“Clinical pattern of bone mineral derangements, if any (High bone turnover disease/ Low bone turnover disease) in CKD Patients undergoing Haemodialysis”
Journal Title: Scholars Academic Journal of Biosciences - Year 2016, Vol 4, Issue 12
Abstract
Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in haemodialysis patients associated with high morbidity and mortality. CKD-MBD, the new terminology used for Renal Osteodystrophy and Renal bone disease (KDIGO).In clinical practice, bone biopsy is used infrequently to detect MBD in CKD, because it is an invasive and often expensive procedure and the samples obtained require specialized processing that is not widely available. Instead iPTH levels can be highly sensitive and it is one of the useful noninvasive biochemical parameters to detect MBD in CKD. Therefore, the present study was carried out to detect Pattern of CKD-MBD by non-invasive biochemical method of serum intact parathyroid hormone (iPTH) estimation in CKD patients who have been on haemodialysis for ≥ 5 months.This study was a cross-sectional observational study. The study population of 330 patients (>18 years) on maintenance haemodialysis coming to Dialysis Unit of Department of Medicine over a period of three years were enrolled in the study. Each patient was considered only once for the study. Also biochemical analysis of serum iPTH, corrected calcium, phosphorus and tALP, of all cases were done using fully automated equipments.Patients were divided into three groups ie. High Bone Turn Over (PTH value > 300pg/ml), Low Bone Turn Over (PTH value < 100pg/ml) and a group with apparently Normal Bone (based on 100-300 pg/ml intact PTH values).All statistical analyses were performed using SPSS statistical software, version 17.Chi square, ANOVA with Post-Hoc Tukey HSD and Coefficient tests were used. The control of CKD-MBD was assessed in the backdrop of the KDIGO guidelines.In the present study Nineteen patients were complained with bone pain and almost five patients were had bone fracture. MBD presents itself in three forms in CKD patients undergoing Haemodialysis in the present study. In clinical pattern most common MBD was found in the present study High bone turn over (40.3%) followed by low bone turn over (33.5 %,iPTH<100 pg/mL) and normal bone turn over (26.2%).There were statistically significant association of serum iPTH, with Corrected Ca and P (p = 0.032 and p = 0.035, respectively) observed. The results of the present study revealed that bone pain was significantly associated with iPTH levels.(χ2 =6.631 and P=0.036).The pattern of CKD-MBD is dominated by high bone turn-over disease in our centre. We have also demonstrated that disorders of mineral metabolism are associated with short-term effects, such as hospital admissions and muscle- and skin and bone complaints. Short of a bone biopsy, biochemical tests such as an intact PTH can be used to evaluate bone disease because markedly high or low values do predict underlying bone turnover.Controlling PTH levels prevents damage to bones. PTH levels should be evaluated regularly in haemodialysis patients and awareness regarding PTH abnormalities should be there among the treating physicians also. Keywords:Haemodialysis, High bone turn over, Low bone turn over, Parathyroid hormone, Bone-Mineral disorders.
Authors and Affiliations
Babita Bansal, Dr. Sushila Gahlot, Dr. Deepak Kumar Agrawal,, Dr. Ishwerdeep singh
Keywords
Related Articles
- EP ID EP372502
- DOI -
- Views 79
- Downloads 0
Addition to the host range of Sclerotinia sclerotiorum in West Bengal
Abstract: During survey in the month of January, 2015 Sclerotinia sclerotiorum (Lib.) de Bary has been recorded first time in West Bengal (India), on five plants which include one vegetable (Daucus carota L.), two orname...
Biochemical and Immunochemical Status of Patients Receiving Herbal Treatment in Some Traditional Herbal Homes in Rural Nigeria
Herbal treatment is currently attracting more patronage due to the effectiveness and low cost of treatments. Many herbs contains phytochemicals of health benefits. Some traditional ways of administering herbal treatments...
A Preliminary Assessment of Physico-Chemical and Bacteriological Characteristics of Lake Edward and Majors Tributaries Rivers, Democratic Republic of Congo
The physico-chemical and bacteriological parameters commonly used to determine water quality of lakes and rivers in tropical areas indicate declining trend of water quality, unsuitable for the growth of higher aquatic sp...
Analysis of Iron and Lipid Profiles in Indian Male Acute Myocardial Infarction Patients
Body iron contributes to pathogenesis of coronary artery disease (CAD) through formation of free radicals by Fenton and Haber-Weiss reactions. Free radicals cause lipid peroxidation leading to formation of atheroscleroti...
Clinico-Etiological Co-relation between Clinical and Radiological Findings Vs Autopsy Findings in Road Traffic Accidents: A Large Study from Eastern India
RTA (road traffic accident) is the third major preventable cause of all deaths. The aim was to study the discrepancies between the clinico–radiological findings and autopsy findings in alleged history of RTA. It was a re...