1. Profile of incident chronic kidney disease related-mineral bone disorders in chronic kidney disease Stage 4 and 5: A hospital based cross-sectional survey.
- Author
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Valson, A. T., Sundaram, M., David, V. G., Deborah, M. N., Varughese, S., Basu, G., Mohapatra, A., Alexander, S., Jose, J., Roshan, J., Simon, B., Rebekah, G., Tamilarasi, V., and Jacob, C. K.
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ABDOMINAL radiography , *ACADEMIC medical centers , *AORTA , *BLOOD testing , *CHI-squared test , *CONFIDENCE intervals , *ECHOCARDIOGRAPHY , *HEART valves , *MULTIVARIATE analysis , *REGRESSION analysis , *STATISTICS , *SURVEYS , *T-test (Statistics) , *U-statistics , *VITAMIN D deficiency , *LOGISTIC regression analysis , *DATA analysis , *SYMPTOMS , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *CALCINOSIS ,CHRONIC kidney failure complications - Abstract
Chronic kidney disease related-mineral bone disorder (CKD-MBD) has been poorly studied in pre-dialysis Indian CKD patients. We aimed to study the clinical, biochemical and extra skeletal manifestations of untreated CKD-MBD in pre-dialysis Stage 4 and 5 CKD patients attending nephrology out-patient clinic at a tertiary care hospital in South India. A hospital based cross-sectional survey including, demographic profile, history of CKD-MBD symptoms, measurement of serum calcium, phosphate, parathyroid hormone, 25 hydroxy vitamin D (25(OH) D) and alkaline phosphatase; lateral abdominal X-rays for abdominal aortic calcification (AAC) and echocardiography for valvular calcification (VC) was carried out. Of the 710 patients surveyed, 45% had no CKD-MBD related symptom. Prevalence of hypocalcemia, hyperphosphatemia, hyperparathyroidism (>150 pg/mL) and 25(OH) D levels <30 ng/mL was 66.3%, 59%, 89.3% and 74.7% respectively. Echocardiography was carried out in 471 patients; 96% of whom had VC (calcification score ≥1). Patients with VC were older and had lower 25(OH) D levels than those without. Lateral abdominal X-rays were obtained in 558 patients, 6.8% of whom were found to have AAC, which was associated with older age. Indian patients with incident CKD-MBD have a high prevalence of hypocalcemia, 25(OH) D deficiency and VC even prior to initiating dialysis while AAC does not appear to be common. The association between 25(OH) D deficiency and VC needs further exploration. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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