Bone metabolic disorder and its contributing factors in patients with chronic kidney disease; a three-year cohort study

Kourosh Eftekharian,Sahar Samimi,Hassan Eftekhar Ardebili,Mohammad Hossein Shojamoradi

doi:10.34172/jrip.2022.05

Kourosh Eftekharian, Sahar Samimi + Show 2 more

Open Access

https://doi.org/10.34172/jrip.2022.05

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Abstract

Introduction: The prevalence of bone mineral disorder is best known in end-stage renal disease (ESRD) patients, but less data is available for the earlier stages. Objectives: We aimed to compare the prevalence of bone metabolic disorder at all stages of chronic kidney disease (CKD) and assess its contribution to CKD progression and patients’ outcome. Patients and Methods: In a retrospective cohort study, CKD patients who were under treatment for three years were selected from a nephrology clinic in Tehran, Iran. Patients’ demographic and laboratory data, as well as the outcome of their treatment were gathered and analyzed. Results: In 473 patients with an average age of 61.5, 60.1% were at stage III, 35.8% were at stage IV, and 4.1% were at stage V of CKD. There was a significant relationship between CKD stage and serum phosphate, calcium-phosphate product, and systolic blood pressure (SBP). Furthermore, the patients’ outcome was significantly related to advanced stages of CKD, higher first phosphate level, diabetes mellitus in medical history, and higher stages of SBP. By multiple Cox regression analysis, after adjustment for glomerular filtration rate (GFR), the first serum phosphate level, and the calcium-phosphate product did not contribute to the undesirable outcome. Conclusion: Although bone metabolic disorder is more frequently seen in advanced stages of chronic kidney disease, these changes can be seen even in earlier stages of the disease. The influence of phosphate abnormality in the patients’ outcome should be studied more in earlier stages for better control.

Highlights

The prevalence of bone mineral disorder is best known in end-stage renal disease (ESRD) patients, but less data is available for the earlier stages
While the etiology of chronic kidney disease (CKD) was unknown for most patients (40.6%), in the remaining individuals, diabetes mellitus followed by glomerulopathy were the most common underlying causes (39.9% and 9%, respectively)
The level of fasting blood sugar (FBS) is demonstrated in Table 1; we found no significant relationship between glomerular filtration rate (GFR) and FBS

Summary

Introduction

The prevalence of bone mineral disorder is best known in end-stage renal disease (ESRD) patients, but less data is available for the earlier stages. Objectives: We aimed to compare the prevalence of bone metabolic disorder at all stages of chronic kidney disease (CKD) and assess its contribution to CKD progression and patients’ outcome. Bone metabolic disorder is one of the main complications of chronic kidney disease (CKD) and has been evaluated for its prevalence and symptoms in many studies. Based on Hill and colleagues’ study, the estimated global prevalence of CKD is 11% to 13% [1] This complication is more prevalent in end-stage renal disease (ESRD) patients; more focus has been put on studying the prevalence of bone metabolic disorder in later stages of the disease. Eftekharian K et al prevalence, its contributing factors, and how these factors might impact the survival and patients’ outcome in earlier stages of the disease

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