PREVALENCE AND PATTERN OF CHRONIC KIDNEY DISEASE-MINERAL AND BONE DISORDER AMONG PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.

Abstract

Abstract Background: Mineral bone disorders in chronic kidney disease (CKD) patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses and almost universally present among dialyzed patients. However, the prevalence and pattern of mineral bone disease in chronic kidney disease patients on maintenance Hemodialysis in our setting and in our country generally has not been established as to our knowledge Objective: Assessment of prevalence and pattern chronic kidney disease mineral bone disorders in patients on hemodialysis in St Paul’s Hospital Millennium Medical College. Methods: A cross-sectional single center study was carried from all CKD patients established on maintenance hemodialysis and have follow up for at SPHMMC. All consecutive patients with CKD undergoing maintenance hemodialysis during the study period were recruited. A structured checklist that contained serum biochemical parameters was used to extract data from patient records. Data were entered and analyzed using SPSS version 26. Descriptive analysis was used to produce frequencies, median and interquartile range, mean and standard deviations for statistical analysis. Pearson’s chi square test was used to identify associations between independent variables and bone turnover status. A p-value <0.05 was considered significant. Texts, tables and figures were used to present the results. Results: Forty patients on maintenance hemodialysis were recruited for the study. Majority (n=26; 65%) were males Patients' age ranged from 23 years to 67 years with a mean of 41.7 years and standard deviation of 11.1. Diabetes mellitus was the predominant cause of CKD (20%). In total, all (100%) of the patients had CKD‑MBD. Secondary hyperparathyroidism was observed in all (100%) of the patients, whereas 31 (77.5%) had hyperphosphatemia. Overall pattern of MBD turnover abnormality was 40%, Of these, 14 (35%) had high bone turnover, while only two (5%) had low turnover pattern. 60% of the patient had target PTH range in accordance with the KIDIGO recommendation. The chi square analysis showed that there was no significant relationship between serum calcium levels, serum phosphate level, serum vitamin D level and the bone turnover status. ix Conclusion: CKD‑MBD is highly prevalent among patients on hemodialysis in our center. Screening for CKD‑MBD and appropriate treatment with phosphate binders and Vitamin D when indicated are highly recommended. Keywords: Hemodialysis, MBD, SPHMMC