Magnitude and Determinants of Biochemical Mineral Bone Disease Abnormalities among Predialysis Chronic Kidney Disease Patients in Tikur Anbessa Specialized Hospital

Sirak Melkeneh
a:1:{s:5:"en_US";s:22:"Addis Ababa University";}
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  • Submited: April 26, 2023
  • Published: January 1, 2025

Abstract

Introduction: Mineral bone disease (MBD) abnormalities are common complications in patients with chronic kidney disease (CKD). The MBD abnormalities are known to be associated with increased morbidity and mortality. In spite of their importance, there is limited data on CKD-MBD abnormalities in Ethiopia. This study looked in to the magnitude and factors associated with biochemical CKD-MBD abnormalities among predialysis CKD patients.    

Methods: A cross-sectional study was conducted from July 1 to September 30, 2020 in Tikur Anbessa specialized hospital. One hundred patients who have had follow-up for at least 6 months with estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2 using CKD-EPI equation without race factor were included. Serum calcium, albumin, phosphorus and PTH levels were determined. Demographic and clinical data were collected using a structured questionnaire. IBM SPSS software version 26 was used for analysis.

Results: Among the 100 patients included in this study; the median age was 58 years with IQR of 73. The male to female ratio was 2.7:1. Patients in stages 3a, 3b, 4 and 5 CKD accounted for 23%, 29%, 26% and 22% respectively. The main causes of CKD were diabetes and hypertension. Among the patients 31% had hyperphosphatemia, 36% had hypocalcemia, and 89% had hyperparathyroidism. Estimated GFR correlated negatively with serum parathyroid hormone (PTH) level but correlated positively with serum calcium level. The mean values of calcium in CKD stage 3a,3b,4 and 5 were 8.91, 8.81, 8.7 and 7.14mg/dl respectively where as those of serum phosphorus were 3.58, 3.83, 3.83 and 5.53mg/dl respectively. The median values of PTH were 140.6, 137.2, 274.05 and 440.85Pg/ml respectively.

Conclusion: Hypocalcemia, hyperparathyroidism, and hyperphosphatemia are common biochemical CKD-MBD abnormalities among predialysis CKD patients in renal clinic of Tikur Anbessa specialized hospital. Monitoring for CKD‑MBD should begin earlier on and treatment should be initiated accordingly to improve patient outcome. 

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How to Cite
Melkeneh, S., & Melkie, A. (2025). Magnitude and Determinants of Biochemical Mineral Bone Disease Abnormalities among Predialysis Chronic Kidney Disease Patients in Tikur Anbessa Specialized Hospital. Ethiopian Medical Journal, 63(1). Retrieved from https://emjema.org/index.php/EMJ/article/view/2367

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