Magnitude and patterns of biochemical mineral bone disease abnormalities among predialysis patients with CKD in TASH renal clinic, 2012 E.C.
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Date
2020-12
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Addis Abeba University
Abstract
Background:Mineral bone disease (MBD) abnormalities are common complications in patients
with kidney disease. MBD abnormalities in chronic kidney disease (CKD)patientsare referred to
as CKD-MBD; the abnormalities could be biochemical, structural changes of the bone, or both.
These abnormalities are known to be associated with increased morbidity and mortality. In spite
of their importance, there is limited data on CKD-MBD abnormalities in Ethiopia. This study
looked in to the magnitude and factors associated with biochemical CKD-MBD abnormalities
among predialysis CKD patients following in a single center in Ethiopia.
Objective:The major objective of the study is to determine the magnitude of biochemical
mineral bone disease abnormalities; namely, serum calcium, phosphorus and parathyroid
hormone levels. Additionally factors associated with these biochemical parameters and the
management practices are assessed.
Methods: This isa cross-sectional study. One hundred consecutive patients who havehad followup
for at least 6 months and eGFRless than 60ml/min/1.73m
2
using CKD- EPI equation were
included in this study. Serum calcium, albumin, phosphorusand PTHlevels weredetermined.
Demographic and clinical data were collected using a structured questionnaire.IBM SPSS
software version26 was used for analysis.
Results:The mean age of the patients was 54 with the range of 18 – 92. The male to female ratio
is 2.7:1. Patients with stages 3a, 3b, 4 and 5 CKD contributed to 23%, 29%, 26% and 22% of the
total respectively. The main causes of CKD were diabetes and hypertension. From the total of
100 patients 31% had hyperphosphatemia,36% hypocalcemia, and 89% had
hyperparathyroidism.Estimated GFR correlated negatively with serum PTHlevel but correlated
positively with serum calcium level.During a six month follow up period serum calcium and
phosphorus were determined at least once in 61% and 62% of patients while serum PTH level
wasdetermined in 15% of the patients. Among patients who require treatment according to
evidenced based guidelines directed to each biochemical CKD-MBD abnormalities, prescription
was given to30% patients for hyperphosphatemia, 38% for those with hypocalcemia, and45% for
patients with hyperparathyroidism.
Conclusion: Hypocalcemia, hyperparathyroidism, and hyperphosphatemia are common
biochemical CKD-MBD abnormalities among predialysis CKD patients following in the renal
clinic of TikurAnbessa specialized hospital, Addis Ababa, Ethiopia.
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Keywords
Biochemical mineral ,bone disease , predialysis patients