Investigation in serum minerals and bone disorder in patients with chronic kidney disease at stages 5 and 5D

  Objective  To compare the serum minerals and bone disorder (MBD) between patients with chronic kidney disease (CKD) at stages 5 and 5D.

  Methods  Clinical data of 240 patients with end-stage renal disease were retrospectively analyzed. According to the condition of hemodialysis, the patients were divided into CKD5 group (treated without dialysis) and CKD5D group (treated with dialysis). The related indexes of serum minerals and bone disorder (serum calcium, phosphorus, whole parathyroid hormone, alkaline phosphatase, etc.) were compared between two groups, and the standard-reaching rates of serum calcium, phosphorus and parathyroid hormone were evaluated.

  Results  The levels of serum intact parathyroid hormone (iPTH), corrected serum calcium, calcium-phosphorus product and serum albumin in the CDK5D group were significantly higher than those in the CKD5 group, and the estimated glomerular filtration rate (eGFR) was significantly lower than that in the CKD5 group (P < 0.01). The incidence rates of hyperphosphatemia, hypocalcemia, hypercalcemia and high parathyroid hormone in the CKD5 and CDK5D groups were 83.75% and 91.25%, 31.25% and 17.50%, 1.88% and 30.00%, 37.50% and 63.75%, respectively.

  Conclusion  Patients with end-stage renal disease are accompanied by severe abnormalities of calcium, phosphorus and parathyroid hormone. Patients with CKD at stage 5 are characterized by high phosphorus, low calcium and high parathyroid hormone. The CKD-MBD status of patients with CKD at 5D stage do not improve due to hemodialysis, but become more serious, which are characterized by high levels of phosphorus, calcium and parathyroid hormone.