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Scholars Academic Journal of Biosciences | Volume-4 | Issue-12
“Clinical pattern of bone mineral derangements, if any (High bone turnover disease/ Low bone turnover disease) in CKD Patients undergoing Haemodialysis”
Babita Bansal, Dr. Sushila Gahlot, Dr. Deepak Kumar Agrawal, Dr. Ishwerdeep singh
Published: Dec. 30, 2016 |
272
174
DOI: 10.36347/sajb.2016.v04i12.007
Pages: 1101-1108
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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 bo