6 3.9 4.2 4.8 5.62006 275 2.1 3.2 3.6 3.9 4.1 4.6 52007 310 2.5 3.1 3.6 3.8 4.1 4.5 5.12008 361 2.7 3.2 3.5 3.8 4.1 4.5 5.72009 399 2.6 3.3 3.6 3.9 4.1 4.7 5.92010 438 2.9 3.4 3.7 3.9 4.2 4.7 6.32011 503 2 3.3 3.6 3.9 4.2 4.6 5.62012 549 2.7 3.3 3.6 3.9 4.1 4.5 5.7


Figure 9.2.11(a): Variation in median corrected calcium x phosphate product among HD patients, HD centres, 2012


1

1.5

2

2.5

3

3.5

4

4.5

5

5.5

6

6.5

7

7.5

Corr

ect

ed c

alc

ium

x p

hosp

hate

pro

duct

, m

mol2

/L2

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower quartile, upper quartile)Median corrected calcium x phosphate product

Table 9.2.12(a): Variation in corrected median calcium x phosphate product PD centres 1997-2012


1997 7 3.5 3.5 3.6 3.7 3.8 3.9 3.91998 9 3.5 3.5 3.6 3.7 3.9 4 41999 9 3.6 3.6 3.7 3.9 4.1 4.3 4.32000 11 3.4 3.4 3.5 3.7 4 4.3 4.32001 12 3.1 3.1 3.4 3.7 3.9 4.3 4.32002 15 3.3 3.3 3.4 3.6 4 4.9 4.92003 18 3.2 3.2 3.4 3.7 3.9 4.1 4.12004 18 3.2 3.2 3.5 3.8 4 4.4 4.42005 19 3.3 3.3 3.5 3.7 4 4.3 4.32006 22 3 3.3 3.6 3.7 4 4.2 4.32007 22 3.1 3.3 3.5 3.8 4.1 4.3 4.32008 24 2.8 3.1 3.3 3.7 4.1 4.7 5.12009 25 3.2 3.3 3.5 3.7 3.9 4.5 4.82010 26 3.1 3.1 3.4 3.8 4.1 4.5 4.62011 28 3 3.1 3.4 3.9 4 4.5 4.52012 28 3.1 3.1 3.5 3.8 4.1 4.3 4.5


Figure 9.2.12(a): Variation in median corrected calcium x phosphate product among PD centres, to 2012


2.5

3

3.5

4

4.5

5

5.5

6

Cor

rect

ed c

alci

um x

pho

spha

te p

rodu

ct, m

mol

2/L2

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre

(lower quartile, upper quartile)Median corrected calcium x phosphate product

Table 9.2.11(b): Proportion of patients with corrected calcium x phosphate < 4.5 mmol2/L2, HD centres


1997 45 15 25 38 54 65 79 1001998 49 18 30 41 52 66 82 911999 65 20 27 44 55 65 91 1002000 89 12 30 49 58 66 78 882001 113 19 37 47 57 70 81 912002 138 18 33 48 56 67 90 1002003 169 25 33 50 61 71 83 1002004 204 15 38 53 63 71 88 1002005 225 24 45 58 69 77 91 1002006 275 30 46 62 70 79 91 1002007 310 32 48 63 73 81 92 1002008 361 27 50 64 72 81 91 1002009 399 25 44 62 71 79 89 952010 438 8 43 60 70 76 88 952011 503 23 47 61 70 79 90 1002012 549 29 50 63 72 80 92 100


Figure 9.2.11(b): Variation in proportion of patients with corrected calcium x phosphate product < 4.5 mmol2/L2, HD centres 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atients

0 50 100 150 200 250 300 350 400 450 500 550Centre

(lower 95% CI, upper 95% CI)% with corrected calcium x phosphate product <4.5 mmol2/L2

Table 9.2.12(b): Proportion of patients with corrected calcium x phosphate < 4.5 mmol2/L2, PD


1997 7 70 70 74 78 82 94 941998 9 66 66 71 73 79 90 901999 9 57 57 65 72 77 80 802000 11 62 62 70 73 81 85 852001 12 50 50 71.5 75 81.5 84 842002 15 43 43 65 77 82 88 882003 18 61 61 65 74.5 82 88 882004 18 56 56 66 72.5 79 89 892005 19 55 55 65 73 78 85 852006 22 56 57 67 70.5 79 88 962007 22 52 57 64 72.5 79 88 982008 24 40 41 62 71.5 81.5 91 972009 25 40 49 68 76 80 86 862010 26 48 49 69 74 80 88 892011 28 48 48 63.5 72.5 80 91 952012 28 47 55 66.5 71 83.5 90 91


Figure 9.2.12(b): Variation in proportion of patients with corrected calcium x phosphate product < 4.5 mmol2/L2, PD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 2 4 6 8 10 12 14 16 18 20 22 24 26 28Centre

(lower 95% CI, upper 95% CI)% with corrected calcium x phosphate product <4.5 mmol2/L2

Table 9.3.1(a): Treatment of hyperparathyroidism in HD patients, 1997-2012

YearNumber of

patients

On calcitriol On Paricalcitol Had Parathyroidectomy

n % n % n %

1997 1695 694 41 0 0 0 01998 2141 652 30 0 0 0 01999 2996 770 26 0 0 0 02000 4390 1082 25 0 0 0 02001 5194 1145 22 0 0 0 02002 6108 1375 23 0 0 0 02003 7018 1690 24 0 0 0 02004 8155 2029 25 0 0 0 02005 9349 2556 27 0 0 43 02006 11682 3823 33 34 0 152 12007 12907 4950 38 58 0 181 12008 15388 6337 41 43 0 173 12009 17968 7784 43 82 0 167 12010 19509 9078 47 154 1 170 12011 22778 11042 48 132 1 178 12012 25800 11972 46 258 1 269 1


Table 9.3.1(b): Treatment of hyperparathyroidism in PD patients, 1997-2012

YearNumber of

patients

On Calcitriol On Paricalcitol Had Parathyroidectomy

n % n % n %

1997 476 114 24 0 0 0 01998 541 110 20 0 0 0 01999 610 75 12 0 0 0 02000 662 96 15 0 0 0 02001 781 84 11 0 0 0 02002 891 130 15 0 0 0 02003 1543 311 20 0 0 0 02004 1842 439 24 0 0 0 02005 2207 534 24 0 0 8 02006 2787 658 24 6 0 27 12007 3577 1033 29 9 0 22 12008 4044 1210 30 6 0 26 12009 3482 1232 35 5 0 16 02010 3844 1531 40 4 0 11 02011 5087 1901 37 24 0 25 02012 5858 2222 38 62 1 48 1


Table 9.3.2(a): Distribution of iPTH, HD patients, 1997-2012

Year Number of Patients Mean SD Median LQ UQ

Percent patients with iPTH (pg/ml)

<150 150 & 300 >300 & 500 >500

1997 1088 195.1 282.9 76.8 26 240.3 66 13 9 111998 938 126.1 202 44 15 141 76 12 6 61999 1533 185.6 260.7 78.9 23.5 240 64 16 10 102000 2242 149.2 230 57.8 17.6 177 72 13 8 72001 2760 141.2 219.5 57 18 164.8 73 15 6 72002 3391 161.6 248 64 19 191 70 14 8 82003 4068 219.1 328.8 79 24.3 263.3 64 14 9 142004 4748 212.1 325.6 74.3 22.6 257.3 65 13 9 132005 5826 221.6 312.5 83.8 26.5 297 61 14 11 142006 7744 219.1 307.2 88 29 292 61 14 11 132007 9151 245.8 332.7 105 30.4 335.5 58 15 12 162008 10753 260.8 330.9 127 36 361 54 17 13 172009 12642 269.4 337.3 140.1 40 367.1 52 18 13 172010 14364 235.6 319.3 98.5 30.5 319.8 58 15 11 152011 16716 222.9 312.5 86.8 29.2 302.4 61 14 12 142012 19189 290.3 339.8 165.6 46.5 408.6 48 18 15 19


Figure 9.3.2(a): Cumulative distribution of iPTH, HD, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750 900 1050iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.2(b): Distribution of iPTH, diabetic HD patients, 1997-2012



<150 150 & 300 >300 & 500 >500

1997 197 129 218 50 17.5 125.5 78 11 7 51998 178 84.5 139.4 24.4 11 90 83 9 6 21999 329 122.4 182.8 54.5 16 148 75 14 6 52000 518 82 123.7 34.8 10 95.5 84 9 6 12001 704 80.6 136 31.2 10.9 87.3 84 11 4 22002 938 90.9 157.4 34.9 10.9 97 83 10 4 32003 1204 120.1 209.3 40.2 13.3 120.3 79 10 6 52004 1532 111.4 193.6 38 14 114.4 80 10 5 52005 2107 149.5 246.1 47.4 16.1 170.5 72 12 8 82006 3069 155 253.2 54 20.8 173.5 72 12 8 72007 3681 183.1 267.4 70.7 23 235.5 66 14 10 102008 4594 208.9 275.3 99 29.1 286.5 59 17 12 122009 5641 218.3 284.1 111.1 33.7 292 57 18 12 122010 6571 189.7 269 75 26 256 64 15 11 102011 7543 182.4 263.7 66.9 24.6 241.4 66 13 10 102012 8737 250.2 290.7 146 42.4 359 51 19 16 15


Figure 9.3.2(b): Cumulative distribution of iPTH, diabetic HD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.2(c): Distribution of iPTH, non-diabetic HD patients, 1997-2012


Percent patients with iPTH (pg.ml)

<150 150 & 300 >300 & 500 >500

1997 891 209.7 293.4 83.5 28.5 272 63 14 10 131998 760 135.9 212.9 49 17 153 74 12 7 71999 1204 202.9 275.8 92.2 26 267 61 17 10 112000 1724 169.4 250 65.9 21.8 204.3 68 14 8 92001 2056 162 238.1 71 23.4 198 69 16 7 82002 2453 188.7 270.1 84 26 235 65 15 10 102003 2864 260.7 359.6 108 33.5 330.5 57 16 10 172004 3216 260.1 362.7 102.3 30.5 338.8 58 14 11 172005 3719 262.5 337.8 114.1 35.5 364.5 55 15 13 172006 4675 261.2 331.4 122.8 39 362.5 54 16 13 172007 5470 288 364.2 135.1 38.7 403 52 15 13 192008 6159 299.5 362.2 155 42.6 418 49 16 14 212009 7001 310.6 369.6 170.5 47.8 433.5 47 17 14 212010 7793 274.4 351.6 126.7 36.5 386 54 15 12 192011 8868 258.1 344.8 108.1 34.7 357.6 56 14 13 172012 10086 328 374.2 190 51.5 469.1 45 17 15 23


Figure 9.3.2(c): Cumulative distribution of iPTH, non-diabetic HD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750 900 1050iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.3(a): Distribution of iPTH, PD patients, 1997-2012



<150 150 & 300 >300 & 500 >500

1997 293 112.3 151 58 25 137 78 12 7 31998 280 93.7 117.4 47.5 18.5 126 81 13 5 11999 365 132.8 176.4 61.5 21 179.3 71 15 10 42000 406 109.8 192.4 46.8 15.5 118 80 12 5 42001 531 108 155.8 51.5 13.5 137.6 76 15 6 32002 681 160.6 219.1 82 26 196 67 17 8 72003 938 230.3 340.3 95 37.4 260 61 18 9 122004 1115 216.4 302.9 105 39.5 260 60 19 10 112005 1071 247.1 306.4 125.3 39 352 54 18 13 152006 1265 224.6 271.9 128 41.5 318 54 20 14 122007 1436 248.4 297.1 152.5 51 332.8 50 22 15 142008 1608 264.2 295.3 170.3 57.3 357.7 46 22 18 152009 1824 270.6 292.7 174.2 67.8 381 45 22 16 162010 1905 261.5 294.8 163 51 371 48 20 16 162011 2093 248.4 283.7 157.5 48.7 342 48 22 15 142012 2317 278.6 298.8 189.5 64 389.6 43 22 19 16


Figure 9.3.3(a): Cumulative distribution of iPTH, PD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750 900 1050iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.3(b): Distribution of iPTH, diabetic PD patients, 1997-2012



<150 150 & 300 >300 & 500 >500

1997 90 61.3 66.1 39 15 90.5 91 7 2 01998 84 59.2 68.4 34.3 10.3 88.5 90 7 2 01999 99 92.9 143 41 17 111 82 11 4 32000 111 48.7 60.8 27.4 6 63 90 9 1 02001 159 63.6 87.1 31 6.8 79 88 9 3 12002 194 98.5 158.3 52.8 15 125.8 82 12 3 32003 312 122.6 179.7 65.6 29 146.8 75 15 6 42004 358 127 187.1 63.3 24.1 145 75 15 4 52005 348 161.4 241.4 67 22.5 192.3 70 15 8 72006 434 149.5 198.4 88.9 32.5 186.5 68 19 8 52007 544 176.4 204.6 113 41.8 237.8 58 25 11 62008 692 211.3 228.4 141.2 56.3 293.8 51 24 17 82009 750 186.8 184.9 132 57.5 255.5 54 26 13 72010 661 197.4 216.8 131 42 295 54 21 16 82011 653 189.2 208.2 128 44 272.5 54 24 16 62012 678 200.5 214.8 131.3 56 282.5 52 25 15 7


Figure 9.3.3(b): Cumulative distribution of iPTH, diabetic PD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.3(c): Distribution of iPTH, non diabetic PD patients, 1997-2012



<150 150 & 300 >300 & 500 >500

1997 203 134.9 171.3 68 29.5 167 72 14 9 41998 196 108.5 130.3 57.5 22.3 139.3 77 16 6 21999 266 147.7 185.4 75.3 22.5 196 67 16 12 52000 295 132.7 218.4 57.5 22.5 141.5 76 13 6 52001 372 127 173.9 67.5 17.2 167 72 18 7 42002 487 185.3 234.7 100 33 241 62 19 10 92003 626 284 385.8 130.8 49.9 321.5 54 19 10 172004 757 258.6 336.3 138 50 325 53 20 12 142005 723 288.3 325.3 172 48.8 413.5 47 19 15 192006 831 263.8 295.9 164 50 386 47 21 16 162007 892 292.3 334 191 57.5 404.8 44 20 18 182008 916 304.1 331.7 208.4 57.5 422.5 41 20 18 202009 1074 329.1 336.7 224.6 80 461 39 20 19 222010 1244 295.6 323.8 186.3 56.6 423.7 45 20 15 202011 1387 277.6 307.7 182.7 55.6 387.5 45 22 16 172012 1586 306 314.8 220.7 69.5 434 40 21 21 19


Figure 9.3.3(c): Cumulative distribution of iPTH, non diabetic PD patients, 1997-2012


0

.25

.5

.75

1

Cum

ulat

ive

dist

ribu

tion

0 150 300 450 600 750 900 1050 1200iPTH (pg/ml)

1997 2000 20042008 2012

Table 9.3.4(a): Variation in iPTH among HD centres 1997-2012


1997 36 8 23.3 47.5 70 104.9 198 5801998 30 8 13.2 24.2 43.5 105 144 295.51999 42 10 17 38.6 76 145.2 250 443.52000 57 5.6 15.4 31.5 48.5 86 347 487.52001 72 7.2 10.4 26.7 56 91 225.8 5362002 92 1.6 10.8 27.2 44.5 138.5 304.5 347.82003 112 4.2 10 34.8 82 175.2 375.2 4602004 136 3.6 12 28.8 72.9 205.4 370.5 6272005 166 6.1 14.3 37.2 95.3 206.8 409.5 626.42006 221 5.9 15.9 41.5 92.9 198 377.5 643.82007 243 12.4 19 46.3 106.5 240 411.1 6432008 292 8.8 22.4 59.1 141.3 243 415 712.52009 336 2.6 27 66.4 156.6 245.2 403.6 825.22010 364 5.5 18.6 41.9 104.1 235.4 384.8 609.32011 431 3.3 19.9 42.1 92.4 228.5 422.5 1217.52012 493 11.4 32.8 71.7 186.1 287.8 459 769.8


Figure 9.3.4(a): Variation in median iPTH among HD patients, HD centres 2012


0

150

300

450

600

750

900

1050

1200

1350

iPT

H, pg/m

l

0 50 100 150 200 250 300 350 400 450 500Centre

(lower quartile, upper quartile)Median iPTH

Table 9.3.4(b): Variation in proportion of patients with iPTH 150-300pg/ml, HD centres, 1997-2012


1997 36 0 0 8 11 18 29 291998 30 0 0 4 8.5 17 29 311999 42 0 0 9 15 24 33 362000 57 0 0 5 10 15 33 362001 72 0 0 5 10 20.5 33 402002 92 0 0 2.5 10 20 32 452003 112 0 0 6 14 20.5 31 422004 136 0 0 5 10 19 36 502005 166 0 0 7 13 20 33 472006 221 0 0 7 14 20 29 472007 243 0 0 8 14 21 31 522008 292 0 0 9 16 23 31 432009 336 0 0 10 17 24 36 632010 364 0 0 7 15 22 33 432011 431 0 0 5 13 20 31 582012 493 0 3 10 17 24 33 53


Figure 9.3.4(b): Variation in proportion of patients with iPTH 150-300pg/ml, HD centres, 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 50 100 150 200 250 300 350 400 450 500Centre

(lower 95% CI, upper 95% CI)% with iPTH 150-300 pg/ml

Table 9.3.5(a): Variation in median iPTH among PD patients 1997-2012


1997 5 36.5 36.5 44.8 47 81 120 1201998 5 16 16 57.5 59.5 66.3 74 741999 8 16.5 16.5 49.9 75.2 87.5 200.9 200.92000 9 16 16 33 46.5 63.5 122 1222001 11 15.4 15.4 42.5 59.5 91 274 2742002 14 27.3 27.3 50 82.9 107 280.5 280.52003 17 22.4 22.4 70 135 175 309.5 309.52004 18 41 41 74.5 138.8 169.3 329.6 329.62005 18 25.5 25.5 85 140.6 259.5 493.3 493.32006 20 35.3 36.1 88 158 233.3 354.8 3672007 22 26.3 32 107.5 202.1 283.5 440 513.92008 22 35 47 120.3 186.2 310.9 352.3 454.52009 23 40 51 129.1 195 317.9 468.8 11712010 24 29.4 33.6 96.8 217.9 287.4 517.3 688.62011 25 25.9 27 91.7 194.7 291.5 362 4192012 27 35.2 46 138.6 259.3 331 478.5 530


Figure 9.3.5(a): Variation in median iPTH among PD patients, PD centres, 2012


0100200300400500600700800900

100011001200130014001500160017001800

iPT

H, p

g/m

l

0 2 4 6 8 10 12 14 16 18 20 22 24 26Centre

(lower quartile, upper quartile)Median iPTH

Table 9.3.5(b): Proportion of patients with iPTH 150-300pg/ml


1997 5 7 7 10 13 15 27 271998 5 0 0 9 15 17 27 271999 8 6 6 7 12 21.5 26 262000 9 0 0 5 12 17 18 182001 11 0 0 9 14 19 30 302002 14 0 0 10 15.5 21 24 242003 17 2 2 12 18 22 33 332004 18 7 7 14 20 25 29 292005 18 0 0 9 15.5 23 33 332006 20 5 5.5 14 20.5 26.5 36.5 402007 22 0 3 15 21.5 27 31 392008 22 0 7 15 20.5 27 31 332009 23 7 11 13 22 26 28 282010 24 0 4 13 20 26 32 432011 25 3 4 13 22 26 33 392012 27 1 10 16 18 27 31 31


Figure 9.3.5(b): Variation in proportion of patients with iPTH 150-300pg/ml, PD centres 2012


0

10

20

30

40

50

60

70

80

90

100

% p

atie

nts

0 2 4 6 8 10 12 14 16 18 20 22 24 26Centre

(lower 95% CI, upper 95% CI)% with iPTH 150-300 pg/ml

Table 9.4.1: Low turnover bone disease vs high turnover bone disease in dialysis patient, 1997-2012

Year Number of Patients

iPTH (pg/ml) & ALP (u/l) groups

iPTH<150 & ALP <120 iPTH >300 & 600 & ALP >150 iPTH >600 & ALP >150

HD PD HD PD HD PD

n % % % % % %

1997 1381 36 14 8 1 4 01998 1218 41 15 5 0 2 01999 1898 35 10 10 1 5 02000 2648 40 9 7 1 4 02001 3291 42 9 6 1 3 02002 4072 41 9 7 1 4 12003 5006 38 9 7 2 6 12004 5863 38 9 7 1 5 12005 6897 40 7 8 1 5 12006 9009 38 6 8 1 5 12007 10587 37 5 9 1 5 12008 12361 36 5 8 1 5 12009 14466 34 4 8 1 5 12010 16269 37 4 7 1 5 12011 18809 38 4 7 1 4 12012 21506 30 3 10 1 6 1


Table 9.4.2: Low turnover bone disease vs high turnover bone disease by gender, 1997-2012


iPTH<150 pg/ml & ALP <120u/l

iPTH>300 & 600 pg/ml & ALP >150 u/l

iPTH>600 pg/ml & ALP >150u/l

Male Female Male Female Male Female

n % % % % % %

1997 1381 29 20 4 2 3 21998 1218 33 24 3 2 2 11999 1898 25 19 5 3 4 22000 2648 27 21 4 2 3 12001 3291 28 23 3 2 2 22002 4072 27 24 3 2 3 22003 5006 25 22 3 2 4 32004 5863 25 22 2 2 4 32005 6897 26 20 3 2 3 32006 9009 25 19 3 3 3 22007 10587 23 19 3 3 3 32008 12361 22 18 2 2 3 32009 14466 21 17 2 2 3 32010 16269 24 18 2 2 3 32011 18451 24 18 2 2 2 22012 21087 19 15 3 3 3 3


Table 9.4.3: Low turnover bone disease vs high turnover bone disease by age group, 1997-2012


iPTH<150 pg/ml & ALP <120u/l

iPTH>300 & 600 pg/ml & ALP >150u/l

iPTH>600 pg/ml & ALP >150u/l

>60years <=60years >60years <=60years >60years <=60yearsn % % % % % %

1997 1381 6 43 0 6 0 41998 1218 6 50 0 4 0 21999 1898 5 39 0 7 0 52000 2648 6 42 0 5 0 42001 3291 9 42 0 5 0 32002 4072 10 41 0 5 0 42003 5006 10 36 0 4 0 72004 5863 11 36 0 4 0 62005 6897 11 35 1 5 0 62006 9009 12 33 1 5 0 52007 10587 12 30 1 4 1 62008 12361 12 28 1 4 1 52009 14466 11 27 1 4 1 52010 16269 12 30 1 3 1 52011 18451 12 30 1 4 1 42012 21087 11 23 1 5 1 6


Table 9.4.4: Low turnover bone disease vs high turnover bone disease by diabetes status, 1997-2012


iPTH<150 pg/ml & ALP <120

iPTH>300 & 600 pg/ml & ALP >150

iPTH>600 pg/ml & ALP >150

Diabetic Non Diabetic Diabetic Non Diabetic Diabetic Non Diabetic

n % % % % % %

1997 1381 13 36 1 8 0 41998 1218 14 43 0 5 0 21999 1898 12 33 1 11 0 52000 2648 14 35 1 7 0 42001 3291 15 36 1 6 0 42002 4072 17 33 1 7 0 42003 5006 17 29 1 8 1 72004 5863 19 28 1 8 0 62005 6897 20 27 2 8 1 52006 9009 20 24 2 8 1 52007 10587 19 23 2 8 1 52008 12361 19 21 3 6 1 42009 14466 18 20 3 6 1 52010 16269 20 22 3 6 1 42011 18451 20 22 3 6 1 42012 21087 16 18 4 7 2 5


Documents

CHAPTER 9 Chronic Kidney Disease – Mineral and Bone Disorder