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Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are emerging as globally important public health problems, and will necessitate improvements in health-care policy. ESRD incidence/prevalence data are not available from large parts of the developing world. The main objective of this study is to describe and assess the current clinical practices for patients on maintenance haemodialysis (HD) living in the province of Tehran., Methods: In December 2005, an observational study was performed with 2630 patients (1505 males and 1125 females) from 56 different centres in the province of Tehran (the entire HD population), which has a population of 13.5 million inhabitants., Results: The prevalence/incidence of HD was 194.8/77.3 p.m.p. The leading causes of ESRD were diabetes and hypertension. Population of 90.3 and 9% received three and two sessions per week, respectively, with a KT/V mean value of 0.97+/-0.25. All centres used synthetic membranes, and 68% of the sessions were performed using bicarbonate as a buffer. The type of vascular access was autogenous arteriovenous fistula in 91% of patients. Our findings indicated that compliance with the K/DOQI recommendations for calcium-phosphorus management is difficult to achieve. Only 1.8% of patients achieved all four target laboratory tests. For the management of anaemia, ferritin was the most commonly performed measure of iron status (76.7%). Iron deficiency was seen in <20% of patients (ferritin

Introduction: Our aim was to evaluate the degree of achievement of the recommended values in National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI) guidelines for the laboratory indicators of bone metabolism in patients undergoing hemodialysis (HD) in Tehran province., Materials and Methods: We evaluated the laboratory information of 2630 HD patients in Tehran province. Demographic data of the patients and the clinical information including the duration of dialysis session, dialysate calcium concentration, Kt/V, and serum values of calcium, phosphorus, and intact parathyroid hormone (PTH) were recorded. The laboratory values were compared to the recommended ranges by the K/DOQI work group in patients with end-stage renal disease., Results: Only 1.8% of the patients could enjoy a successful management according to the K/DOQI recommendations for the 4 target laboratory tests of serum calcium, phosphorus, intact parathyroid hormone, and calcium-phosphorus product. Hypocalcemia was diagnosed in 33.2% of the patients, whereas 13.6% were diagnosed with hypercalcemia. Hypophosphatemia and secondary hyperparathyroidism were diagnosed in 6.8% and 24.2% of the patients, respectively., Conclusions: Our findings proved that complying with the recommendations established by the K/DOQI work group in the clinical management of mineral metabolism is very demanding. Phosphate binders frequently lead to untoward toxicities and imbalance in bone metabolism of patients on HD, warranting new cost-effective therapies with fewer side effects. It would be of great interest to analyze, in the future, the benefits derived from the effect of new therapies such as calcimimetics or new phosphate binders regarding the achievement of the K/DOQI guidelines.