Osteodystrophy in Indonesian haemodialysis patients

Abstract

A preliminary study of the intact-parathyroid hormone (i-PTH) measurements from haemodialysis patients was conducted to determine the prevalence of renal bone diseases at the Dr Soetomo Hospital. The objective of this study is to evaluate the osteodystrophy renal pattern in haemodialysis patients using i-PTH and radiological parameters. The selected populations of 48 (32 males and 16 females), the mean age 48 +/- 10.3 years, was evaluated to conduct a cross-sectional study. The calorimetric method was applied to measure serum P and Ca, while a radioimmunoassay was used to assay the i-PTH level. Of those 48 patients receiving haemodialysis, with a duration ranging from 4 to 432 weeks, 61% had hypocalcaemia and 10% had hypercalcaemia. The i-PTH levels below 100 pg/mL (normal, 10-65 pg/mL) suggested 'aplastic' bone, and values of 100-200 pg/mL most commonly indicated 'normal' bone turnover. The i-PTH levels over 200 pg/mL suggested hyperparathyroidism. The results of this study demonstrated that 42% of those patients had <100 pg/mL (low turnover bone presumed, no biopsy), 23% had 100 - <200 pg/mL ('normal' bone turnover) and 35% of them had >200 pg/mL ('hyperparathyroidism'). In addition, the radiological study showed that 10% of those patients were positive for renal bone diseases. In conclusion, this study shows that the common type of renal osteodystrophy was of a low turnover type, which was different from the findings in other previous studies. It is postulated that this difference is likely to be caused by some factors such as the general health condition of the population those patients belong to and, in particular, the nutritional status of those patients.

Prevalence and pattern of chronic kidney disease-mineral bone disorders among hemodialysis patients in kano, northwest nigeria

“…reported. [1819] Santoso et al . studied 48 Indonesian hemodialysis patients with iPTH and found a prevalence of 72%.…”

Mineral and Bone Disease in Black African Hemodialysis Patients: A Report From Senegal

“…Also, low turn-over osteodystrophy in our study was less frequent than reported in Canada (9). This can be related to a younger age of our patients like in many developing countries where access to dialysis is generally limited to active adult population (10). Manifestations of CKD-MBD were unspecific and the majority of our patients were asymptomatic.…”

“…Manifestations of CKD-MBD were unspecific and the majority of our patients were asymptomatic. This lack of specificity of clinical symptoms had been emphasized by many authors and it makes diagnosis of CKD-MBD more difficult (10-12). In the study by Hercz et al, about two thirds of patients with aplastic osteopathy did not present any clinical symptom (9).…”

Prevalence of Renal Osteodystrophy and its Related Factors among End-stage Renal Disease Patients Undergoing Hemodialysis: Report from Imam Reza Referral Hospital of Medical University of Kermanshah, Iran

“…This finding is consistent with the nature of CKD and the result of an Indonesian study that reported hypocalcemia in 61% of patients. 18 The development of ROD begins too early during CKD. The three important pathogenic mechanisms include reduced calciferol production (glomerular filtration rate (GFR) < 90 mL/min/1.73 m 2 ), hyperphosphatemia (GFR < 35–30 mL/min/1.73 m 2 ), and hypocalcemia occurring relatively early during CKD.…”