Effect of control of secondary hyperparathyroidism and hyperphosphatemia on slowing chronic kidney disease progression

Document Type : Original Article

Authors

1 Department of internal medicine, Benha university hospitals, Benha university, Egypt

2 Internal medicine, faculty of medicine, Banha, Qualyoubia

Abstract

Background: Chronic Kidney Disease (CKD) is a progressive disease which takes from months to years depending on many factors. Treatment of CKD aims at slowing progression as long as possible with better quality of life. Hyperphosphatemia and secondary hyperparathyroidism (SHPT) are major complications of CKD. They have been associated with higher morbidity and mortality, which led to the assumption that their correction could reduce complications and CKD progression.

Aim: to study the possible role of controlling of secondary hyperparathyroidism and hyperphosphatemia on slowing progression of chronic kidney disease in patients with chronic kidney disease stage 3 and stage 4.

Materials & Methods: We included in this cohort study 200 patients with stage 3–4 CKD; recruited from nephrology departments and outpatient clinics in Benha hospitals. Participants underwent baseline measurement of CKD-MBD biomarkers and updated at each study visit, scheduled at a monthly interval over a 6-month follow-up. Ethical guidelines of our institutions were considered and consent was obtained from participants.

Results: In our study on 200 CKD patients of stage 3-4, it was found that the lower phosphate and PTH levels at the initial measurement and after 6 months were significantly associated with slower CKD progression. In addition, the use of cinacalcet, phosphate binders and alphacalcidol were significantly associated with slower CKD progression.

Conclusion: The control of secondary hyperparathyroidism (SHPT) and hypophosphatemia are independently associated with slowing chronic kidney disease progression in CKD patients stage 3-4, which encourages their early control to delay loss of renal function in this population.

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