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Nephrourol Mon. 2014 Jan 20;6(1):e14944. doi: 10.5812/numonthly.14944. eCollection 2014 Jan.

Bone mineral metabolism and subsequent hospitalization with poor quality of life in dialysis patients.

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Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Department of Nephrology, Tehran University of Medical Sciences, Tehran, IR Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.



Significant impairment in health-related quality of life (HRQOL) among dialysis patients could be partly explained by some co-morbid disorders, such as chronic kidney disease-mineral and bone disorder (CKD-MBD). Also disturbance in calcium and phosphorus metabolism would increase mortality and morbidity. Therefore, further efforts to treat these abnormalities may improve the survival.


We designed a large multicenter population-based study in Iran to describe and assess the relation between HRQOL, hospitalization, and bone metabolism markers.


We enrolled a total of 5820 dialysis patients from 132 dialysis centers in different parts of the country whom were volunteers to cooperate between October 2010 and August 2011. The Iranian adapted version of the Kidney disease quality of life-short form (KDQOL-SF(TM)) version 1.3 questionnaire was used to assess the health related quality of life. The clinical and demographic characteristics were gathered from patients' data files.


The mean (SD) age of patients was 54.88 (16.36) years, and the range was 2 to 99 years. Of all patients, 43.1% were female. The scores of kidney disease component summary (KDCS), physical component summary, mental component summary, and total quality of life were significantly higher in the lower quartile of corrected serum calcium and higher quartile of serum parathyroid hormone (PTH) levels (P < 0.05). In a regression analysis of multilevel data, while corrected serum calcium level was associated with total KDCS and short form health survey (SF-36) scores after adjusting for other variables, hospitalization was directly correlated with serum phosphorus level and had reverse correlation with dialysis duration and quality of life.


In the current study, quality of life was correlated with serum calcium level, calcium-phosphate product, and serum PTH level, while hospitalization was correlated only with serum phosphorus level. However, quality of life was inversely correlated with hospitalization.


Bone Density; Calcium; Phosphate; Quality of Life; Renal Dialysis

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