Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region
DOI:
https://doi.org/10.18203/2320-6012.ijrms20193144Keywords:
Renal failure, Secondary hyperparathyroidism, Serum parathyroid hormoneAbstract
Background: Secondary hyperparathyroidism is known and early complication of chronic renal failure patients. Aim of this study was to assess the prevalence of secondary hyperparathyroidism and correlation between serum parathyroid hormone level with biochemical parameters in renal failure patients in tertiary care hospital in Kota, Rajasthan.
Methods: A cross sectional observational study was carried out in 50 patients who had creatinine clearance of 30ml/min/1.73m2 or less for greater than 6 weeks attended the OPD of department of General Medicine, New Medical College hospital, Kota, Rajasthan from May 2018 to November 2018. Investigations like complete blood count, renal function test, urine routine microscopy and USG abdomen with serum parathyroid hormone, serum phosphorus, serum calcium levels were done. Serum parathyroid hormone level was done by calorimetric method.
Results: The prevalence of secondary hyperparathyroidism in our study was 72%.
In hyperparathyroidism patient’s serum calcium level was low and the difference was highly significant (p<0.001). There is negative correlation between S.PTH and S. calcium level (r=-0.536). Mean serum calcium level in our study is 1.6mmol/l. In hyperparathyroidism patient’s serum phosphate level was high and the difference was highly significant (p<0.001). There was positive correlation between S.PTH and S.PO4 level (r=0.402). Mean serum phosphorus level in our study is 5.7 mg/dl. Prevalence of hyperparathyroidism was high among CRF patients with normal BP than hypertensive patients and with normal sugar than diabetics but the difference in proportion was not significant (p=0.87, p=0.98 respectively). 90% patients were on haemodialysis while 10% patients were on conservative management.
Conclusions: Early detection of secondary hyperparathyroidism in chronic renal failure patients can reduce its complications like bone fracture and cardiovascular complications.
References
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):S1-266.
Rajapurkar M, Dabhi M. Burden of disease-Prevalence and incidence of renal disease in India. Clin Nephrol. 2010;74 (Suppl 1):S9-12.
Warade JP, Kavitha R. Secondary hyperparathyroidism in chronic kidney disease. IAIM. 2015;2(7):42-8.
Slaiba W, El-Haddad B. Secondary hyperparathyroidism: pathophysiology and treatment. J Am Board Fam Med. 2009;22(5):574-81.
Madorin C, Owen RP, Fraser WD, Pellitteri PK, Radbill B, Rinaldo A, et al. The surgical management of renal hyperparathyroidism. Eur Arch Otorhinolaryngol. 2012;269(6):1565-76.
Tominaga Y, Tanaka Y, Sato K, Nagasaka T, Takagi H. Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):78-86.
Malawadi Bn, Suma Mn, Prashant V, Akila P, Anjalidevi Bs, Manjunath S. Secondary hyperparathyroidism in all the stages of chronic kidney disease in Southern Indian population. Int J Pharm Pharm Sci. 2014;6(4):287-90.
Kratz A. Appendix: Laboratory values of clinical importance. In: Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 19th Ed. New York, NY: McGraw-Hill; 2015:2754-2769.
Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant. 2005;20(8):1638-42.
Ghosh B, Brojen T, Banerjee S, Singh N, Singh S, Sharma OP, et al. The high prevalence of chronic kidney disease-mineral bone disorders: A hospital-based cross-sectional study. Indian J Nephrol 2012;22(4):285-91.
Jalalzadeh M, Mousavinasab N. Effects of Inactive Vitamin D on Persistent Secondary Hyperparathyroidism in Patients on Hemodialysis, Nephro-Urol Mon. 2017;9(2):e45029.
Owda A, Elhwairis H, Narra S, Towery H, Osama S. Secondary hyperparathyroidism in chronic hemodialysis patients: prevalence and race. Ren Fail. 2003;25(4):595-602.
Pineda AM, Aguilera ML, Meléndez HJ, Lemus JA, Peñalonzo MA. Sagliker syndrome in patients with secondary hyperparathyroidism and chronic renal failure: Case report. Inte J Surg Case Rep. 2015;8:127-30.
El Desoky S, Farag YM, Safdar E, Shalaby MA, Singh AK, Kari JA. Prevalence of Hyperparathyroidism, Mineral and Bone Disorders in Children with Advanced Chronic Kidney Disease. Indian J Pediatr. 2016;83(5):420-5.
Arévalo-Lorido JC, Carretero-Gómez J, García-Sánchez F, Maciá-Botejara E, Ramiro-Lozano JM, Masero-Carretero A et al. Secondary hyperparathyroidism prevalence and profile, between diabetic and non-diabetic patients with stage 3 to 4 chronic kidney disease attended in internal medicine wards. MiPTH study. Diabetes Metab Syndr. 2016;10(2 Suppl 1):S16-21.
