EVALUATION OF THE EFFECTS OF BIOCHEMICAL MARKERS LIKE CALCIUM, PHOSPHORUS AND PARATHORMONE IN PREDICTING THE COMPLICATIONS & MORTALITY IN CHRONIC KIDNEY DISEASE

Abstract

Introduction: Chronic kidney disease (CKD) is an international public health problem affecting about 5–10% of the population. As kidney function declines, there is a progressive deterioration in mineral homeostasis with disruption of normal serum concentrations of phosphorus, calcium and changes in circulating levels of hormones like parathyroid hormone (PTH) and Vitamin D₃.

Hyperparathyroidism plays a vital role in the excess morbidity and mortality in chronic kidney disease. As a result; patients are at increased risk of bone disease, extraosseous calcification, and death.

Aims and Objectives: To estimate the serum Calcium, Phosphorus, Parathyroid Hormone levels in patients with CKD and to compare them with healthy individuals. To know the association between Calcium, phosphorus and PTH in CKD patients.

Material & Methods: 50 cases of CKD and 50 controls were included in the study. Serum calcium, phosphorus and PTH were measured in both cases and controls.

Statistically significant increases in levels of all parameters were seen in cases as compared to controls.

Conclusion: The levels of PTH, calcium & phosphorus are used as surrogate markers of disease progression. Abnormalities can occur subtly, usually without any symptoms, and may progress to cause more complications if not detected early. The ultimate goals of treating secondary hyperparathyroidism are to normalize mineral metabolism, prevent bone disease, and prevent extra skeletal manifestations of the altered biochemical processes.

Various CKD Guidelines recommend targets and early treatment strategies to correct serum levels of phosphorus, calcium, and PTH levels.

Keywords: CKD – Chronic kidney disease, PTH – Parathyroid hormone, ESRD – End stage renal disease, Glomerular filtration rate -GFR