Disorders of bone mineral metabolism in patients with chronic kidney disease at the Hospital Nacional (2023-2024)
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Abstract
Introduction: alterations in bone mineral metabolism have an impact as a cardiovascular risk factor; it is necessary to recognize them early to prevent their progression. Objective: To describe the frequency of alterations in calcium-phosphorus metabolism in adult patients with chronic kidney disease (CKD) at different stages who attend the Hospital Nacional in the period 2023-2024.
Methodology: a descriptive, observational, cross-sectional, retrospective study that included adult patients with CKD at different stages. Demographic variables (sex, age, origin), laboratory variables (serum levels of PTH, calcium, vitamin D, and phosphorus), and clinical variables (CKD stage, presence of hypothyroidism, need for hemodialysis, comorbidities) were studied.
Results: 81 patients with CKD between 21 and 97 years of age (rIC:50,63)were included, 87 % from rural areas, 62 % (n = 50) male. Regarding comorbidities and etiologies of CKD, 52 % (n = 43) had type 2 diabetes mellitus, followed by arterial hypertension (13 %) among the most frequent. 86 % were in stage V, all on three-weekly dialysis. 85 % showed vitamin D deficiency. Hypothyroidism was found in 5 % (n = 4). An association was observed between higher levels of phosphate and lower levels of calcium in advanced stages of the disease and an increase in PTH from stage IV showing an association with higher levels of urea and creatinine.
Conclusion: a high frequency of alterations in bone mineral metabolism was found from early stages of the disease, therefore its routine study should be a common practice in order to provide adequate supplementation and avoid progression to secondary hyperparathyroidism
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