Secondary hyperparathyroidism among Nigerians with chronic kidney disease|
Gimba, Zumnan M; Abene, Esala E; Agbaji, Oche O O & Agaba, Emmanuel I
Background: Secondary hyperparathyroidism (SHPT) is a manifestation of chronic kidney disease mineral bone disorder
(CKD-MBD). SHPT is common in patients with chronic kidney disease (CKD) and is associated with significant morbidity and
Methods: A cross- sectional descriptive study involving 230 patients with CKD.
Results: The mean age of the study population was 44.17±15.24 years. The median intact parathyroid hormone and alkaline
phosphatase levels were 96pg/ml (range 4-953pg/ml) and 88 iu/l (range 10-800 iu/l) respectively. The mean (with standard deviation) calcium, serum phosphate, calcium phosphate product and haemoglobin levels were 2.22±0.29mmol/l, 1.8±0.62mmol/l,
and 9.90±1.87g/dl respectively. Majority of patients had advanced CKD with 70.3% of patients in stage
G5. The prevalence rates of SHPT, hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase and elevated calcium
phosphate product were 55.2%, 34.8%, 66.1%, 42.2% and 25.2% respectively.
Univariate analysis revealed that SHPT was associated with hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase,
proteinuria, anaemia, hypertension, left ventricular hypertrophy and stage of kidney disease; being worse with advancing kidney
disease. Independently associated with SHPT were hypocalcaemia (OR=4.84), hyperphosphataemia (OR=3.06), and elevated
alkaline phosphatase (OR=2.04).
Conclusion: The prevalence of SHPT in CKD is high, occurs early and is independently associated with hypocalcaemia, hyperphosphataemia and elevated alkaline phosphatase. The prevalence of SHPT also increases with worsening renal function.
Secondary hyperparathyroidism; chronic kidney disease; intact parathyroid hormone; hypocalcaemia; hyperphosphataemia; elevated alkaline phosphatase