Christopher Lim Thiam Seong Liew Yew Fong Fuah Kar Wah Table 711 Phosphate Binder in HD patients 20122022 Year Number of patients Number of patients On CaCO 3 Number of ID: 1045128
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1. CHAPTER 7CHRONIC KIDNEY DISEASE - MINERAL AND BONE DISORDER IN DIALYSIS PATIENTSChristopher Lim Thiam SeongLiew Yew FongFuah Kar Wah
2. Table 7.1.1: Phosphate Binder in HD patients, 2012-2022YearNumber of patientsNumber of patients On CaCO3Number of patients on LanthanumNumber of patients on Sevelamer Number of Patients on Other Phosphate Binders n%n%n%n%20225040946392923051195741960202149829458989232411628314102020478354397092337115973145020194478040243906832146031620201841796375989067421194317102017402603719892694292921510201636505341079361325061500201533953315949380423591750201431353290599378322101190201328251262259372531070123020122480822954936423830980
3. Table 7.1.2: Phosphate Binder in PD patients, 2012-2022YearNumber of patients Number of patients On CaCO3Number of patients on LanthanumNumber of patients on Sevelamer Number of Patients on Other Phosphate Binders n%n%n%n%2022757964418566157281002021718261398563147976020206475534283581418612020195885504686691373620201853894667877413206302017502143018692227454020164564385084962170410201542353584851223932002014364431378611934013020133188274286109323120201228002393851014120181
4. Table 7.1.3: Phosphate Binders by Sector in HD patientsYearSectorCaCO3LanthanumSevelamer Other Phosphate Bindersn%n%n%n%2022Public929020752562232158 Private28084611565111005614272 NGO9017197424235123920 Total4639110030510019571001961002021Public9414219429501312518 Private271625916049919568661 NGO9310207022208133021 Total4588610032410016281001411002020Public95042211434453283423 Private251725716348910578659 NGO9287216018234152517 Total4396310033710015971001451002019Public92432317325424291710 Private2226455307458095511169 NGO87322220330227163421 Total4023910068310014601001621002018Public89412417726343291911 Private2017254294446525510461 NGO84832320330199174828 Total375961006741001194100171100
5. Table 7.1.3: Phosphate Binders by Sector in HD patients (cont.)YearSectorCaCO3LanthanumSevelamer Other Phosphate Bindersn%n%n%n%2017Public8833241862726328149 Private198985330644527578154 NGO84662320229139155637 Total371971006941009291001511002016Public80762419932121241020 Private180255324740325643162 NGO800623167276012918 Total34107100613100506100501002015Public74552424530742168 Private165275234843244684965 NGO7612242112641112027 Total31594100804100359100751002014 Public69952423230422015 Private146195032842147701474 NGO744526223282110421 Total29059100783100210100191002013Public664325220301918108 Private12527483214478738367 NGO705527184251093024 Total262251007251001071001231002012Public63242823637101299 Private10119442353765785455 NGO651128171278103536 Total229541006421008310098100
6. Table 7.2.1: Distribution of corrected serum calcium, HD patients 2012-2022YearNumber of patientsMeanSDMedianLQUQ% patients ≥2.1 & ≤2.37 mmol/L2022492012.20.22.22.12.3492021489952.20.22.22.12.3492020472192.20.22.22.12.4492019443912.20.22.22.12.4502018414932.20.22.22.12.4502017399682.20.22.22.12.3492016362992.20.22.22.12.3502015337862.20.22.22.12.3512014311502.20.22.22.12.4502013280462.20.22.22.12.4492012246212.20.22.22.12.451
7. Figure 7.2.1: Cumulative distribution of corrected serum calcium, HD patients 2012-2022
8. Table 7.2.2: Distribution of corrected serum calcium, PD patients 2012-2022YearNumber of patientsMeanSDMedianLQUQ%patients ≥2.1 & ≤2.37 mmol/L202272582.20.22.222.347202168242.20.22.222.345202061982.20.22.222.346201958282.20.22.22.12.347201853552.20.22.222.345201749882.20.22.222.345201645452.20.22.222.345201542152.20.22.222.344201436292.20.22.222.344201331642.20.22.222.446201227802.20.22.22.12.348
9. Figure 7.2.2: Cumulative distribution of corrected serum calcium, PD patients 2012-2022
10. Table 7.2.3: Distribution of serum phosphate, HD patients 2012-2022YearNumber of patientsmeanSDMedianLQUQ%patients <0.8 mmol/L%patients ≥0.8&<1.3mmol/L%patients≥1.3&<1.8mmol/L%patients≥1.8&<2.2mmol/L%patients≥2.2 mmol/L2022497291.80.51.81.42.11153726212021491541.80.51.81.52.11143727212020474031.80.51.81.52.11143826202019442201.80.51.71.42.11163827182018413381.80.51.71.42.11173826182017399611.80.51.71.421164025172016361951.80.51.71.421173827172015336781.70.51.71.421183925172014310471.70.51.71.422183924172013278801.70.51.71.42.12173924182012244511.80.51.71.42.1217392419
11. Figure 7.2.3: Cumulative distribution of serum phosphate, HD patients 2012-2022
12. Table 7.2.4: Distribution of serum phosphate, PD patients 2012-2022YearNumber of patientsmeanSDMedianLQUQ%patients <0.8 mmol/L%patients≥0.8&<1.3mmol/L%patients≥1.3&<1.8mmol/L%patients≥1.8&<2.2mmol/L%patients≥2.2 mmol/L202273431.70.51.61.32121412117202170321.70.51.71.32121382317202063731.70.51.61.32222392116201958021.70.51.61.32223402115201853481.70.51.61.32223392215201749811.70.51.61.32224392014201645371.60.51.61.31.9225401914201542041.60.51.61.31.9226411813201436211.60.51.61.31.9227401813201331491.60.51.51.21.9327411812201227731.60.51.51.21.9328391713
13. Figure 7.2.4: Cumulative distribution of serum phosphate, PD patients 2012-2022
14. Table 7.2.5: Distribution of corrected calcium x phosphate product, HD patients 2012-2022YearNumber of patientsmeanSDMedianLQUQPercent patients with calcium phosphate product:<3.5 mmol2/L2≥3.5 & <4.5 mmol2/L2≥4.5 & <5.5 mmol2/L2≥5.5 mmol2/L220224906841.23.83.14.73931191220214884941.23.93.24.83632191220204710441.23.93.14.7373319122019441873.91.23.83.14.7393219102018413023.91.23.83.14.6393218102017398753.91.23.83.14.6403317102016360983.91.23.834.641331792015336183.91.23.734.6423117102014309723.91.23.734.6423117102013278013.91.23.834.6403218102012243903.91.23.834.740311811
15. Figure 7.2.5: Cumulative distribution of corrected calcium x phosphate product, HD patients 2012-2022
16. Table 7.2.6: Distribution of corrected calcium x phosphate product, PD patients 2012-2022YearNumber ofpatientsmeanSDMedianLQUQPercent patients with calcium phosphate product:<3.5 mmol2/L2≥3.5 & <4.5 mmol2/L2≥4.5 & <5.5 mmol2/L2≥5.5 mmol2/L2202271993.71.23.52.84.44828159202167873.81.23.62.94.54630159202061573.71.23.62.94.44829159201957893.71.23.52.84.44928158201853423.61.23.52.84.45028148201749753.61.23.52.74.35128148201645283.61.23.42.74.25427127201541993.51.23.42.74.25527127201436143.51.23.42.74.25527127201331443.51.23.32.74.15626126201227713.51.23.32.74.25624127
17. Figure 7.2.6: Cumulative distribution of corrected calcium x phosphate product, PD patients 2012-2022
18. Table 7.2.7(a): Variation in corrected median serum calcium level among HD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax202284522.12.22.22.32.32.5202181222.12.22.22.32.32.420207771.52.12.22.22.32.32.4201975422.12.22.22.32.32.420187351.92.12.22.22.32.32.420177201.82.12.22.22.32.32.420166961.72.12.22.22.32.32.5201567222.12.22.22.32.32.520146421.92.12.22.22.32.32.6201360822.12.22.22.32.42.6201255222.12.22.22.32.42.6
19. Figure 7.2.7(a): Variation in median serum calcium level among HD patients, HD centres 2022
20. Table 7.2.7(b): Proportion of patients with serum calcium 2.1 to 2.37 mmol/L, HD centres, 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20228451033435056669120218121032424955659520207770344349556691201975473343505766822018735733434956679020177201032424956678820166965304450577083201567213324352586982201464214324450586992201360813314349576782201255216304350597389
21. Figure 7.2.7(b): Variation in proportion of patients with serum calcium 2.1 to 2.37mmol/L, HD centres 2022
22. Table 7.2.8(a): Variation in corrected median serum calcium level among PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20225022.12.12.22.22.32.3202146222.12.22.32.42.4202042222.12.22.32.42.42019391.922.22.22.32.32.4201840222.12.22.32.42.42017381.922.12.22.32.42.42016361.922.12.22.22.32.42015351.71.92.12.22.22.42.42014321.91.92.12.22.32.32.4201328222.12.22.32.42.42012272.12.12.22.22.32.32.4
23. Figure 7.2.8(a): Variation in median serum calcium level among PD patients, PD centres 2022
24. Table 7.2.8(b): Proportion of patients with serum calcium 2.1 to 2.37mmol/L, PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022502731404750586720214628293743.550606320204219293943.5515871201939212440465358602018401323354550.557.57320173811183545516161201636242537.54551.557582015351821354147555520143217233844.549.56061201328202735.54549.5565820122723303745525959
25. Figure 7.2.8(b): Variation in proportion of patients with serum calcium 2.1 to 2.37mmol/L, PD centres 2022
26. Table 7.2.9(a): Variation in median serum phosphate level among HD centres, 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20228481.31.51.61.81.922.420218171.31.51.71.81.92.12.320207801.21.51.71.81.92.12.320197541.31.51.61.71.922.220187361.21.51.61.71.822.220177210.61.51.61.71.822.320166961.21.51.61.71.822.320156721.21.51.61.71.822.420146411.31.51.61.71.822.420136041.21.51.61.71.822.620125511.11.51.61.71.822.4
27. Figure 7.2.9(a): Variation in median serum phosphate level among HD patients, HD centres 2022
28. Table 7.2.9(b): Proportion of patients with serum phosphate 1.13-1.78 mmol/L, HD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022848102637435060832021817132535425063932020780102637445164812019754926374552648920187361426374552648620177218283845546995201669613283845526488201567202939.54753648620146419263947546377201360492638.54754638820125516293946546593
29. Figure 7.2.9(b): Variation in proportion of patients with serum phosphate 1.13-1.78 mmol/L, HD centres 2022
30. Table 7.2.9(c): Proportion of patients with serum phosphate 0.8-1.3 mmol/L, HD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022848041015202950202181703813182754202078003913182856201975404914203045201873605101521327320177210410152132532016696041115213154201567204111622.53362201464105121723325320136040411162233582012551041016233262
31. Figure 7.2.9(c): Variation in proportion of patients with serum phosphate 0.8-1.3 mmol/L, HD centres 2022
32. Table 7.2.10(a): Variation in median serum phosphate level among PD centres, 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022491.41.51.61.71.822.12021471.41.51.61.71.81.91.92020431.41.51.61.71.8222019391.41.41.51.71.81.91.92018401.41.51.61.71.81.81.92017381.41.41.51.61.71.82.22016361.41.41.51.61.71.81.92015351.41.41.51.61.81.81.82014321.41.41.51.61.71.922013281.41.41.51.61.71.91.92012271.31.41.51.61.71.91.9
33. Figure 7.2.10(a): Variation in median serum phosphate level among PD patients, PD centres 2022
34. Table 7.2.10(b): Proportion of patients with serum phosphate 1.13-1.78 mmol/L, PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20224917334248546275202147263141465155562020431933414652575920193935374248526170201840293743.547.55569.58620173830304547.55461802016363233465055636420153517374452567377201432232645475661612013283639464954647720122732364349556169
35. Figure 7.2.10(b): Variation in proportion of patients with serum phosphate 1.13-1.78 mmol/L, PD centres 2022
36. Table 7.2.10(c): Proportion of patients with serum phosphate 0.8-1.3 mmol/L, PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20224956141924324320214704141924313820204308141926313820193900152028363620184008.513.5202536.53920173805192428333520163651016.523.52836432015350015253037382014322515222939422013280315.523.529.53436201227891324333846
37. Figure 7.2.10(c): Variation in proportion of patients with serum phosphate 0.8-1.3 mmol/L, PD centres 2022
38. Table 7.2.11(a): Variation in corrected median calcium x phosphate product HD centres, 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20228452.93.33.63.84.14.55.420218122.63.33.73.94.24.65.420207772.43.33.63.94.14.65.320197532.93.23.63.84.14.55.120187352.73.23.63.84.14.4520177192.73.23.63.844.55.220166962.13.23.53.844.4520156722.63.23.53.744.45.220146402.43.23.53.744.45.320136032.73.23.53.844.56.320125502.33.23.53.84.14.55.5
39. Figure 7.2.11(a): Variation in median corrected calcium x phosphate product among HD patients, HD centres 2022
40. Table 7.2.11(b): Proportion of patients with corrected calcium x phosphate <4.5 mmol2/L2, HD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022848102637435060832021817132535425063932020780102637445164812019754926374552648920187361426374552648620177218283845546995201669613283845526488201567202939.54753648620146419263947546377201360492638.54754638820125516293946546593
41. Figure 7.2.11(b): Variation in proportion of patients with corrected calcium x phosphate product <4.5 mmol2/L2, HD centres 2022
42. Table 7.2.12(a): Variation in corrected median calcium x phosphate product PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax2022492.83.13.43.63.84.24.72021463.23.33.43.63.94.34.32020423.13.33.43.63.84.44.72019392.933.33.53.94.34.420184033.23.43.63.744.12017382.933.33.53.744.42016362.82.93.23.43.744.22015352.933.13.33.74.14.42014322.933.33.53.94.34.52013283.13.13.23.53.744.22012272.82.93.23.53.844.4
43. Figure 7.2.12(a): Variation in median corrected calcium x phosphate product among PD patients, PD centres 2022
44. Table 7.2.12(b): Proportion of patients with corrected calcium x phosphate <4.5 mmol2/L2, PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20224917334248546275202147263141465155562020431933414652575920193935374248526170201840293743.547.55569.58620173830304547.55461802016363233465055636420153517374452567377201432232645475661612013283639464954647720122732364349556169
45. Figure 7.2.12(b): Variation in proportion of patients with corrected calcium x phosphate product <4.5 mmol2/L2, PD centres, 2022
46. Table 7.3.1(a): Treatment of hyperparathyroidism in HD patients, 2012-2022YearNumber ofpatientsNumber of Patients on calcitriolNumber of patients on ParicalcitolNumber of patients on CalcimimeticsNumber of Patients had Para-thyroidectomyn%n%n%n%202250409332356624002128441912021498293212064248020354231020204783531150653011199943771201944780250465623714581389120184179623382562040349134112017402602277857225125614081201636505206265720411050269120153395318619551781900243120143135316537532311510314120132825113764492101110316120122480811614472631202631
47. Table 7.3.1(b): Treatment of hyperparathyroidism in PD patients, 2012-2022YearNumber ofpatientsNumber of Patients on calcitriolNumber of patients on ParicalcitolNumber of patients on CalcimimeticsNumber of Patients had Para-thyroidectomyn%n%n%n%2022757934354540162238120217182339547301502180202064752882451012823512019588525564320801401201853892313432053124020175021207341504812812016456417073760281261201542351584378016022120143644133737503027120133188108734140101912012280010563831100241
48. Table 7.3.2(a): Distribution of iPTH, HD patients 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & <300 pg/ml≥300 & <500 pg/ml≥500pg/ml202244459165.121168.329.8217.46813910202143312164.4211.467.528.72196813109202041715177.9220.775.431.824466131011201938927181.7220.279.933.325364141011201835391185.5224.880.132.926364141111201734343201.5229.995.136.3301.160151213201628082206232.89736314.559151313201526353238.8242.314443.5372.651181516201423730231.3241.2134.740.535852181515201320680186.5216.789.73227462161211201218054235237.814642.9365.451181615
49. Figure 7.3.2(a): Cumulative distribution of iPTH, HD patients 2012-2022
50. Table 7.3.2(b): Distribution of iPTH, diabetic HD patients, 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & >300 pg/ml≥300 & >500 pg/ml≥500pg/ml202222390157.8201.36529.9206.56913108202122761155.9200.963.9292066913108202022590168.2210.270.131.9228.467131010201921594170207.47433235.66614109201819867172212.172.132.1239.866141110201719084190.5220.18635.328262151211201615233192.9222.484.734.629361141312201513865225.3230133.841.9349.452181614201412518216.3226.8125.83933053181513201310571169.4201.478.330.3246.3641611920129020214.9221129.939.933353191513
51. Figure 7.3.2(b): Cumulative distribution of iPTH, diabetic HD patients 2012-2022
52. Table 7.3.2(c): Distribution of iPTH, non-diabetic HD patients, 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & >300 pg/ml≥300 & >500 pg/ml≥500pg/ml202222069172.5220.17229.5228.96713911202120551173.9222.27228.4232.46713911202019125189.3231.983.331.7263.364141012201917333196.1234.489.633.7276.862151113201815524202.923992.934.3294.761141114201715259215.3240.8107.237.932358161215201612849221.5243.5112.538.1342.156161315201512488253.8254.5157.945.4400.449181518201411212248.1255.3147.842.739150171518201310109204.5230.2104.534.33095916131320129034255.1251.9163.946.8401.748181618
53. Figure 7.3.2(c): Cumulative distribution of iPTH, non-diabetic HD patients 2012-2022
54. Table 7.3.3(a): Distribution of iPTH, PD patients 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & >300 pg/ml≥300 & >500 pg/ml≥500pg/ml20225265175.320392.430.1251.7611911920214959194.9212.9115.936286.75719131020204488231.9225.5157.849.6350.84921171320194516235.9228.616550.53524822161320183967228.8221158.147.9337.84822171320173861221.3219.2153.448.73154924151220163541245.3224.318065.5357.54524171420153378225.9225.614448.8331.55121141420142860235.1218.716557.7347.34722171420132548189.3186.612749.7269.1552415720122197239.6215.9178.859.336545232013
55. Figure 7.3.3(a): Cumulative distribution of iPTH, PD patients 2012-2022
56. Table 7.3.3(b): Distribution of iPTH, diabetic PD patients, 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & >300 pg/ml≥300 & >500 pg/ml≥500pg/ml20222391153.4180.480.428.3216.2651910620212337181.3200.8104.433.7260.1592012820202183217210.1146.748.53225022161120192272208.2203.314247302.8522316920182011189.8188.1127.442280542315820171962188.3188.8133.144.3263.8542613820161821214.5198152.663302.24925161020151718190.9198.3117.942.6270562212920141429204.1192.714051301.2522316920131226162.9167.511043.1216.559269620121012192.7180.8131.951.4293.25324176
57. Figure 7.3.3(b): Cumulative distribution of iPTH, diabetic PD patients, 2012-2022
58. Table 7.3.3(c): Distribution of iPTH, non diabetic PD patients, 2012-2022YearNumber of PatientsMeanSDMedianLQUQPercent patients with iPTH:<150pg/ml≥150 & >300 pg/ml≥300 & >500 pg/ml≥500pg/ml20222874193.5218.4107.431.5278.75819121120212622207222.4122.837.2305.35519141220202305246.1238.416750.3375.34721171620192244263.9248.6191.855.5402.54421171820181956268.8243.9202.360.9418.34221191820171899255.3242.1182.1563834423171620161720277.9245213.670.8419.44122191920151660262.1245.7180.757412.34619161820141431266.1238195.765.9410.44320191820131322213.8199.7149.357.6328502119920121185279.7234.722674.1433.338222218
59. Figure 7.3.3(c): Cumulative distribution of iPTH, non diabetic PD patients, 2012-2022
60. Table 7.3.4(a): Variation in iPTH among HD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20228369.82640.959.2202.3373.6556.8202180312.726.239.957.1202353.8504.720207698.329.343.962.5221.9366.4622.8201973612.628.145.368.6219.6366.5564.820187157.8284465.6241.3381568201769411.430.646.785.8248.7387.6571.5201664216.229.547.7103.8249.4384.9544.5201562612.331.166.8178.3274393.8650.9201458411.729.456.5160.3264.1381.5538.820135178.321.543.989.1219.3373528.9201248310.630.467.4162.5256.8387.2569.4
61. Figure 7.3.4(a): Variation in median iPTH among HD patients, HD centres, 2022
62. Table 7.3.4(b): Variation in proportion of patients with iPTH 150-300pg/ml, HD centres, 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax202283600511203257202180300511203355202076900611203247201973600613213256201871500612213250201769400713223153201664200714223148201562600101724335620145840210172435502013517006142335702012483031118253554
63. Figure 7.3.4(b): Variation in proportion of patients with iPTH 150-300pg/ml, HD centres, 2022
64. Table 7.3.5(a): Variation in median iPTH among PD patients 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20224817.42044.8173.7223.7306.1451.620214713.52545.2183.7259.8346.141320204221.431.1102.5193242376.5430.720193915.734.695231.2298.6409.2445.320183420.431.9106207.5305.1393.542220173533.93597.8180287.1413503.420163438.662.6126.3207.8296.9396.5411.52015343740.7113.6199.1276442.4490.520142940.441.6114.2209.5283.5388.8406.320132637.442.180.1194245.832742120122634.845132244.4308.2426.5427.5
65. Figure 7.3.5(a): Variation in median iPTH among PD patients, PD centres, 2022
66. Table 7.3.5(b): Variation in proportion of patients with iPTH 150-300pg/ml, PD centres 2012-2022YearNumber of centresMin5th CentileLQMedianUQ95th CentileMax20224800722.534.54251202147031022293946202042001422273354201939051422283740201834061121.5283647201735441825333839201634491824283136201534081421283238201429061320263450201326351124.5323844201226191522.5263132
67. Figure 7.3.5(b): Variation in proportion of patients with iPTH 150-300pg/ml, PD centres 2022