Prevalence of Mineral Bone Disorders in Chronic Kidney Disease Patients
DOI:
https://doi.org/10.48165/z6qt2f73Keywords:
CKD, MBD, Hyperparathyroidism, Hyperphosphatemia, HypocalcemiaAbstract
Background: Chronic kidney disease (CKD) is a progressive loss in renal function which involves in deterioration in mineral homeostasis with disruption of normal serum and tissue concentration of phosphorus and calcium. Also changes in circulating levels of hormones parathyroid hormone (PTH), calcitriol (1,25(OH)2 D), and fibroblast growth factor-23 (FGF-23). Here our aim is to study the prevalence of markers associated with MBD in CKD stage 3-5 patients. Patients with CKD stage 3-5 were included in this observational study with all necessary parameter. X-RAY abdomen and echocardiography was done to look for evidence of vascular and valvular calcification respectively. Statistical analysis was done using SPSS software. A total of 170 patients (128 males, 42 females) (M:F = 3:1) were included in this study with a mean age of 50.54 years. Among CKD stages 3 to 5, the prevalence of hypocalcemia was 22.2%, 33.3% & 48.9%, hyperphosphatemia was 11.1%, 25.5% & 63%, hyperparathyroidism was 48.1%, 67.3% & 89.1%, high total alkaline phosphatase was 0%, 5.9% & 45.7% , low 25-OH-vit D was 59.2%, 70.6% & 79.4% respectively. Low 25 (OH) D levels, hyperparathyroidism, and hyperphosphatemia were the noticeable markers of CKD-MBD in our patients. Mineral bone disorder are common in CKD patients which start in early CKD stages & worsen with disease progression that causes morbidity and decreased quality of life.
References
1. Eknoyan G, Lameire N, Barsoum R, Eckardt KU, Levin A, Levin N, Locatelli F, Macleod A, Vanholder R, Walker R, Wang H. The burden of kidney disease: improving global outcomes. Kidney international 2004 ;66(4):1310-4.
2. Banerjee S, Ghosh B, Brojen T, Singh N, Singh S, Sharma OP, et
al.The high prevalence of chronic kidney disease-mineral bone disorders: a hospital-based cross-sectional study. Indian J Nephrol 2012; 22: 285–291.
3. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002; 39 (Suppl 1):S1–S266.
4. Martin KJ, Gonzalez EA. Strategies to minimize bone disease in renal failure. Am J Kidney Dis 2001; 38:1430–1436.
5. Agarwal SK. Assessment of renal bone mineral disorder in naïve CKD patients: A single center prospective study. Indian J Nephrol 2007;17:96.
6. Sakuja V, Jha V, Ghosh AK, Ahmed S, Saha TK. Chronic renal failure in India. Nephrol Dial Transplant 1994; 9:871-2.
7. B. Ghosh, T. Brojen. The high prevalence of chronic kidney disease mineral bone disorders: A hospital based cross sectional study. Indian Journal of Nephrology 2012; 22 : 285-291.
8. Nissenson AR, Pereira BJ, Collins AJ, Steinberg EP. Prevalence and characteristics of individuals with chronic kidney disease in a large health maintenance organization. Am J Kid Dis 2001;37:1177‑83.
9. Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant 2005;20:1638‑42.
10. LaClair RE, Hellman RN, Karp SL, Kraus M, Ofner S, Li Q, et al. Prevalence of calcidiol deficiency in CKD: A cross‑sectional study across latitudes in the United States. Am J Kidney Dis 2005; 45:1026‑33.
11. Jabbar Z, Aggarwal PK, Chandel N, Khandelwal N, Sakhuja V, Jha V. Noninvasive assessment of bone mineral status in indian CKD population‑ a cross‑sectional study. Indian J Nephrol 2007; 17:93.
12. Levin A, Bakris GL, Molitch M, Smulders M, Tian J, Williams LA, Andress DL. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney international. 2007; 71(1):31-8.
13. Shantha GP, Kumar AA, Mancha A, Christopher M, Koshi R, Abraham G. Is abdominal aortic calcification score a cost‑effective screening tool to predict atherosclerotic carotid plaque and cardiac valvular calcification in patients with end‑stage renal disease. Indian J Nephrol 2012; 22: 431‑7.
14. Valson AT, Sundaram M, David VG, Deborah MN, Varughese S, Basu G, Mohapatra A, Alexander S, Jose J, Roshan J, Simon B. Profile of incident chronic kidney disease related-mineral bone disorders in chronic kidney disease Stage 4 and 5: A hospital based cross-sectional survey. Indian journal of nephrology. 2014; 24(2):97.
15. Leskinen Y, Paana T, Saha H, Groundstroem K, Lehtimäki T, Kilpinen S, et al. Valvular calcification and its relationship to atherosclerosis in chronic kidney disease. J Heart Valve Dis 2009;18: 429‑38.
