SERUM LEVELS OF IONISED CALCIUM, PHOSPHATE, MAGNESIUM, PARATHYROID HORMONE AND VITAMIN D IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN ZARIA,KADUNA STATE

Abstract

Background: The burden of chronic kidney disease (CKD) is increasing rapidly worldwide and has
become a major health issue. Disturbances in minerals of bone metabolism and their management
early in the course of CKD are vital for improving the patient’s quality of life and longevity. Changes
in these biochemical markers in patients with CKD has been associated with increased morbidity and
mortality, hence the need to evaluate these markers here in Zaria.
Objective: To assess the pattern of serum ionised calcium, phosphate, magnesium, vitamin D and
intact parathyroid hormone (iPTH) among CKD patients in ABUTH Zaria, to compare the mean values
with that of controls and to correlate these analytes with the stages of CKD.
Method: It was a descriptive cross sectional study that involved 125 CKD patients and 125 age- and
sex-matched controls. The patients were recruited consecutively from Nephrology Clinic of ABUTH
Zaria, while controls were sourced from ABUTH staff, patient’s relatives and general population of
Zaria. Five milli litre of blood was collected and serum separated from each patient and control.
Vitamin D and parathyroid hormone were determined using enzyme linked immunosorbent assay
technique (WKEA med supplies); ionised calcium was measured using ion selective electrode
method, while colorimetric method was used to determine phosphorus, magnesium and creatinine
(Labkit). Estimated creatinine clearance was calculated using Cockroft and Gault formula. SPSS
version 17.0 was used for data analysis and P-value of <0.05 was taken as statistically significant.
Result: The three leading causes of CKD found in this study were hypertensive nephropathy, diabetic
nephropathy and adult polycystic kidney disease. Most (41%) of the CKD patients were in stage
5.CKD patients had significantly higher serum phosphorus, magnesium, parathyroid and creatinine
when compared with controls (P<0.00) and had lower serum calcium and vitamin D than controls

(P<0.00). Estimated creatinine clearance decreased progressively throughout the stages, Calcium,
vitamin D and eCrCl were decreasing as the stage of CKD advances. Phosphate, magnesium and iPTH
were increasing as the stage progresses.
Conclusion: This study has shown that minerals of bone metabolism were deranged in patients with
CKD. Majority of the patients had hypocalcaemia (57.6%), Hyperphosphataemia (52.8%),
hypovitaminosis D (45.6%) and hyperparathyroidism (68.8%). Serum ionised calcium and vitamin D
levels decreased, while serum phosphate, magnesium and iPTH increase with progressing stages of
CKD. Therefore the estimation of these biochemical analytes which are amenable to therapy will
help in the early diagnosis and management of CKD patients.

SERUM LEVELS OF IONISED CALCIUM, PHOSPHATE, MAGNESIUM, PARATHYROID HORMONE AND VITAMIN D IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN ZARIA,KADUNA STATE