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Article Type

Original Study

Abstract

Objective The aim of this study was to determine the prevalence of mineral bone disorders (MBDs) among hemodialysis (HD) patients in Menoufia Governorate. Background As kidney function declines, there is progressive deterioration in mineral homeostasis manifesting as disruption of serum and tissue concentrations of phosphorus and calcium (Ca), as well as changes in circulating levels of hormones such as parathyroid hormone (PTH). These mineral and endocrine functions are critically important in the regulation of both bone modeling and bone remodeling. Chronic kidney disease-MBD describes a broad clinical syndrome that develops as a systemic disorder of mineral and bone metabolism because of chronic kidney disease. Patients and methods This study was carried out on 100 patients with end-stage renal disease on regular HD in Menoufia Governorate. After obtaining informed consent, the included patients underwent the following examination: complete blood count, blood sugar level, lipid profile, blood urea level, serum creatinine level, albumin level, uric acid level, Ca level, phosphate level, alkaline phosphatase level, and PTH level. Results Hyperparathyroid bone disease was prevalent in 55% of the studied patients and low bone turnover in 30% of the studied patients, and both of the two groups showed highly significant association with serum Ca and phosphate levels. Suggestive MBD-related symptoms were prevalent in both high bone turnover and low bone turnover (60 and 70%, respectively). Hypocalcemia and hyperphosphatemia were observed in 64 and 74% of the studied patients, respectively. Conclusion The prevalence of MBD among the studied HD patients was 85% depending on abnormal PTH levels (55% of patients with high PTH level and 30% with low PTH levels). Most of patients with high PTH level (high bone turnover) had low serum Ca with high serum phosphorus levels (83.6 and 81.8%, respectively), whereas most of patients with low PTH levels (low bone turnover) had normal serum Ca with high serum phosphorus levels (60 and 63.3% respectively).

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