PTH AND METABOLISM OF CALCIUM AND PHOSPHORUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE TREATED BY HEMODIALYSIS

Cilj istraživanja: Ispitati serumsku razinu kalcija, fosfora, CaxP umnoška, iPTH i usporediti s aktualnim smjernicama u bolesnika koji se liječe hemodijalizom u KBC Osijek. Nacrt studije: Istraživanje je presječna studija. Ispitanici i metode: Istraživanjem je obuhvaćeno 100 bolesnika sa završnim stadijem KBB-a liječenih hemodijalizom tijekom 2017. godine. Iz medicinske dokumentacije prikupljeni su osnovni demografski podatci bolesnika te podatci o duljini liječenja hemodijalizom, a iz povijesti bolesti prikupljeni su laboratorijski nalazi pomoću kojih su se pratile serumske vrijednosti kalcija, fosfora, i iPTH tijekom godinu dana. Prikupljeni podatci zatim su se usporedili s aktualnim smjernicama. Rezultati: Istraživanje je pokazalo da su kod većine boelsnika kalcij, fosfor i iPTH vađeni unutar preporučenih smjernica. Nisu prisutne značajne razlike u prosječnim godišnjim vrijednostima u odnosu na spol. Vrijednosti kalcija u preporučenom rasponu ima 56 % bolesnika, fosfora 25 %, a iPTH 78 % bolesnika. Stariji bolesnici imaju značajno niže vrijednosti fosfora i CaxP umnoška i obratno. Bolesnici s većom tjelesnom masom imaju značajno više vrijednosti iPTH i CaxP umnoška i obratno. Oni bolesnici koji su na dijalizi duže vrijeme imaju značajno više vrijednosti kalcija i obratno. Nema značajne razlike u vrijednostima kalcija i fosfora u odnosu na vrijednosti iPTH. Zaključak: KBB se može dijagnosticirati jednostavnim laboratorijskim testovima pomoću kojih se na vrijeme otkrivena može spriječiti. Važno je prevesti ove prednosti laboratorijske dijagnostike u jednostavne i primjenjive javnozdravstvene mjere, odnosno smjernice ili preporuke koje će biti prihvaćene na globalnoj razini.Objectives: The objective of the study was to examine the serum levels of calcium, phosphorus, CaxP product, and iPTH, and to compare those levels with the levels present in patients being treated with haemodialysis at the University Hospital Centre Osijek. Study design: The study is designed as a cross sectional study. Material and methods: The study included 100 patients suffering from end-stage CKD, treated with haemodialysis during 2017. The basic demographic data and the data on the length of the treatment were taken from the medical documentation, while the laboratory reports were taken from the medical histories of each patient. These laboratory reports were used to monitor the serum levels of calcium, phosphorus, and iPTH over the period of one year. The gathered data was then compared with the actual guidelines. Results: The study has shown that, calcium, phosphorus, and iPTH for most patients were drawn within the recommended guidelines. Considering gender, no significant differences in the average yearly values were found. Also, calcium values were found to be within the recommended range for 56 % of the patients, as were phosphorus values for 25 %, and iPTH values for 78 % of the patients. Moreover, it was found that older patients have considerably lower values of phosphorus and CaxP, and vice versa, while the ones with higher body mass have considerably higher values of phosphorus, iPTH, and CaxP, and vice versa. Also, the patients who were on dialysis for a longer period of time have considerably higher values of calcium, and vice versa. No significant difference was found in the values of calcium and phosphorus in regards to iPTH values. Conclusion: CKD can be diagnosed with simple laboratory tests, which can also prevent it, if it is diagnosed early enough. It is important to use these advantages provided by laboratory diagnostics and to convey them into simple and applicable public health measures or guidelines, which will then be accepted on a global level