DOI: https://doi.org/10.36347/sasjm.2026.v12i04.013

Pages: 304-312

Background: Chronic kidney disease-mineral and bone disorder (CKD-MBD) and secondary hyperparathyroidism (SHPT) are common complications of non-dialysis chronic kidney disease (CKD) and generally become more pronounced as kidney function declines. This study aimed to describe stage-stratified patterns of intact parathyroid hormone (iPTH), phosphate, and albumin-corrected calcium in a hospital-based CKD cohort. Methods: We conducted a retrospective single-center laboratory-based study at the Clinical Biochemistry Laboratory of Arrazi Hospital, CHU Mohammed VI, Marrakech, Morocco, between January and December 2025. We included 150 non-dialysis patients with eGFR <60 mL/min/1.73 m² (CKD stages G3a–G5) and retained one index sample per patient. Eligible patients had concurrent measurements of iPTH, total calcium, albumin, phosphate, and creatinine. Corrected calcium was calculated as total calcium (mg/L) + 0.8 × (40 − albumin [g/L]), and eGFR was estimated using the CKD-EPI 2021 equation. Stage comparisons were performed with non-parametric tests, and correlations were assessed using Spearman's rho. Results: The median age was 46.50 years (IQR 33.25–63.75), and 54.0% of patients were male. Median eGFR was 12.24 mL/min/1.73 m² (IQR 6.26–31.93), indicating a cohort largely composed of advanced CKD, with G5 accounting for 56.0% of cases. Median iPTH was 269.00 pg/mL (IQR 159.25–612.25), corrected calcium was 86.71 mg/L (IQR 82.85–89.63), and phosphate was 46.00 mg/L (IQR 37.00–58.00). Hyperphosphatemia (>45 mg/L) was present in 52.7% of patients, and corrected-calcium-defined hypocalcemia (<85 mg/L) in 38.7%. Across CKD stages, iPTH and phosphate increased significantly, whereas corrected calcium declined modestly. Median iPTH rose from 144.00 pg/mL in G3a to 448.50 pg/mL in G5 (p < 0.0001), while hyperphosphatemia increased from 11.8% to 70.2% (p < 0.0001). iPTH correlated inversely with eGFR (rho = -0.545; p < 0.001). Conclusion: In this predominantly advanced non-dialys