Effect of Hemodialysis on Serum Phosphate Levels in Patients with End-Stage Renal Disease: A Quasi-Experimental Study at Sir Ganga Ram Hospital, Lahore

Hemodialysis on Serum Phosphate Levels in Patients with End-Stage Renal Disease

Abstract

Hyperphosphatemia is a common complication in patients with end-stage renal disease (ESRD). Hemodialysis remains the primary mode of phosphate elimination; however, the impact of demographic and clinical factors on individual patients' clearance is still being studied. Objective: To determine the mean change in serum phosphate levels before and after a single session of hemodialysis in patients with ESRD. Methods: This quasi-experimental study included 115 adult patients undergoing maintenance hemodialysis three times a week at the Department of Nephrology, Sir Ganga Ram Hospital, Lahore, between February and July 2025, and were recruited. Serum phosphate concentration was measured at the beginning and end of the dialysis session. The statistical analysis was performed using SPSS version 26.0, with significance set at p<0.050. Results: Among the 115 patients (mean age, 46.5 years), a statistically significant decrease in mean serum phosphate levels from 5.44 ± 1.71 mmol/L to 2.53 ± 0.98 mmol/L was observed as a result of hemodialysis. Multivariate regression supported the view that the model explained 77.3% of the variance in phosphate reduction (R² = 0.773, p<0.001), with pre-dialysis levels being the only significant independent predictor (β = -0.892, p<0.001). There was no statistically significant influence of age, gender, or BMI on the magnitude of reduction (p>0.050). Conclusions: A single maintenance hemodialysis session significantly reduced serum phosphate levels in patients with ESRD. Although reductions were observed across all demographic variables, the magnitude of reduction did not differ significantly between these groups.