Biochemical and Clinical Variables of Normal Parathyroid and Hyperparathyroid Diabetic Chronic Kidney Disease Patients

  • Syed Abdul Kader Assistant Professor, Department of Endocrinology and Metabolism, Sher-e-Bangla Medical College & Hospital, Barisal
  • Faruque Pathan Professor, Department of Endocrinology and Metabolism, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka
  • Md Ruhul Amin Associate Professor, Department of Endocrinology and Metabolism, Sir Salimullah Medical College & Hospital, Dhaka
  • Md Azizul Hoque Associate Professor, Department of Endocrinology, Shaheed M. Monsur Ali Medical College, Sirajgonj
  • Sonia Afrin Rob Research Associate, Action Research on Community Adaptation in Bangladesh (ARCAB), Bangladesh Centre for Advanced Studies (BCAS) and Lecturer, Department of Dental Pharmacology, Marks Dental College, Dhaka
Keywords: Chronic kidney disease, Secondary hyperparathyroidism, Intact PTH, Active vitamin D3

Abstract

Background: In chronic kidney disease (CKD) intact parathyroid hormone (iPTH) level is often increased before clinical hyperphosphatemia occurs. Despite its importance very few studies evaluated parathyroid status in CKD.

Objective: The study was undertaken to estimate level of parathormone in diabetic CKD patients at a tertiary level hospital and assessing its relationship with different parameters like hemoglobin, calcium etc. and comparing biochemical and clinical variables between normal parathyroid and hyperparathyroid groups.

Materials and Methods: It was a hospital based cross-sectional study involving purposively selected chronic kidney disease patients attending nephrology and endocrinology outdoor and indoor services of BIRDEM hospital, Dhaka, Bangladesh. Study was conducted during the period of April to October 2010. All the subjects were divided into two groups based on serum parathormone level and different parameters were compared between groups.

Results: The mean duration of chronic kidney disease was significantly higher in hyperparathyroid group than that in the normal group (<0.001). Retinopathy and hypertension were more common in hyperparathyroid group than that in patients with normal serum parathormone (p<0.001 and p=0.012). Neuropathy was solely present in hyperparathyroid group (p<0.001). Mean fasting blood glucose, serum creatinine and serum phosphate were significantly higher in the hyperparathyroid group compared to normal group (p<0.001 in all cases) while the mean serum calcium and haemoglobin were lower in hyperparathyroid group than those in the normal group (p<0.001 in both cases). Serum creatinine and serum parathormone bears a significantly linear relationship (r=0.986, p<0.001), while serum parathormone and serum calcium bears a significantly negative relationship (r=?0.892 and p<0.001).

Conclusion: Earlier intervention on the basis of iPTH in addition to other biochemical parameters of chronic kidney disease is recommended.

J Enam Med Col 2016; 6(3): 140-147

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Author Biography

Syed Abdul Kader, Assistant Professor, Department of Endocrinology and Metabolism, Sher-e-Bangla Medical College & Hospital, Barisal


Published
2016-10-20
How to Cite
Kader, S., Pathan, F., Amin, M. R., Hoque, M. A., & Rob, S. (2016). Biochemical and Clinical Variables of Normal Parathyroid and Hyperparathyroid Diabetic Chronic Kidney Disease Patients. Journal of Enam Medical College, 6(3), 140-147. https://doi.org/10.3329/jemc.v6i3.29680
Section
Original Articles