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Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria

Received: 4 October 2019     Accepted: 21 October 2019     Published: 6 December 2019
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Abstract

Mineral bone disease (MBD) is a common complication in patients with chronic kidney disease (CKD). The objective of this study is to determine the characteristics of CKD-MBD among adult patients with CKD in South-South, Nigeria. One hundred and fifty consecutive consenting chronic kidney disease patients who fulfilled the inclusion criteria for this study were recruited. Patients had a detailed clinical assessment, biochemical and radiological evaluations for CKD-MBD. Biochemical investigations included serum calcium, phosphate, parathyroid hormone (PTH) and alkaline phosphatase while the radiological investigations included X-ray of the skull, spine, wrist and phalanges. The age range of the patients was 22-80 years, with a mean of 45.1 (±11.9) years. There were 90 males and 60 females with male to female ratio of 1.5:1. Symptoms suggestive of CKD-MBD in the study population were bone pain and pruritus occuring in 34.9% and 12.0% of the CKD-MBD patients. Other symptoms presented by the patients included leg swelling in 126 (84%), frothiness of urine in 123 (82%), vomiting in 109 (72.7%), facial puffiness in 102 (68%), haematuria in 18 (12%) and chest pain in 73 (48.7%) of the patients. The mean values for serum PTH, serum calcium, serum phosphate, alkaline phosphatase and caxpo4 product among the CKD-MBD patients were 205.06±112.6 pg/ml, 2.56±0.73mmol/l, 1.63±0.63mmol/l, 109.26±65.57IU/L and 4.07±1.28mmol2/l2 respectively. There was hypercalcaemia in 44.6%, hypocalcaemia in 26.0%, hypophosphataemia in 12.0% and hyperphosphataemia in 29.3% of the patients. High alkaline phosphatase was observed in 36.0% while 8.7% had low alkaline phosphatase. There was high calcium x phosphate product in 34.0% of the patients. Radiological features in keeping with CKD-MBD was present in only 6% of those with CKD-MBD. Hypercalcemia is the major biochemical abnormalilty in patients with CKD-MBD in our environment.

Published in American Journal of Internal Medicine (Volume 7, Issue 6)
DOI 10.11648/j.ajim.20190706.15
Page(s) 163-168
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

CKD, MBD, Kidney Function, Calcium

References
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[7] National Kidney Foundation. K/DOQI clinical practice guideline for chronic kidney disease: evaluation, classification and stratification. Am J Kid Dis. 2002; 39: 1-226.
[8] Baker LRL. Renal Disease In: Kumar P, Clark M. Clinical medicine, 4th edn. W. B Saunders. Philadephia. 1999; 20: 572-73.
[9] Kadiri S. Towards reducing the impact of chronic kidney disease. African Health 2001; 23: 9-10.
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[23] London GM, Pannier B, Marchias SJ, Guerin A. Calcification of aortic valve in dialysed patients. J Am Soc Nephrol 2000; 11: 778-783.
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  • APA Style

    Ndu Victor Onyebuchi, Oko-Jaja Richard I., Emem-Chioma Pedro, Wokoma Friday. (2019). Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria. American Journal of Internal Medicine, 7(6), 163-168. https://doi.org/10.11648/j.ajim.20190706.15

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    ACS Style

    Ndu Victor Onyebuchi; Oko-Jaja Richard I.; Emem-Chioma Pedro; Wokoma Friday. Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria. Am. J. Intern. Med. 2019, 7(6), 163-168. doi: 10.11648/j.ajim.20190706.15

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    AMA Style

    Ndu Victor Onyebuchi, Oko-Jaja Richard I., Emem-Chioma Pedro, Wokoma Friday. Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria. Am J Intern Med. 2019;7(6):163-168. doi: 10.11648/j.ajim.20190706.15

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  • @article{10.11648/j.ajim.20190706.15,
      author = {Ndu Victor Onyebuchi and Oko-Jaja Richard I. and Emem-Chioma Pedro and Wokoma Friday},
      title = {Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria},
      journal = {American Journal of Internal Medicine},
      volume = {7},
      number = {6},
      pages = {163-168},
      doi = {10.11648/j.ajim.20190706.15},
      url = {https://doi.org/10.11648/j.ajim.20190706.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20190706.15},
      abstract = {Mineral bone disease (MBD) is a common complication in patients with chronic kidney disease (CKD). The objective of this study is to determine the characteristics of CKD-MBD among adult patients with CKD in South-South, Nigeria. One hundred and fifty consecutive consenting chronic kidney disease patients who fulfilled the inclusion criteria for this study were recruited. Patients had a detailed clinical assessment, biochemical and radiological evaluations for CKD-MBD. Biochemical investigations included serum calcium, phosphate, parathyroid hormone (PTH) and alkaline phosphatase while the radiological investigations included X-ray of the skull, spine, wrist and phalanges. The age range of the patients was 22-80 years, with a mean of 45.1 (±11.9) years. There were 90 males and 60 females with male to female ratio of 1.5:1. Symptoms suggestive of CKD-MBD in the study population were bone pain and pruritus occuring in 34.9% and 12.0% of the CKD-MBD patients. Other symptoms presented by the patients included leg swelling in 126 (84%), frothiness of urine in 123 (82%), vomiting in 109 (72.7%), facial puffiness in 102 (68%), haematuria in 18 (12%) and chest pain in 73 (48.7%) of the patients. The mean values for serum PTH, serum calcium, serum phosphate, alkaline phosphatase and caxpo4 product among the CKD-MBD patients were 205.06±112.6 pg/ml, 2.56±0.73mmol/l, 1.63±0.63mmol/l, 109.26±65.57IU/L and 4.07±1.28mmol2/l2 respectively. There was hypercalcaemia in 44.6%, hypocalcaemia in 26.0%, hypophosphataemia in 12.0% and hyperphosphataemia in 29.3% of the patients. High alkaline phosphatase was observed in 36.0% while 8.7% had low alkaline phosphatase. There was high calcium x phosphate product in 34.0% of the patients. Radiological features in keeping with CKD-MBD was present in only 6% of those with CKD-MBD. Hypercalcemia is the major biochemical abnormalilty in patients with CKD-MBD in our environment.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Clinical Characteristics of Mineral Bone Disease Among Patients with Chronic Kidney Disease in Southern, Nigeria
    AU  - Ndu Victor Onyebuchi
    AU  - Oko-Jaja Richard I.
    AU  - Emem-Chioma Pedro
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    N1  - https://doi.org/10.11648/j.ajim.20190706.15
    DO  - 10.11648/j.ajim.20190706.15
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    EP  - 168
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20190706.15
    AB  - Mineral bone disease (MBD) is a common complication in patients with chronic kidney disease (CKD). The objective of this study is to determine the characteristics of CKD-MBD among adult patients with CKD in South-South, Nigeria. One hundred and fifty consecutive consenting chronic kidney disease patients who fulfilled the inclusion criteria for this study were recruited. Patients had a detailed clinical assessment, biochemical and radiological evaluations for CKD-MBD. Biochemical investigations included serum calcium, phosphate, parathyroid hormone (PTH) and alkaline phosphatase while the radiological investigations included X-ray of the skull, spine, wrist and phalanges. The age range of the patients was 22-80 years, with a mean of 45.1 (±11.9) years. There were 90 males and 60 females with male to female ratio of 1.5:1. Symptoms suggestive of CKD-MBD in the study population were bone pain and pruritus occuring in 34.9% and 12.0% of the CKD-MBD patients. Other symptoms presented by the patients included leg swelling in 126 (84%), frothiness of urine in 123 (82%), vomiting in 109 (72.7%), facial puffiness in 102 (68%), haematuria in 18 (12%) and chest pain in 73 (48.7%) of the patients. The mean values for serum PTH, serum calcium, serum phosphate, alkaline phosphatase and caxpo4 product among the CKD-MBD patients were 205.06±112.6 pg/ml, 2.56±0.73mmol/l, 1.63±0.63mmol/l, 109.26±65.57IU/L and 4.07±1.28mmol2/l2 respectively. There was hypercalcaemia in 44.6%, hypocalcaemia in 26.0%, hypophosphataemia in 12.0% and hyperphosphataemia in 29.3% of the patients. High alkaline phosphatase was observed in 36.0% while 8.7% had low alkaline phosphatase. There was high calcium x phosphate product in 34.0% of the patients. Radiological features in keeping with CKD-MBD was present in only 6% of those with CKD-MBD. Hypercalcemia is the major biochemical abnormalilty in patients with CKD-MBD in our environment.
    VL  - 7
    IS  - 6
    ER  - 

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Author Information
  • Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

  • Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

  • Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

  • Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

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