Disturbances of bone and mineral metabolism in patients on hemodialysis

Abstract

Introduction: Unless promptly treated, disturbances of bone and mineral metabolism during the course of chronic kidney disease can lead to serious complications. These abnormalities as well as other factors related to the uremic state affect the skeleton and result in disruption of homeostasis in the bone and mineral turnover. It is manifested by abnormal concentration of phosphorus and calcium in serum and tissues and changes in the concentration of PTH. The spectrum of skeletal abnormalities seen in renal osteodystrophy includes: osteitis fibrosa, osteomalacia, adynamic bone disease (ABD), osteopenia or osteoporosis and combinations of these abnormalities termed mixed renal osteodystrophy. Aim of the study: The aim of our study was to assess biochemical parameters of mineral and bone metabolism in hemodialysis patients. Patients and Methods: The research involved 30 patients (retrospective type of study), mean age 62.43; fifteen men (50%) and fifteen women (50%). Patients were divided into groups in respect to the length of dialysis treatment (group I - up to 5 years, group II - 5-10 years and group III - over 10 years). Conclusion: Serum phosphorus, calcium, alkaline phosphatase and PTH values were increased with duration of dialysis. The most reliable marker for clinical monitoring of bone disease in dialysis patients is PTH, which correlates well with the values of alkaline phosphatase (p=0,006) and calcium (p=0,021).

Keywords

• mineral and bone metabolism
• pth
• calcium
• phosphorus
• hemodialysis