The COMPARISON OF VASCULAR CALCIFICATION AND MINERAL BONE DISEASE IN NON-DIALYSIS (CKD4/5ND) VS DIALYSIS DEPENDENT (CKD5D) PATIENTS
DOI:
https://doi.org/10.55519/JAMC-01-9399Abstract
Background: Chronic kidney disease (CKD) has been a highly prevalent medical condition in all parts of the world affecting the haemostasis of the body in number of ways. Epidemiological data suggest that no region of the world has been spared from this condition and both developing and developed countries equally share the burden of this disease. Objective was to compare the vascular calcification and mineral bone disease in non-dialysis vs dialysis patients suffering from chronic kidney disease at a tertiary care hospital of Pakistan. It is a Comparative study, conducted at the Department of nephrology Pak Emirates Military Hospital Rawalpindi. Four months from November 2020 to February 2021. Methods: A total of 310 cases were included in the study, which were diagnosed as chronic kidney disease in nephrology department by a consultant nephrologist on basis of National Kidney Foundation/Kidney Disease Outcome Quality Initiative (NKF/KDOQI) 2002. They were divided into two equal groups by block randomization. Group I had the patients who were not dependent on dialysis (CKD4/5ND) while group II had dialysis dependent patients. Abdominal aorta, mitral and tricuspid valves were assessed to look for vascular calcification. Calcium, phosphate and parathyroid hormone levels were done to assess the mineral bone profile. Results: Out of 310 patients, 192 (61.9%) patients were males and 118 (38.1%) were females. 98 (31.6%) had evidence of vascular calcification while 212 (68.4%) did not have vascular calcification. 147 (47.4%) had hypocalcaemia, 167 (53.8%) had hyperphosphatemia while 98 (31.6%) patients had raised Parathyroid hormone levels. Regression analysis revealed that vascular calcification and abnormal mineral bone profile was significantly present more among patients who were dependent on dialysis (p-value<0.05). Conclusion: Bone mineral disease and vascular calcification were consistent findings among patients suffering from chronic kidney disease. Patients who were dependent on dialysis were more prone to develop these complications as compared to those who were not dependent on dialysis.References
Fraser SD, Blakeman T. Chronic kidney disease: identification and management in primary care. Pragmat Obs Res 2016;7:21–32.
O'Callaghan-Gordo C, Shivashankar R, Anand S, Ghosh S, Glaser J, Gupta R, et al. Prevalence of and risk factors for chronic kidney disease of unknown aetiology in India: secondary data analysis of three population-based cross-sectional studies. BMJ Open 2019;9(3):e023353.
Ruwanpathirana T, Senanayake S, Gunawardana N, Munasinghe A, Ginige S, Gamage D, et al. Prevalence and risk factors for impaired kidney function in the district of Anuradhapura, Sri Lanka: a cross-sectional population-representative survey in those at risk of chronic kidney disease of unknown aetiology. BMC Public Health 2019;19(1):763.
Grill AK, Brimble S. Approach to the detection and management of chronic kidney disease: What primary care providers need to know. Can Fam Physician 2018;64(10):728–35.
Aoun M, Karam R, Sleilaty G, Antoun L, Ammar W. Iron deficiency across chronic kidney disease stages: Is there a reverse gender pattern? PLoS One 2018;13(1):e0191541.
Pazianas M, Miller PD. Current Understanding of Mineral and Bone Disorders of Chronic Kidney Disease and the Scientific Grounds on the Use of Exogenous Parathyroid Hormone in Its Management. J Bone Metab 2020;27(1):1–13.
Iseri K, Dai L, Chen Z, Qureshi AR, Brismar TB, Stenvinkel P, et al. Bone mineral density and mortality in end-stage renal disease patients. Clin Kidney J 2020;13(3):307–21.
Peeters MJ, van den Brand JA, van Zuilen AD, Koster Y, Bots ML, Vervloet MG, et al. Abdominal aortic calcification in patients with CKD. J Nephrol 2017;30(1):109–18.
Xiong J, He T, Wang M, Nie L, Zhang Y, Wang Y, et al. Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis. J Nephrol 2019;32(5):791–802.
Janjua TK, Mukhtar KN, Naveed AK, Ahmed EB, Rehan M. Frequency of maintenance hemodialysis patients meeting K/DOQI criteria for serum calcium, phosphorus, calcium phosphorus product and PTH levels; a single institutional experience from Pakistan: a cross sectional study. Pan Afr Med J 2019;33(1):183.
Zhou Y, Hellberg M, Kouidi E, Deligiannis A, Höglund P, Clyne N. Relationships between abdominal aortic calcification, glomerular filtration rate, and cardiovascular risk factors in patients with non-dialysis dependent chronic kidney disease. Clin Nephrol 2018;90(6):380–9.
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1–266.
Tariq S, Lone KP, Tariq S. Comparison of parameters of bone profile and homocysteine in physically active and non-active postmenopausal females. Pak J Med Sci 2016;32(5):1263–7.
Kauppila LI, Polak JF, Cupples LA, Hannan MT, Kiel DP, Wilson PW. New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis 1997;132(2):245–50.
Slouma M, Sahli H, Bahlous A, Laadhar L, Smaoui W, Rekik S, et al. Mineral bone disorder and osteoporosis in hemodialysis patients. Adv Rheumatol 2020;60(15):1693.
Brandenburg VM, Schuh A, Kramann R. Valvular Calcification in Chronic Kidney Disease. Adv Chronic Kidney Dis 2019;26(6):464–71.
Hsu CY, Chen LR, Chen KH. Osteoporosis in Patients with Chronic Kidney Diseases: A Systemic Review. Int J Mol Sci 2020;21(18):6846.
Reiss AB, Miyawaki N, Moon J, Kasselman LJ, Voloshyna I, D'Avino R Jr. et al. CKD, arterial calcification, atherosclerosis and bone health: Inter-relationships and controversies. Atherosclerosis 2018;278(3):49–59.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
