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

scholarly journals Serum Intact Parathyroid Hormone Level is Inversely Correlated with Glycated Haemoglobin in Diabetic Chronic Kidney Disease Stages 3-5 Predialysis Patients

2017 ◽  
Vol 7 (2) ◽  
pp. 110-113
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Tabassum Samad ◽  
Samira Humaira Habib ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Negative Correlation ◽  
Glycated Haemoglobin ◽  
Diabetic Patients ◽  
Intact Parathyroid Hormone ◽  
Ipth Level ◽  
Ckd Stage ◽  
The Relationship

Introduction: Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). Management of chronic kidney disease-mineral and bone disorder (CKD-MBD) is an integral component of CKD management; serum intact parathyroid hormone (iPTH) level is the key target. This study was designed to evaluate the relationship between glycated haemoglobin (HbAlc) and iPTH in diabetic CKD stages 3-5 patients not yet on dialysis.Methods: This cross-sectional study was conducted in BIRDEM General Hospital, Dhaka, Bangladesh from January 2013 to December 2014. Diabetic patients suffering from CKD stages 3-5, who were not on dialysis, were consecutively and purposively included in this study. Along with base-line characteristics, clinical and laboratory data including HbAlc 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 HbAlc and iPTH.Results: Total patients were 306, including 166 (54.2%) males. Mean age was 56.5±11.3 years. Mean duration of 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 CKD stage 4 and rest 167 (54.6%) in CKD stage 5. Mean HbAlc (%), serum creatinine (mg/dl), urea (mg/dl), calcium (mg/dl), phosphate (mg/dl), alkaline phosphatase (U/L) and iPTH (pg/ml) were 7.77±2.14, 6.8±3.0, 141.1±75.7, 8.1±1.2, 5.2±1.9,164.1±135.3 and 229.7±151.2 respectively. Mean HbAlc (%) and iPTH (pg/ml) in CKD stages 3, 4 and 5 were 8.36±1.59 and 171.7±127.9, 7.99±1.92 and 179.5±131.4, and 7.77±2.14 and 273.8±119.2 respectively. On correlation analysis, HbAlc had a significant negative correlation with iPTH (r=-0.002).Conclusion: The results of current study showed that most diabetic CKD stages 3-5 predialysis patients had poor glycaemic control and HbAlc had negative correlation with iPTH. As iPTH level is influenced by presence and control of DM, the targets of iPTH in CKD stages 3-5 in general, as recommended in existing guidelines, may not be appropriate in diabetic CKD patients and this issue merits further investigation.Birdem Med J 2017; 7(2): 110-113

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.

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 Serum intact parathyroid hormone levels in cats with chronic kidney disease

2013 ◽  
Vol 33 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Luciano H. Giovaninni ◽  
Marcia M. Kogika ◽  
Marcio D. Lustoza ◽  
Archivaldo Reche Junior ◽  
Vera A.B.F. Wirthl ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Stage Iv ◽  
Control Group ◽  
Intact Parathyroid Hormone ◽  
Acid Base ◽  
Acid Base Status ◽  
Serum Ionized Calcium ◽  
Progression Of Renal Disease

Chronic kidney disease (CKD) is frequently observed in cats and it is characterized as a multisystemic illness, caused by several underlying metabolic changes, and secondary renal hyperparathyroidism (SRHPT) is relatively common; usually it is associated with the progression of renal disease and poor prognosis. This study aimed at determining the frequency of SRHPT, and discussing possible mechanisms that could contribute to the development of SRHPT in cats at different stages of CKD through the evaluation of calcium and phosphorus metabolism, as well as acid-base status. Forty owned cats with CKD were included and divided into three groups, according to the stages of the disease, classified according to the International Renal Interest Society (IRIS) as Stage II (n=12), Stage III (n=22) and Stage IV (n=6). Control group was composed of 21 clinically healthy cats. Increased serum intact parathyroid hormone (iPTH) concentrations were observed in most CKD cats in all stages, and mainly in Stage IV, which hyperphosphatemia and ionized hypocalcemia were detected and associated to the cause for the development of SRHPT. In Stages II and III, however, ionized hypercalcemia was noticed suggesting that the development of SRHPT might be associated with other factors, and metabolic acidosis could be involved to the increase of serum ionized calcium. Therefore, causes for the development of SRHPT seem to be multifactorial and they must be further investigated, mainly in the early stages of CKD in cats, as hyperphosphatemia and ionized hypocalcemia could not be the only factors involved.

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