“Alterations in Parathormone, Calcium and Phosphorus Levels in CKD Patients on Maintenance Haemodialysis in a Hospital Setting in PUNJAB.” (original) (raw)
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Journal of Research in Clinical Medicine
Introduction: Chronic kidney disease (CKD) and subsequent end-stage renal disease (ESRD) are public health problems worldwide, and their prevalence is increasing worldwide. Abnormalities in calcium and phosphorus are common problems that need to be considered alongside other important factors when choosing a dialysis method. Hence, the present study aimed to assess and compare the calcium and phosphorus homeostasis in ESRD patients on hemodialysis and peritoneal dialysis (PD). Methods: In this descriptive cross-sectional study, 150 patients with ESRD on hemodialysis and 150 patients with ESRD on PD in the dialysis department of Imam Reza hospital of Tabriz University were selected randomly. The serum levels of calcium, phosphorus, and intact parathyroid hormone (iPTH) before the initiation of dialysis and one year afterward were considered for comparison. Results: In the hemodialysis group, 33.1% of patients were female and 66.9% were male but in the PD group, sex distribution was 4...
2021
Background: Chronic kidney disease (CKD) is considered the popular disorder throughout the world. It associates with abnormalities of mineral metabolism such as calcium, phosphorus and parathyroid hormone. Objectives: The study aimed to evaluate the alteration of serum levels of Ca, Ph, and PTH in hemodialysis patients in in Zawia Kidney Center, Western Libya, and determining the relationship of age with the levels of these parameters. Subjects and Methods: One hundred subjects were included in the present study. Out of which 50 cases were dialysis patients collecting from AZ-Zawia kidney center and 50 subjects were health individuals used as control divided into male and female, mean age was 47.03±14.14 years. Five ml of venous blood was collected from each participant for estimating the serum levels of PTH, Ca, and Ph. Results: The result showed that the level of PTH was higher than normal, where the mean level of PTH in dialysis patients was 421.64±391.30 and 44.59 ± 12.32 pg/ml ...
Serum Calcium, Phosphorous, and Parathyroid Hormone in Sudanese Patients under Regular Haemodialysis
2013
Background Secondary hyperparathyroidism (SHPT) is an important complication of end-stage renal disease. Bone disease, a well-recognized complication of SHPT, represents only a small concern in light of the evidence that correlates SHPT with cardiovascular disease and an increased risk of morbidity and mortality in patients with CKD. Identifying patients at risk and evaluating for SHPT is imperative because early intervention may slow or arrest the progression of both bone and cardiac disease. Dietary concerns, pharmacotherapy, and patient adherence are all important considerations in creating a successful treatment plan. Aims To evaluate serum calcium, phosphorus and parathyroid hormone concentrations in hemodialyzed renal failure patients. Materials and Methods The study involved a control group of apparently healthy (N = 50) matched for age with a test group of hemodialyzed renal failure patients (N = 50). The age range of both groups was 25-65 years. Calcium, phosphorus and para...
Journal of Nephrology, 2014
Background Whether the traditional treatment of chronic kidney disease (CKD)-mineral and bone disorder is effective in the setting of tertiary nephrology care is an unexplored question. We evaluated phosphate, calcium and PTH levels during the first year of nephrology care and the prognostic role of month-12 levels in non-dialysis patients referred prior to availability of the novel P binders. Methods We studied a historical cohort of consecutive patients with CKD stage 3-5 at referral (baseline), and after 6 and 12 months of nephrology care; thereafter, patients were followed for renal survival (time to death or end-stage renal disease). Results At month 12, versus baseline, we detected a larger implementation of dietary protein restriction (P = 0.001), vitamin D and P binder (P \ 0.0001 for both). Mean serum P remained unchanged (4.02 ± 0.77, 4.01 ± 0.79, 4.10 ± 0.85 mg/dL at baseline, month 6 and 12, respectively) with only 18, 16 and 21 % patients showing uncontrolled serum P at the three study visits. Similarly, calcium levels were unchanged and within the target in most cases. Conversely, intact PTH increased from 102 pg/mL (interquartile range 67-139) to 113 (68-179), P = 0.015, with 59, 60 and 53 % patients showing high values at the three study visits. During the subsequent follow-up (31 months), 96 renal deaths occurred. Cox analysis evidenced a significant prognostic role of the interaction P 9 PTH (P = 0.002), that is, the risk of renal death associated with serum P increased in the presence of higher PTH. Conclusions In patients under nephrology care, P and PTH should be considered in concert to optimize risk stratification for renal death.
Therapeutic Apheresis and Dialysis, 2008
Disturbances in bone mineral metabolism are common in chronic hemodialysis (HD) patients and often underlie morbid conditions and mortality; however, no large epidemiological study for Asian dialysis patients has been performed. We analyzed the database of the Japanese Society for Dialysis Therapy registry. In this study, data from patients who were on HD at the end of 2000 was compiled. The Cox's proportional hazard analysis was carried out to evaluate the significance of the impact of variables related to bone mineral metabolism on survival after adjusting for possible confounding variables. The study period was three years, and a cohort of 27 404 HD patients was studied. The hazard ratios were 1.098 (P = 0.0129) for serum calcium levels ranging 10.0-10.9 mg/ dL, and 1.243 (P = 0.0001) for serum calcium levels >11.0 mg/dL when the reference serum calcium level range was 9.0-9.9 mg/dL. Similarly, the hazard ratios were significantly higher in a serum phosphorous level of 5.0 mg/dL than for the reference serum phosphorous level range of 4.0-4.9 mg/dL. For intact parathyroid hormone (iPTH), the hazard ratios were significantly small (<119 pg/mL) when the reference iPTH level range was 180-359 pg/mL. However, the hazard ratio did not increase when the iPTH level increased to >360 pg/mL. Results showed that disturbances in bone mineral metabolism, such as those involving serum calcium, phosphorous, and iPTH, have a significant impact on survival in Japanese dialysis patients.
Nephrology Dialysis Transplantation, 2013
Background. Establishing an optimal dialysate calcium (DCa) concentration in haemodialysis patients is crucial. DCa individualization has been advocated but most dialysis centres use a fixed DCa, preferably 1.25 mmol/L in the USA and 1.5 mmol/L in European countries. The aim of the study was to assess the short-term biological impact of individual DCa prescription aiming at maintaining normal serum calcium and serum parathyroid hormone (PTH) between 150 and 300 pg/mL. Methods. Between January 2008 and December 2010, all prevalent patients were checked for the need for DCa change according to our usual strategy. Baseline (T0) and after 3 months (T3), values were compared for serum calcium, phosphate, total alkaline phosphatases (t-ALP) and PTH. Results. Seventy-eight patients were followed up for analysis with only one DCa change. Vitamin D derivatives, oral calcium and cinacalcet doses remained stable. Increasing DCa from 1.25 to 1.5 mmol/L and from 1.5 to 1.75 mmol/L led to a significant increase of calcaemia (+2.2 and +1.7%) and a decrease of phosphataemia (−7 and −9%), t-ALP (−10 and −12%) and PTH (−50 and −62%). Decreasing DCa from 1.75 to 1.5 mmol/L and from 1.5 to 1.25 mmol/L led to a decrease of calcaemia (−2.5 and −1.7%) and an increase of phosphataemia (+11 and +12%), t-ALP (+12 and +10%) and PTH (+138 and +175%). Conclusions. DCa individualization has a significant impact on mineral metabolism parameters, especially on serum PTH levels, and could be considered as an additional therapy in a more global strategy together with phosphate binder, vitamin D and calcimimetics prescription.
Parathyroid gland function in dialysis patients
Journal of Parathyroid Disease, 2015
Parathyroid disorder, is a common consequence of end-stage kidney disease (ESRD) and maintenance dialysis patient. This article, aims to investigate parathyroid disorders consisting symptoms, signs, laboratory findings, prevention and its treatment in dialysis patients. Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, and Web of Science has been searched. Secondary hyperparathyroidism is one of disorders in minerals metabolism in ESRD patients, resulted from calcium reduction in blood due to a decrease in synthesis of active vitamin D, acidosis, and an increase in blood phosphorus, and also 1-alpha-hydroxylase deficiency that can cause bone demineralization as well as renal osteodystrophy with symptoms such as bone pain and fractures, and even vessels and soft-tissue calcification which can affect duration of hospitalization, hospital costs and length and quality of life. The findings show that with accurate measurement of serum level of laboratory values of alkaline phosphatase, calcium, and phosphorous monthly, and parathormone every six months, training the dialysis patients, recommending a diet with low phosphorous and appropriated use of phosphate binding agents will improve the outcome of hemodialysis patients.
Universal Journal of Pharmaceutical Research
The control of phosphorus and calcium metabolism is one of the objectives in treatment protocol for CKD patients. The levels of these minerals in serum are affected by dietary patterns and nutritional status of the patients. India being a large country, diet patterns vary from one state to another. Thus, we suspect a close association between dietary intake and alterations in homeostasis of calcium and phosphorus in CKD patients. Therefore, we conduct this study to describe the effect of dietary factors and nutritional status on serum calcium and phosphorus levels in CKD patients on treatment in a tertiary care setting in North India. In the present study 330 CKD patients coming to dialysis unit, were recorded with detailed Medical history as well as baseline demographic data. Also, biochemical analysis of serum albumin corrected, calcium, phosphorus, and serum albumin of all cases were done using fully automated equipment. All statistical analyses were performed using SPSS statisti...