Prevalence of Secondary Hyperparathyroidism in Adult Chronic Hemodialysis Patients in Somalia

Abstract Background: Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD). Aim: The exact prevalence of secondary hyperparathyroidism in chronic hemodialysis patients in Somalia is unknown. In this study, we aimed to determine the prevalence of SHPT in chronic hemodialysis patients in Mogadishu, Somalia. Method: This retrospective analysis was carried out at the Mogadishu Somali Turkey Training and Research Hospital, Somalia’s largest dialysis center. All hemodialysis patients aged 18 years and older from the last year were included. The research excluded parathyroidectomy patients and patients on steroids, phenytoin, or phenobarbitone. This analysis covered 195 patients. Calcium, phosphate, albumin, vitamin D, urea, creatinine, and other electrolytes were tested. Results: The mean age of the 195 patients was 56.0±17.4, with 49.2% males and 50.88% females. End-stage kidney disease (ESKD) was caused by hypertension in 64.1% of the patients and diabetes in 30.8%. The mean hemodialysis time was 7.8±1.3 hours per week, and the mean duration was 39.6±15 months. The mean intact parathyroid hormone (iPTH) concentration was 458.59±636.96 pg/mL, phosphate was 4.24±2.15 mg/dL, corrected calcium was 8.70±0.97 mg/dL, and calcium phosphate product was 36.60±19.78 mg/dL. The mean vitamin D concentration was 33.53±19.70. We found that the prevalence of secondary hyperparathyroidism was 65.6%. Conclusion: We conclude that there is a high prevalence of secondary hyperparathyroidism in chronic hemodialysis patients in Somalia and that measures that predict vitamin D response, including sestamibi parathyroid scans and gland volume, should be studied further to prevent this high prevalence.