Endocrine Abstracts (2010) 22 P81

Abnormalities in calcium, phosphorus and parathyroid hormone in patients with end stage chronic kidney disease on hemodialysis

Katerina Thisiadou1, Ioannis Karamouzis1, Stella Arampatzi1, Alexandra Tsolakidou1, Athanasios Sioulis2 & Despoina Michailidou1

1Biochemistry Laboratory, Faculty of Medicine Aristotle University, Thessaloniki, Greece; 2Nephrology Unit, First Medical Department, Ahepa Hospital, Aristotle University, Thessaloniki, Greece.

Introduction: The decline of renal function is closely associated to increased parathyroid hormone secretion, resulting to secondary hyperparathyroidism because of: 1) hypocalcemia; 2) hyperphosphatemia; 3) reduced activity of calcitriol; 4) skeletal resistance to the calcemic action of parathyroid hormone (PTH) and 5) reduced secretion of the calcium-sensing receptor (CaSR) in the parathyroid glands.

The retention of phosphorus is considered to take an important role in the evolution of secondary hyperparathyroidism.

The recent use of vitamin D analogues (3rd G of calcitriol–elocalcitol, paricalcitol-) which bare eclectic affinity to its receptors repress the infusion of PTH and improve the secondary hyperparathyroidism.

Aim: The study of calcium (Ca), phosphorus (P) and intact parathyroid hormone (i-PTH) serum disturbances in end stage renal disease patients who were on haemodialysis (eGFR<15 ml/min per 1.73 m2).

Patients and methods: In 27 individuals undergoing hemodialysis (HD), the levels of calcium, phosphorus were determined using photometric method by the Roche biochemical analyser Modular P 800 and the i-PTH levels were measured by electrochemiluminescence method in Modular Analytics E 170 immunoassay analyser. The same parameters were determined in a control group (CG) consisting of 44 normal subjects.

Results: There was a statistically significant difference in i-PTH levels among HD and controls groups (P<0.001).

Statistically significant difference (P<0.001) is also observed in the levels of P between the patients (5.62±1.29 mg/dl) and the control group (3.78±0.51 mg/dl).

The levels of Ca in the control group (9.44±0.47 mg/dl) were significantly higher than the HD group (8.35±1.07 mg/dl) (P<0.001).

Conclusions: Even after the use of the new calcitriol analogues, secondary hyperparathyroidism continues to exist in chronically undergoing hemodialysis patients, though a number of patients present normal i-PTH values. The disturbances in calcium and phosphorus concentrations are noticed to be milder.

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