Changing Spectrum of Mineral Bone Disorder in Chronic kidney disease stage 3 to 5 D and Its Associated Factors, A Prospective Cross-Sectional Study from Tertiary Care Hospital in Northern India

Authors

  • Suman Sethi Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author
  • Nitin Sethi Plastic and Cosmetic surgery, Fortis Hospital, Ludhiana, India Author
  • Jasvinder Singh Sandhu Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author
  • Vikas Makkar Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author
  • Simran Kaur Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author
  • Preet M Sohal Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author
  • Sudhir Mehta Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India Author

Abstract

Introduction. Mineral bone disease is an important complication of chronic kidney disease ends up in increased cardiovascular morbidity and mortality in these patients. The aim of present study was to determine the pattern, prevalence and the clinical, biochemical and radiological profile of mineral bone disease in predialysis and dialysis (stage 5D) patients of chronic kidney disease. Methods. Patients of stage 3, 4, 5 and 5D of chronic kidney disease admitted to the department of nephrology were enrolled in this study. Results. 200 patients of chronic kidney disease (19, 29, 43 and 109 cases of stage 3, 4, 5 and 5D respectively) with mean age of 52.4 ± 16.7 years and male to female ratio of 2.4:1 were enrolled. Diabetic nephropathy (45%), hypertensive nephropathy (33%), and chronic glomerulonephritis (14.5%) were the most common etiologies of chronic kidney disease. Proximal muscle weakness (91.5%) bone pain (59.5%) and pruritus (25.5%) were the common symptoms. Biochemical parameters showed hypercalcemia (19%), hypocalcaemia (55%), hyperphosphatemia (75.5%) and vitamin D deficiency in 84.5% of cases. High turnover bone disease was present in all predialysis and only 7% of dialysis patients. Adynamic bone disease was observed in 92.7% of dialysis patients. On univariate analysis i-PTH was significantly associated with sex, eGFR, serum calcium, and 25(OH) vit-D level and no association was found with age and FGF-23 levels. Conclusion. Adynamic bone disease has emerged as the most common form of CKD-MBD in dialysis patients and secondary hyperparathyroidism being common in the predialysis patients of chronic kidney disease. Hyperphosphatemia and vitamin D deficiency were the most common reported biochemical abnormalities.

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Author Biographies

  • Suman Sethi, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India
    Assitant Professor, Department of Nephrology, Dayanand Medical College and Hospital
  • Nitin Sethi, Plastic and Cosmetic surgery, Fortis Hospital, Ludhiana, India
    Additional Director, Plastic and Cosmetic surgery, Fortis Hospital, Ludhiana, India 
  • Jasvinder Singh Sandhu, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India

    f

    Pro    Professor, Ex HOD

            Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India

  • Vikas Makkar, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India

    PrProfessor and Head

          Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India

  • Simran Kaur, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India
    Assitant Professor, Department of Nephrology, Dayanand Medical College and Hospital
  • Preet M Sohal, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India
    Assitant Professor, Department of Nephrology, Dayanand Medical College and Hospital
  • Sudhir Mehta, Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India
    DM Resident, Department of Nephrology, Dayanand Medical College and Hospital

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Published

2021-05-15

Issue

Section

ORIGINAL | Dialysis

How to Cite

Changing Spectrum of Mineral Bone Disorder in Chronic kidney disease stage 3 to 5 D and Its Associated Factors, A Prospective Cross-Sectional Study from Tertiary Care Hospital in Northern India. (2021). Iranian Journal of Kidney Diseases, 15(3), 199-205. https://ijkd.org/index.php/ijkd/article/view/5725