Mineral Derangement and Bone Diseases in Uremic Patients on hemodialysis in Ibn-Sina Hemodialysis Center / Diyala

Abstract

Background: Chronic kidney disease is an international public health problem affecting 5–10% of the world population. As kidney function declines, there is a progressive deterioration in mineral homeostasis, with a disruption of normal serum and tissue concentrations of phosphorus and calcium, and changes in circulating levels of hormones. Objective: To determine the severity of bone and mineral disease in chronic renal failure and how efficiently controlled by drugs and hemodialysis procedure in Ibn sina dialysis center.

Patients and Methods: A case control study was carried out among 75 patients with chronic kidney disease (stage5) on regular hemodialysis in Ibn Sina dialysis center. Blood was taken before dialysis session and measurements of serum calcium, phosphorus, serum alkaline phosphatase, .protein and albumin levels, Serum parathyroid hormone and VIT D3   were determined.  and another group of 25 normal peoples from surrounding area.

Results: The mean parathyroid hormone level was 145.62pg/ml, with 57.33% having normal acceptable rang of parathormone level, 41% of patients having hyperparathyroidism and 1.33% having hypoparathyroidism. There was no significant correlation between serum PTH and dexa scan. Hypocalcemia was found in 52% of patients, 33% with hypercalcemia patients . There was a significant correlation found between Hypocalcemia and dexa scan results. Majority of patients had high serum phosphate levels (54.6%).and normal phosphate level in 40% while the hypophosphatemia result 5.33% and mean phosphate level is2.24 mmol/l.Total serum protein mean is 61.51 a 37.33% of them had hypoproteinemia and 62.66 %of them had normal serum protein. Also our results show 97, 33%of uremic patients have low vit D While 2.33% have normal level of serum vit D. There was a significant correlation between dexa scan and vit D level, calcium, alkaline phosphatase, female gender, smoking and body mass index.

Conclusion: The current study demonstrated that we can predict the chronic kidney diseases- Metabolic bone disorder from mineral scores before potentates the diagnosis by dexa scan.