scholarly journals The Impact of Serum Magnesium Level Disorders on Parathyroid Hormone and Alkaline Phosphatase Levels in Patients with Chronic Kidney Disease Stage 5 under Maintenance Hemodialysis

2020 ◽  
Vol 5 (3) ◽  
pp. 1-8
Author(s):  
E.L. El-shehawy ◽  
S.B. Allah ◽  
A.T. Mahmoud ◽  
A.E. Mansour ◽  
O.M. Elsayed
PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253592
Author(s):  
Mayumi Ito ◽  
Makoto Yamaguchi ◽  
Takayuki Katsuno ◽  
Hironobu Nobata ◽  
Shiho Iwagaitsu ◽  
...  

Background Several studies have revealed the relationship between serum magnesium levels and vascular calcification in chronic kidney disease patients. Despite excellent predictability of abdominal aorta calcification for cardiovascular disease events, the relationship between serum magnesium levels and abdominal aorta calcification, as evaluated by quantitative methods, in pre-dialysis patients remains unclear. This study aimed to determine the abdominal aorta calcification volume using computerized tomography and its association with serum magnesium levels in pre-dialysis chronic kidney disease stage 5 patients. Methods This single-center cross-sectional study included 100 consecutive patients with pre-dialysis chronic kidney disease stage 5 between January 2016 and May 2020 at Aichi Medical University Hospital, Japan. The relationships between serum magnesium levels and the abdominal aorta calcification volume were assessed using multiple linear regression models after adjusting for clinically relevant factors. We also assessed clinical factors that affect serum magnesium levels. Results The mean serum magnesium level was 2.0 mg/dL (interquartile range, 1.8 to 2.3). Multivariate analyses revealed that a higher serum magnesium level (stand. β = -0.245, p = 0.010) was significantly associated with a reduced abdominal aorta calcification volume, and that a history of cardiovascular disease (stand. β = 0.3792, p < 0.001) and older age (stand. β = 0.278, p = 0.007) were significantly associated with an increased abdominal aorta calcification volume. Moreover, multivariate analysis showed that the use of proton pump inhibitor or potassium-competitive acid blocker was significantly associated with lower serum magnesium levels (stand. β = -0.246, p = 0.019). Conclusions The present study revealed that the higher Mg level was significantly associated with lower volume of abdominal aorta calcification in pre-dialysis chronic kidney disease stage 5 patients. Further studies should be undertaken to determine the appropriate magnesium level to suppress vascular calcification.


2019 ◽  
Vol 25 ◽  
pp. 107602961989662
Author(s):  
Aleksander Druck ◽  
Dimpi Patel ◽  
Vinod Bansal ◽  
Debra Hoppensteadt ◽  
Jawed Fareed

Chronic kidney disease stage 5 (CKD5) marks the fifth stage of renal failure, frequently causing dysregulation of bone and mineral metabolism. Challenges exist in evaluating and managing chronic kidney disease–mineral bone disorder (CKD-MBD) with the standard panel of biomarkers. Our objective was to profile osteopontin (OPN) in patients with CKD5 on maintenance hemodialysis (CKD5-HD) and elucidate its relationship to phosphorus (P), calcium (Ca2+), alkaline phosphatase (AP), and intact parathyroid hormone (iPTH) to improve understanding of the present model of CKD-MBD. Elevation of plasma OPN was seen in the CKD5-HD cohort (n = 92; median: 240.25 ng/mL, interquartile range [IQR]: 169.85 ng/mL) compared to a normal group (n = 49; median: 63.30 ng/mL, IQR: 19.20 ng/mL; p < .0001). Spearman correlation tests revealed significant positive correlations of OPN with iPTH ( p < .0001; r = 0.561, 95% confidence interval = 0.397-0.690) and OPN with AP ( p < .0001; r = 0.444, 95% confidence interval = 0.245-0.590) in CKD5-HD patients. Ultimately, OPN may play an integral role in the MBD axis, suggesting that it may be important to actively monitor OPN when managing CKD5-HD.


2019 ◽  
Vol 8 (2) ◽  
pp. 51-54
Author(s):  
Laxman Prasad Adhikary ◽  
Aarjan Khanal

Background: Secondary hyperparathyroidism is present in majority of patients with estimated glomerular filtrate rate less than 60 mL/min/1.73 m2. Sustained elevated parathyroid hormone level can cause osteitis-fibrosa-cystica, fracture, hypercalcemia, hyperphosphatemia, and calciphylaxis. Kidney Disease Improving Global Outcome guidelines for Chronic Kidney Disease Mineral and Bone Disorder 2017 recommends treatment with calcitriol or vitamin D analogue if parathyroid hormone level is progressively increasing and remains persistently above the upper limit despite correction of modifiable factors. Objectives: The objective of this study was to determine the mean change in intact parathyroid hormone aftercalcitriol supplementation in patients with chronic kidney disease (stage 3 to 5). Methodology: This prospective observational study enrolled 92 patients with chronic kidney disease stage 3 to 5, not under maintenance hemodialysis. Patients who had intact parathyroid hormone level more than 200 pg/ml, serum phosphate level less than 4.5 mg/dl and corrected serum calcium less than 9.5 mg/dl were selected for the study. They were supplemented with oral calcitriol 0.25μg thrice weekly for three months and intact parathyroid hormone level was measured after three months. Results: Mean intact parathyroid hormone level before supplementation was 332.91 ± 96.046pg/ml and after three months of supplementation with calcitriol was 176.49 ±53.764pg/ml. This finding was statistically significant (Correlation: 0.471, p-value less than 0.05). Thus, supplementation of calcitriol reduced the mean intact parathyroid hormone level in the chronic kidney disease patients in our study. Conclusion: Calcitriol supplementation seems to be an effective measure to reduce intact parathyroid hormone level in chronic kidney disease patients when it remains persistently high despite correction of modifiable factors.


2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Medhyka S.A. Kawilarang ◽  
Arthur E. Mongan ◽  
Maya Memah

Abstract: Magnesium is a metal, one of the eight most abundant element in universe. Magnesium also is a mineral that responsible for bone metabolism control, neural transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor, and blood pressure. In chronic kidney disease stage 4-5, compensation mechanism become inadequate that caused a hypermagnesemia. Objectives: This study aimed to know the picture of magnesium serum in non dialysis CKD stage 5 in Manado. Material Methods: This is a descriptive study, conducted by selecting 35 blood samples in Nephrology-Hypertension Polyclinic and IRINA of Interna of Prof. Dr. R.D Kandou Hospital and Teling Adventist Hospital. Result: There are 16 samples (45.7%) experience hypomagnesemia consisted of 8 home-care patient (22.9%) and 8 hospital-care patient (22.9%), 10 samples (28.6%) are in normal range consisted of 3 home-care patient (8.6%) and 7 hospital-care patient (20.0%), and 9 samples (25.7%) are experience hypermagnesemia consisted of 6 home-care patient (17.1%) and 3 hospital-care patient (8.6%) from total non dialysis CKD stage 5 samples result from laboratory examination. Conclusion: Patient with hypomagnesemia most frekuent than patient with hypermagnesemia.Keywords: magnesium, chronic kidney disease, non dialysisAbstrak: Magnesium merupakan logam yang masuk dalam delapan elemen paling melimpah di alam semesta. Magnesium juga merupakan mineral yang bertanggung jawab dalam pengaturan metabolisme tulang, transmisi saraf, eksitabilitas jantung, konduksi neuromuskular, kontraksi muscular, vasomotor, dan tekanan darah. Pada penyakit ginjal kronik stadium 4-5 mekanisme kompensasi ginjal menjadi inadekuat sehingga dapat menghasilkan hipermagnesemia. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran kadar serum magnesium pada pasien PGK non dialisis stadium 5 di Manado. Metode Penelitian: Penelitian ini adalah penelitian yang bersifat deskriptif yang dilaksanakan dengan cara mengambil sampel darah di Poliklinik Nefrologi-Hipertensi dan IRINA bagian Penyakit Dalam RSUP Prof. DR. R. D. Kandou Manado dan RS Advent Teling sebanyak 35 sampel. Hasil: Tercatat 16 orang yang mengalami hipomagnesemia (45,7%) diantaranya 8 orang pasien rawat jalan (22,9%) dan 8 orang pasien rawat inap (22,9%), 10 orang dalam batas nilai normal (28,6%) diantaranya 3 orang pasien rawat jalan (8,6%) dan 7 orang pasien rawat inap (20,0%), serta 9 orang mengalami hipermagnesemia (25,7%) diantaranya 6 orang pasien rawat jalan (17,1%) dan 3 orang pasien rawat inap (8,6%) dari total jumlah pasien terdiagnosis dokter PGK stadium 5 non dialisis yang didapatkan dari hasil pemeriksaan laboratorium. Simpulan: Frekuensi pasien yang mengalami hipomagnesemia lebih banyak dibandingkan pasien hipermagnesemiaKata kunci: magnesium, penyakit ginjal kronik, non dialisis


2016 ◽  
Vol 27 (2) ◽  
pp. 233 ◽  
Author(s):  
Manal Abdel-Salam ◽  
ManalMohamed Zaher ◽  
Ragaa Abdel-Salam ◽  
Randa Sabour ◽  
AmalAbd El-Aleem Morsy ◽  
...  

2020 ◽  
Vol 28 (1) ◽  
pp. 54-59
Author(s):  
Rafiqul Hasan ◽  
Md Nizamuddin Chowdhury ◽  
Md Nazrul Islam ◽  
Parvez Iftekher Ahmed ◽  
ASM Tanim Anwar ◽  
...  

Background: Pruritus is a common manifestation in patients on hemodialysis. The aim of this study is to determine the distribution of pruritus and evaluate the association between pruritus and serum parathormone levels in chronic kidney disease patients on maintenance haemodialysis. Methods:This analytic, descriptive, cross-sectional study was performed over 191 patients of maintenance haemodialysis in 2014. Information related to the patients including age, gender, residence, pruritus was extracted from questionnaires. Serum levels of intact parathormone were measured & data were analyzed. Results: 68% of the patients had pruritus. The Mean ± SD of serum parathormone was 53.25±7.96 pg/ml in patients with pruritus and 81.91±9.34 pg/ml in patients without pruritus. Our study showed that most patients with pruritus had normal serum parathormone levels and no significant association was found between pruritus and serum parathormone levels. Conclusion: serum parathormone level may not play a role in uraemic pruritus in these patients. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 54-59


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