Background: Elevated serum phosphorus is a common complication of end-stage renal disease (ESRD) and mainly affects hemodialysis (HD) patients. Hypophosphatemia contributes to secondary hyperparathyroidism, chronic kidney disease–mineral bone disorder (CKD-MBD), metastatic calcifications, and calcific uremic arteriolopathy. There is a significant association between hypophosphatemia and increased morbidity and mortality in ESRD patients, including cardiovascular morbidity and mortality; it is also associated with prolonged hospitalization of HD patients,

This study aimed to evaluate the serum phosphorus lowering effect of niacin in HD patients.

Results: There was a decrease in phosphate values during the first three months of the study in the niacin group, with a significant change in phosphate level in the third month (5.90 ± 0.52 vs. 6.42 ± 0.65 (mEq/l); P< 0.001) and at the sixth month (5.12 ± 0.41 vs. 5.76 ± 0.47 (mEq/l); P< 0.001) compared to the control group. It was noted that both groups had an insignificant difference regarding baseline parathormone (PTH), though the PTH showed a significantly lower level in the third month (192.39 ± 78.85 vs. 388.27 ± 263.10 pg/ml; P< 0.001) and at the sixth month (127.56 ± 90.87 vs. 249.85 ± 97.69 pg/ml; P< 0.001) in the niacin group.

Conclusion: Niacin caused a statistically significant decrease in levels of phosphate and PTH in dialysis patients. 

Esraa Rezk received her medical degree from Assiut School of Medicine, Egypt. She completed her residency and fellow training in internal medicine with a particular interest in nephrology at Malawi Specialized Hospital. Recently, she obtained a master’s degree in Nephrology at the Assiut University Hospital, Egypt.

She is a Senior Resident at Malawi Specialized Hospital, Division of Nephrology, Egypt. She has a Specialty Certificate form her workplace with multiple ongoing research studies.