Bone mineral disorders and mortality in dialysis patients

Journal of Nephrology & Therapeutics

ISSN: 2161-0959

Open Access

Bone mineral disorders and mortality in dialysis patients

9th International Conference on Dialysis and Renal Care

August 18-19, 2016 London, UK

Navjit Kaur

Monilek Hospital & Research Centre, India

Scientific Tracks Abstracts: J Nephrol Ther

Abstract :

Numerous studies have demonstrated that Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is related to cardiovascular events and hospitalization. This prospective study was conducted for CKD-MBD in end stage kidney disease (ESRD) patients in a dialysis center to quantify their impact on mortality. Study considered the enrollment of 70 patients over 18 years old. Investigators reviewed biochemical markers, and appraised vascular calcifications with X-ray calculating the Adrago and Kaupilla scores. The mean age was 58.0├?┬▒14.9 year old and 62.0% were male. The principal cause of CKD was diabetes and nephroangiosclerosis (28.2 and 23.5% respectively). Approximately 81.7% of patients were on hemodialysis, with a median time from onset therapy of 41.6 months. About 54.7% had secondary hyperparathyroidism figure, with a mean intact parathyroid hormone level of 536├?┬▒481 pg/ ml. The serum calcium and phosphorus level was 8.4├?┬▒0.8 mg/dl respectively. Fibroblast growth factor 23 (FGF23) values showed extensive variations with a mean of 166+196 pg/dl, while fetuin A showed lower values of 0.5+0.3 mg/dl. The Adrago and Kaupilla scores were reported to be 3.4 and 8.1, respectively. No association was observed between vascular calcification and FGF 23 or fetuin A. The follow-up time was three years. Around 27.5% of patients were transplanted, 34.8% continued on dialysis and 37.7% died during the follow-up observation period. The prime cause of mortality was cardiovascular (42.3%). Those who died demonstrated higher phosphate and iPTH level compared to live patients (6.1├?┬▒2.2 versus 5.2├?┬▒1.6 mg/dl and 808.7├?┬▒62.6 versus 481.1├?┬▒426.2 pg/ dl, respectively). Additionally, patients who died showed lower values of fibroblast growth factor 23 and a greater tendency for vascular calcification evaluated by Adragao score in comparison to their counterparts (60.8├?┬▒86.9 versus 203.6├?┬▒210.7 pg/dl and 4.54├?┬▒ 2.96 versus 2.94├?┬▒3.19, respectively). Multivariate analysis showed that the increase of one unit of the calcium-phosphorus result in an increase of 3% on the risk of death with statistical significance. The study results accentuated a high prevalence of secondary hyperparathyroidism, with correlation between serum phosphorus, PTH level and calcium-phosphorus product, and mortality. The decreased patient unveiled a tendency for lower level of FGF23 and major vascular calcification.

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