Biochemical Markers of Mineral Bone Disorder in Chronic Kidney Disease Patients on Maintenance Hemodialysis

Author(s): Dhar S, Iqbal MM, Debnath DK, Hussain MZ, Mahmud MA, Sarker S, Uddin MR, Khatun MA, Mekhola MH, Rahman AKMS

Mineral and bone disorder (MBD) in chronic kidney disease (CKD) is associated with increased morbidity and mortality. The CKDMBD syndrome is comprised of biochemical abnormalities, vascular calcification, and bone fragility, and each is consistently associated with elevated risks for morbidity and mortality across the spectrum of CKD. This study was aimed to assess the biochemical markers of mineral bone disorder in chronic kidney disease patients on maintenance hemodialysis. This cross-sectional study was conducted at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka, Bangladesh from March 2022 to September 2022. A total of 160 cases with end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) were enrolled. Demographic profile, detailed case history with clinical examination findings of each study patient was recorded and relevant investigations were done accordingly. The mean age of the study patients was 45.9±12.4 years and their mean duration of dialysis was 2.0±0.8 years. Maintained intact parathyroid hormone (iPTH) was in 55% of study patients and maintained bone alkaline phosphatase (BALP) was in 83.7% of study patients. Total 20.6% of study patients had high turnover and 24.4% had low turnover bone disease according to iPTH. Most of the study participants had history of taking oral phosphate binder, calcium and activated form of vitamin D. Among the total participants, 8.1% had hypocalcemia, 46.9% had hypercalcemia, 56.9% had hyperphosphatemia, 15.6% had hypophosphatemia, and 77.5% had vitamin D deficiency. This study concluded that, abnormalities of biochemical markers of mineral bone disorder are common in maintenance hemodialysis patients despite of oral supplementation.