Prevalence of CKD-MBD in pre-dialysis patients using biochemical markers in Enugu, South-East Nigeria

Okoye, J.; Arodiwe, Ejikeme; Ulasi, Ifeoma; Ijoma, CK; Onodugo, Obinna

doi:10.4314/ahs.v15i3.31

Cited by 16 publications

(22 citation statements)

References 22 publications

(23 reference statements)

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“…Similar to the present study, Okoye et al [8] concluded that the prevalence of various mineral bone disease abnormalities was 70% of hyperphosphatemia and 85% of hyper-parathyroidism among the patients. Vhora et al [21] reported hyperparathyroidism in 95% of CKD patients.…”

Section: Alterations In Biochemical Profile: Mbd Among Ckd Patients Usupporting

confidence: 78%

“…These are closely inter-related and together make major contribution to morbidity and mortality of patients with CKD receiving dialysis [8]. The KDIGO [5] for bone metabolism and disease in CKD (USA) recommend that, in stage 5 CKD, the target levels for calcium (Ca) (corrected for serum albumin), phosphorus (P), calcium × phosphorus (Ca × P) product, and PTH levels should be maintained at 8.5-10.5 mg/dl, 2.5-4.5 mg/dl, <55 mg…”

Section: Introductionmentioning

confidence: 99%

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“Alterations in Parathormone, Calcium and Phosphorus Levels in CKD Patients on Maintenance Haemodialysis in a Hospital Setting in Punjab.”

Bansal

Gahlot

Prasher

et al. 2017

Asian J Pharm Clin Res

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Objective: Many people who have severe chronic kidney disease (CKD) will eventually develop kidney failure and will require dialysis. The control of parathormone (PTH), phosphorus, and calcium metabolism is one of the objectives in an adequate dialysis protocol. Therefore, we conducted this study to describe alterations in PTH, calcium, and phosphorous homeostasis in patients with CKD on hemodialysis in our center. Our study also aimed to find an association between hormonal and biochemical abnormalities in CKD patients, who have been on hemodialysis for ≥5 months and comparing the results obtained with that recommended by Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Methods:This was a hospital-based cross-sectional observational study. The study population of 330 patients (>18 years) on maintenance hemodialysis coming to dialysis Unit of Department of Medicine of Gian Sagar Hospital, Ramnagar (Patiala), over a period of 3 years (2012)(2013)(2014)(2015), were enrolled in the study. Each patient was considered only once for the study. In addition, biochemical analysis of serum intact PTH (iPTH), corrected calcium, phosphorus, total alkaline phosphatase (tALP), serum creatinine, blood urea, serum albumin, and hemoglobin of all cases was done using fully automated equipment. All statistical analyses were performed using SPSS statistical software, version 17. Results:The study population of 330 patients comprised adults, mainly illiterate (54.5%) predominantly belonging to the rural (66.4%) strata with a mean age of 52.67±15.05 (range: 25-98 years). The abnormality in the laboratory profile of the patients was found to be hyperparathyroidism in 40.3% as compared to hypoparathyroidism in 33.5% and normal iPTH levels in 26.2%. Hypocalcaemia was detected in 50.6% and hyperphosphatemia in 62.1% of the patients. There was statistically significant association of serum iPTH, with corrected calcium and phosphorus (P=0.032 and P=0.035, respectively). Corrected calcium was also significantly associated with phosphorus (P=0.001) and tALP (P=0.007). Conclusion:We showed in the present study that disorders of mineral metabolism are common in hemodialysis patients and that only a small proportion adheres to the targets as advised in the KDIGO guidelines for bone metabolism and disease in CKD. We demonstrated that these disorders are associated with important negative clinical outcomes, such as increased all-cause lack survival, more muscle and bone problems. Our findings, therefore, support a strict control of mineral metabolism in dialysis patients. Further research and progress in this area are required to establish a more rational approach with a view toward improving patient outcomes.

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Section: Alterations In Biochemical Profile: Mbd Among Ckd Patients Usupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

“Alterations in Parathormone, Calcium and Phosphorus Levels in CKD Patients on Maintenance Haemodialysis in a Hospital Setting in Punjab.”

Bansal

Gahlot

Prasher

et al. 2017

Asian J Pharm Clin Res

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show abstract

“…2 Initially, transient retention of phosphorus, due to failing kidney, results decreased activity of renal 1-a hydroxylase in proximal tubule with decreased calcitriol (1,25 OH2 vitamin D) synthesis there by probably due to its prevalence in general population or due to different factors related to CKD has predisposed low vitamin D level with its greater incidence in CKD compared to healthy control. [6][7][8] Apart from calcitrophic effects, vitamin D has multiple beneficial effects in the body and h y p o v i t a m i n o s i s D r e s u l t s i n i n c r e a s e d cardiovascular mortality in CKD as vitamin D supplementation in these patients had decreased cardiovascular risk with increased survival. 6,9,10 Prevalence of hypovitaminosis D in 73.7% healthy Nepalese population and 89.1% patients with different health related problem were reported.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Serum Vitamin D, Calcium and Phosphorus in Chronic Kidney Disease

Rajbhandari

Agrawal

Baral

et al. 2017

Med. J. Shree Birendra Hosp.

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h y p o c a l c a e m i a a n d c o m p e n s a t o r y hyperparathyroidism. But with advancing disease, the compensatory mechanism can no more maintain the mineral homeostasis and biochemical a b n o r m a l i t i e s l i k e h y p e r p h o s p h a t e m i a , hypocalcaemia and hyperparathyroidism become obvious at stage 4 CKD. 3,4 Besides, decreased kidney function, lack of adequate storage of vitamin D (25, OH vitamin D / calcidiol) is responsible for decreased calcitriol synthesis and its consequences in CKD. 5 Studies have shown vitamin D deficiencies (20-29 ng/ml) and insufficiency (<20 ng/ml) in CKD, both in pre dialysis and maintenance hemodialysis patients, MJSBH Vol 16 Issue 1 Jan-June 2017 30ABSTRACT Introduction: Abnormalities in mineral metabolism are invariable with progressive deterioration of kidney function in chronic kidney disease (CKD). These abnormalities are documented in CKD on dialysis in our population but not on pre dialysis. So, present study aims to estimate serum vitamin D, calcium and phosphorus in CKD stage 3-5ND. Methods: It was a cross sectional study of established new CKD patients not on dialysis, vitamin D, calcium, phosphate binders and corticosteroids therapy. Blood sample was drawn for estimation of serum vitamin D, creatinine, calcium, phosphorus and albumin and CKD staging done by KDIGO (2012) criteria. SPSS software version 19 was used for data analysis and chi-squared and ANOVA test was applied as the test of significance. Results: Sixty six (51 male and 15 female) CKD patients with a mean age of 54.3±14.8 years were studied. Hypovitaminosis D (<30 ng/ml) was present in 84.8%, with deficiency (<20 ng/ml) in 50% and insufficiency (20-30) ng/ml in 34.8%. Other abnormalities observed were hypocalcemia (60.6%), hypercalcemia (1.5%) and hyperphosphatemia (63.6%) with no difference of corrected calcium, significant difference of serum phosphorus (p<0.001) with hyperphosphatemia in stage 4 and 5 CKD and vitamin D insufficiency in stage 3b, deficiency in stage 3a, 4 and 5 CKD. There was no correlation of serum vitamin D with calcium and phosphorus in different stages of CKD. Conclusion: Present study concludes that hypovitaminosis D, hypocalcemia and hyperphosphatemia is common in our pre-dialysis CKD patients and serum phosphorus raises more with reduction of GFR.

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“…The raised alkaline phosphatase (AP) could not be attributed to CHC but to CKD. For the most part, patients with CKD have AP in the nonpathological ranges with higher than normal means [12]. In our study, this equation was disrupted by the two cases of multiple myeloma, which raised the mean significantly.…”

Section: Discussionmentioning

confidence: 63%

Treatment Outcomes for Patients Undergoing Hemodialysis with Chronic Hepatitis C on the Sofosbuvir and Daclatasvir Regimen

Butt

Abbasi

Khan

et al. 2019

Cureus

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BackgroundHepatitis C (HCV) infection is the most commonly acquired infection for patients on hemodialysis and is associated with significant morbidity and disease progression. Direct-acting antivirals (DAAs) have revolutionized the management of HCV. However, limited data exist regarding their efficacy in end-stage renal disease (ESRD), especially for patients on dialysis in South Asia.AimsTo evaluate the treatment outcomes of patients undergoing hemodialysis with chronic hepatitis C (CHC) on the sofosbuvir (SOF) and daclatasvir (DAC) regimen.Materials and methodsAll patients who were 18 years or older, diagnosed cases of chronic kidney disease (stage V), and undergoing maintenance hemodialysis were inducted into this study. Active HCV infection was demonstrated by polymerase chain reaction (PCR) HCV ribonucleic acid (RNA) (qualitative). All patients were then treated with a double regimen of SOF (400 mg once daily) and DAC (60 mg once daily) taken per oral for 12 weeks. Response to treatment was assessed at four, 12, and 52 weeks.ResultsA total of 31 out of 80 patients were inducted into the study over two years. The prevalence of HCV in hemodialysis patients was 38.75%. Sustained virological response (SVR) was achieved by 27 (87.09%) patients at one year. Four (12.90%) patients had a relapse of HCV. There was no deterioration of hepatological status in any of the patients. Overall survival at one year was 93.54%.ConclusionHCV is highly prevalent in patients undergoing hemodialysis. Prompt treatment with SOF and DAC demonstrates a good response, with negligible side effects.

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Prevalence of CKD-MBD in pre-dialysis patients using biochemical markers in Enugu, South-East Nigeria

Cited by 16 publications

References 22 publications

“Alterations in Parathormone, Calcium and Phosphorus Levels in CKD Patients on Maintenance Haemodialysis in a Hospital Setting in Punjab.”

“Alterations in Parathormone, Calcium and Phosphorus Levels in CKD Patients on Maintenance Haemodialysis in a Hospital Setting in Punjab.”

Estimation of Serum Vitamin D, Calcium and Phosphorus in Chronic Kidney Disease

Treatment Outcomes for Patients Undergoing Hemodialysis with Chronic Hepatitis C on the Sofosbuvir and Daclatasvir Regimen

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