No abstract

Preeclampsia is an idiopathic multisystem disorder specific to pregnancy and development of hypertension and proteinuria, increased vascular resistance and endothelial dysfunction in the mother , altered placental perfusion and restricted fetal growth. The vasospasm leads to destruction of RBCs release iron thus, there is elevated serum iron levels in preeclamptic women. The excess iron released from destruction of RBCs can react with free radicals produced from cell membrane (as it is rich in polyunsaturated fatty acids) and circulating lipoproteins initiates lipid peroxidation both in placenta and vasculature. This is one of the significant etiologic factors in the endothelial cell damage of preeclampsia. the raised serum iron levels in turn alters the iron related parameters like total iron binding capacity(TIBC), serum ferritin, transferrin, percent saturation.

The parathyroid hormone (PTH) is a 115 amino acid precursor molecule; the intact PTH (iPTH) contains only 84 amino acids which is biologically active molecule. The PTH helps in regulation of serum calcium levels, either hyper or hypocalcaemia causes release of PTH. It regulates the serum calcium levels by increasing the flow of calcium from bone to extracellular fluid, by increasing the re-absorption of calcium from renal tubules and it also causes increased intestinal absorption of ionized calcium via Vitamin D. The iPTH is predominantly cleared in liver and kidney, the assay of iPTH is used for differently diagnosis of hypercalcaemia. The iPTH levels will be elevated if hypercalcaemia is due to exaggerated secretion of PTH otherwise it remains normal. Thus total calcium and ionized calcium levels will also be regulated by PTH. Secondary Hyper parathryoidism (SHPT) is a common complication of end stage renal disease (ESRD) in which there is hyperplasia of parathyroid gland. Thus, we conclude that there is an association of iPTH with ionized calcium in patients with SHPT and those undergoing hemodialysis. It is recommended that a by using a universal panel reference range in the assay of iPTH it is possible to minimize the complications in patients with chronic kidney disease.

The parathyroid gland secretes parathyroid hormone (PTH) which is a key element in the regulation of serum calcium. The PTH elevates serum calcium activities by regulating its action on the bones, kidneys and small intestine. The set point of PTH secretion defines the sensitivity of the parathyroid glands to calcium concentration. Secondary hyperparathyroidism (SHPT) is a common complication of end stage renal disease (ESRD). Ionized calcium is physiologically active form of calcium status of the body and is used for accurately monitoring calcium status in renal diseases. The present study states that the ionized calcium is the set point of secondary hyperparathyroidism undergoing haemodialysis and the range of set point lies between 2.3-4.8 mg/dl (0.57-1.2 mmol/L). The status of iPTH, set point are frequently monitored in subtotal hyperparathyroidectomy where imaging studies are not beneficial (anatomically situated on postero-lateral surface of thyroid gland) to know the appearance of parathyroid gland.

Preeclampsia is a severe disorder of pregnancy characterized by the development of hypertension and proteinuria, increased vascular resistance and endothelial dysfunction in the mother, altered placental perfusion and restricted fetal growth. There is increased release of soluble growth factor like sFlt 1 from placenta, which decreases the availability of Vascular Endothelial Growth Factor(VEGF) receptors and decreases the availability of endothelial Nitric Oxide synthase. This inturn decreases the diastolic relaxation and endothelial dysfunction, podocyte injury of glomerular cells, increased excretion of podocyte specific proteins in urine leads to proteinuria. Cardiac hypertrophy further complicates the heart function. There is a raise in liver function; soluble factor like tyrosine kinase 1 (sFlt 1) may cause a disturbance in thyroid hormone function, thus prone to thyroid problem during or after pregnancy.