Prevalence and biochemical profile of adynamic bone disease in a hemodialysis population

Abstract

Introduction and Aim: The number of patients suffering from end stage renal disease (ESRD) requiring dialysis has increased worldwide. Mineral bone disorders (MBD) commonly occur in ESRD patients. MBD is classified into high turnover bone disease and low turnover bone disease. Biochemical parameters play a key role in classifying MBD. Data on adynamic bone disease (ABD) in hemodialysis (HD) patients is sparse. The aim is to study the prevalence and biochemical profile of ABD in hemodialysis patients. Materials and Methods: This study was done as a cross sectional study in HD patients of a tertiary care hospital in South India. Baseline demographic data of the study population was collected. Biochemical data such as serum creatinine, blood urea nitrogen (BUN), bone markers for the diagnosis of CKD-MBD including serum calcium, phosphorus, alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH) were collected. Based on the biochemical values, patients who had parameters suggestive of ABD were grouped as a separate cohort. Prevalence of ABD was calculated. Descriptive analysis of ABD cohort was done. Correlation of various bone markers with iPTH was carried out. Results: The study population (n=150) included 96 male (64%) and 54 female (36%) HD patients. The mean age of the study population is 54.54±14.81 years. 32.7% (n=49) of our study population had ABD. Serum calcium was found to be significantly higher in the ABD group. ALP and phosphorus were significantly lower in the ABD group. Conclusion: The prevalence of ABD in our HD population was 32.7%. The prevalence of ABD was the same among males and females. There was significant correlation of iPTH levels with ALP, calcium, and phosphorus levels.