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. 2018 Jun;18(2):446-457.
doi: 10.4314/ahs.v18i2.30.

Secondary hyperparathyroidism among Nigerians with chronic kidney disease

Zumnan M Gimba  1 , Esala E Abene  1 , Oche O O Agbaji  1   2 , Emmanuel I Agaba  1   2
Affiliations

Secondary hyperparathyroidism among Nigerians with chronic kidney disease

Zumnan M Gimba et al. Afr Health Sci. 2018 Jun.

Abstract

Backround: Secondary hyperparathyroidism (SHPT) is a manifestation of chronic kidney disease mineral bone disorder (CKD-MBD). SHPT is common in patients with chronic kidney disease (CKD) and is associated with significant morbidity and mortality.

Methods: A cross- sectional descriptive study involving 230 patients with CKD.

Results: The mean age of the study population was 44.17±15.24 years. The median intact parathyroid hormone and alkaline phosphatase levels were 96pg/ml (range 4-953pg/ml) and 88 iu/l (range 10-800 iu/l) respectively. The mean (with standard deviation) calcium, serum phosphate, calcium phosphate product and haemoglobin levels were 2.22±0.29mmol/l, 1.8±0.62mmol/l, 3.94±1.42mmol2/l2 and 9.90±1.87g/dl respectively. Majority of patients had advanced CKD with 70.3% of patients in stage G5. The prevalence rates of SHPT, hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase and elevated calcium phosphate product were 55.2%, 34.8%, 66.1%, 42.2% and 25.2% respectively.Univariate analysis revealed that SHPT was associated with hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase, proteinuria, anaemia, hypertension, left ventricular hypertrophy and stage of kidney disease; being worse with advancing kidney disease. Independently associated with SHPT were hypocalcaemia (OR=4.84), hyperphosphataemia (OR=3.06), and elevated alkaline phosphatase (OR=2.04).

Conclusion: The prevalence of SHPT in CKD is high, occurs early and is independently associated with hypocalcaemia, hyperphosphataemia and elevated alkaline phosphatase. The prevalence of SHPT also increases with worsening renal function.

Keywords: Secondary hyperparathyroidism; chronic kidney disease; elevated alkaline phosphatase; hyperphosphataemia; hypocalcaemia; intact parathyroid hormone.

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Figures

Figure 1
Figure 1
Bar graph showing aetiology of CKD in the study population
Figure 2
Figure 2
Bar graph showing CKD stages based on GFR categories
Figure 3
Figure 3
Bar graph showing prevalence of SHPT across different CKD stages
Figure 4
Figure 4
Mean values of calcium, phosphate, CaXP, iPTH and alkaline phosphatase levels across GFR ranges
See this image and copyright information in PMC

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References

    1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD work group, author. KDIGO clinical practice guidelines for the diagnosis, evaluation, prevention and treatment of Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD) Kidney Int. 2009;76(suppl 113):S1–S130. - PubMed
    1. Sarnak MJ, Levey AS. Cardiovascualr disease and chronic renal disease: a new paradigm shift. Am J Kidney Dis. 2000;35:S117–S131. - PubMed
    1. Foley RN, Parfrey PS, Sarnak MJ. Cinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32:S112–S119. - PubMed
    1. Silver J. Regulation of parathyroid hormone gene by vitamin D, calcium and phosphate. Kidney intl. 1999;56(suppl73):S2–S7. - PubMed
    1. Khan S. Vitamin D deficiency and secondary hyperparathyroidism among patients with chronic kidney disease. Am J Med Sci. 2007;333:201–207. PubMed. - PubMed

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