scholarly journals Outcome of supplementation of vitamin D on intact parathyroid hormone level in chronic kidney disease patients

2019 ◽  
Vol 8 (2) ◽  
pp. 51-54
Author(s):  
Laxman Prasad Adhikary ◽  
Aarjan Khanal
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Hormone Level ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Intact Parathyroid Hormone ◽  
Parathyroid Hormone Level ◽  
Modifiable Factors ◽  
The Mean

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.

scholarly journals Osteopontin Levels in Patients With Chronic Kidney Disease Stage 5 on Hemodialysis Directly Correlate With Intact Parathyroid Hormone and Alkaline Phosphatase

2019 ◽  
Vol 25 ◽  
pp. 107602961989662
Author(s):  
Aleksander Druck ◽  
Dimpi Patel ◽  
Vinod Bansal ◽  
Debra Hoppensteadt ◽  
Jawed Fareed
Keyword(s):  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Mineral Metabolism ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
Intact Parathyroid Hormone

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.

Renal Osteodystrophy due to Secondary Hyperparathyroidism in a Cat

2021 ◽  
Author(s):  
Sara Elizabeth Gonzalez ◽  
Ira G. Roth ◽  
Chad W. Schmiedt ◽  
Michelle H. Patrick ◽  
Alison G. Meindl
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Hormone Level ◽  
Health Assessment ◽  
Clinical Manifestations ◽  
Parathyroid Hormone Level ◽  
Creatinine Concentration ◽  
Normal Limits

A 6 yr old neutered male mixed-breed cat presented for renal transplantation (RTx) for chronic kidney disease. Severe periodontal disease was identified, and before initiation of immunosuppressive therapy, a comprehensive oral health assessment and treatment procedure was performed to reduce the burden of existing oral infection. Dental radiography revealed diffuse, severe bone demineralization across the mandible and maxilla, with thinning of the cortices. Nasal turbinates were easily visualized owing to the decreased opacity of maxillary bone. Generalized bone resorption left teeth to appear minimally attached. A Vitamin D panel revealed a severely elevated parathyroid hormone level. Full mouth extractions were performed. Seven days following this procedure, RTx was performed. Serum creatinine concentration was within normal limits by 48 hr after surgery and remained normal until discharge 12 days after RTx. At 3.5 mo after RTx, the cat was mildly azotemic, and the parathyroid hormone level was elevated but significantly decreased from the original measurement. Secondary hyperparathyroidism is a common abnormality in cats with chronic kidney disease. However, clinical manifestations of hyperparathyroidism are rare in this species. This is a novel presentation of a cat demonstrating bone loss in the oral cavity as a result of renal secondary hyperparathyroidism.

scholarly journals Intact Parathyroid Hormone Level in Different Stages of Chronic Kidney Disease

2011 ◽  
Vol 17 (Number 2) ◽  
pp. 9-14
Author(s):  
N Y Mili ◽  
R Begum ◽  
Md. E Hoque ◽  
Q S Akhter
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Hormone Level ◽  
Stage Iv ◽  
Control Group ◽  
Parathyroid Hormone Level ◽  
Intact Pth ◽  
Three Stages ◽  
Pth Level

Secondary hyperparathyroidism is the first and most recognizable complication of chronic kidney disease (CKD) because parathyroid hormone (PTH) plays a compensatory role to maintain calcium and phosphate homeostasis. Progressive renal failure give rise to a steady increase in parathyroid hormone concentration. which is related to occurrence of renal bone disease. The objective of this study was to find out the httact parathyroid hormone level in different stages of chronic kidney disease patients. This cross sectional study was carried ow in the department of physiology. Dhaka Medical College from January to December 2009. 100 chronic kidney disease patients aged 20 to 60 years were selected as experimental group and 20 apparently healthy subjects were in control group and were matched for age and body weight. Patients were divided into three stages based on their creatinine clearance rate (Ccr). Group B, includes 34 patients marked as stage 11 with Ccr 60-89 ml/min, Group Ba Group B3 consists of 36 and 30 patients each and marked as stage 111 and stage IV with Ccr 30-59 mIhnin and 15-29 Skills respectively. Intact PTH was measured by chemiluminescent hnutuno assay method. Statistical analysis was done by unpaired Student's "1"- test and pearson's Correlation test. Mean serum PTH level was significantly higher in all experimental groups than that of control group (p< 0.001). High level of Pal was found in 74% patients in stage 11, 81% in stage III and 97% patients in stage IV. Again, a significant negative correlation of parathyroid hormone with Ccr was observed in patients with CKD in all three stages. From the findings of the present study it may be concluded that intact PTH level progressively increases from early stage to late stage of chronic kidney disease.

scholarly journals CHRONIC KIDNEY DISEASE

2015 ◽  
Vol 22 (09) ◽  
pp. 1138-1143
Author(s):  
Muhammad Iqbal Shah ◽  
Ramesh Kumar Suthar ◽  
Mukhtiar Ahmed Soomro
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Ii ◽  
Frequent Pattern ◽  
Disease Stage ◽  
Female Ratio ◽  
Ckd Stage ◽  
Normochromic Anemia ◽  
The Mean

Chronic kidney disease is usually related with anemia and the level of anemiacorrelates with the severity of renal failure. A chronic kidney disease is complicated byanemia and anemia may contribute to adverse clinical outcomes. No large-scale populationdata are available for patients with chronic kidney disease regarding prevalence of anemia,subpopulations at risk, and relationships between anemia and renal dysfunctionObjectives:Theobjective of this study is to determine the frequency of different patterns of anemia in relationto glomerular filtration rate in patients suffering from chronic kidney disease stage II and abovepatients.Material &Methods:Study Design: Cross sectional study. Setting:Medical andNephrology wards of Liaquat University Hospital Hyderabad / Jamshoro. Period:20th January2013 to 19thDecember 2013.Results:During the study period, total 339 patients of chronickidney disease with stage II and above patients were enrolled. The mean age + StandardDeviation and range) of patients was 50.65 + 11.86 (16 to 80 years, n = 339). 211(62.2%) weremale and 128(37.8%) were female. (Male to Female Ratio 1:6). Mean Hemoglobin + SD was7.16 + 3.89 (3.0 to 17.0 g/dL). The frequency of anemia was present in 285(84.1%) patientswith mean Hb+ SD 6.02 + 2.1 (g/dL). The mean weight + SD was 56.50 + 9.84 (40 to 81 kg).The mean serum creatinine + SD was 5.63 + 2.48 (0.9 to 12.0 mg/dL) and we observed thatmost frequent pattern of anemia was normocytic-normochromic anemia in 216(77.0%) patients,hypochromic-microcytic in 61(18.0%) and macroyctic in 17(5.0%) patients. We also found thatas anemia increased progressively with declining GFR with mean hemoglobin concentrationof 11.78 +2.8 g/dL in CKD stage 2, 10.14 + 3.6 g/dL in CKD stage 3, 6.8 + 3.6 g/dL in CKDstage 4, 7.44 + 4.0 g/dL in CKD stage 5.Conclusion: Frequency of anemia increases withthe progression of stage of chronic kidney disease (decreased GFR) and anemia was mostcommon in stage 5 patients of chronic kidney disease.Most frequent pattern of anemia isnormocytic normochromic anemia.

scholarly journals Correlation of serum intact parathyroid hormone and alkaline phosphatase in diabetic chronic kidney disease stage 3 to 5 patients with mineral bone disorders

2019 ◽  
Vol 12 (2) ◽  
pp. 80-85
Author(s):  
Mehruba Alam Ananna ◽  
Wasim Md Mohosin Ul Haque ◽  
Muhammad Abdur Rahim ◽  
Tufayel Ahmed Chowdhury ◽  
Tabassum Samad ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Disease Stage ◽  
Diabetic Patients ◽  
Intact Parathyroid Hormone ◽  
Serum Ipth ◽  
Study Population ◽  
The Relationship

Introduction: Chronic kidney disease (CKD) amongst diabetic patients is a worldwide public health problem. It is associated with cardiovascular disease and CKD mineral bone disorder (CKD-MBD). Cardiovascular and MBD are important contributors of morbidity and mortality in CKD patients. Serum intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) are two important markers to identify and mange CKD-MBD. This study was designed to evaluate the relationship between serum iPTH and alkaline phosphatase in diabetic CKD stages 3-5 patients with MBD. Methods: This cross-sectional study was conducted in BIRDEM General Hospital, Dhaka, Bangladesh from January 2013 to December 2014. Diabetic patients suffering from stage 3-5 CKD with MBD and not on dialysis, were consecutively and purposively included in this study. Along with base-line characteristics, clinical and laboratory data including serum alkaline phosphatase and iPTH levels were recorded for all patients. Data were analyzed by using SPSS version 20.0 and Pearson’s correlation test was applied to evaluate the relationship between iPTH and serum ALP. Results: Total patients were 306, of which 166 (54.2%) were males and 140 females (45.8%). Mean age of the study population was 56.5±11.3 years. Mean duration of diabetes mellitus (DM) and CKD were 12.8±7.6 and 2.9±1.7 years respectively. Among the study population, 49 (16.0%) were in CKD stage 3, 90 (29.4%) in stage 4 and rest 167 (54.6%) in stage 5. The mean HbA1c level did not differ significantly (p>0.05 by ANOVA) amongst CKD-MBD stage 3, 4 and 5 cases. Mean±SE values of glycated haemoglobin (HbAlc %), serum creatinine (mg/dl), urea (mg/dl), calcium (mg/dl), phosphate (mg/dl), ALP (U/L) and iPTH (pg/ml) of total study population were 7.77±0.12, 6.8±0.17, 141.1±4.33, 8.1±0.07, 5.2±0.11, 164.1±7.74 and 229.7±8.64 respectively. Out of total cases, serum ALP was raised in only 53.9% CKD-MBD cases compared to 76.8% for iPTH. Serum iPTH level was found elevated in 79.6%, 83.3% and 72.5% CKD-MBD stage 3, 4 and 5 cases respectively while in comparison, serum ALP was found raised in 44.8%, 54.4% and 56.2% cases respectively. On correlation analysis between serum iPTH and ALP, the r values observed were 0.074, 0.231 and 0.046 for stage 3, 4 and 5 CKD-MBD cases respectively. Conclusion: The results of current study showed that most diabetic stage 3-5 pre-dialysis CKD-MBD patients had raised serum iPTH. In comparison, significantly low number of cases had raised serum ALP. IMC J Med Sci 2018; 12(2): 80-85

Sign in / Sign up

Export Citation Format

Share Document