THE PREVALENCE OF BONE AND MINERAL DENSITY DISORDERS AMONG CKD PATIENTS AT PAF HOSPITAL ISLAMABAD

Abstract

Chronic kidney disease (CKD) impairs calcium-phosphate metabolism, causing mineral and bone problems. These problems include hypocalcemia, hyperphosphatemia, secondary hyperparathyroidism, vitamin D insufficiency, and low bone mineral density (BMD). However, statistics on CKD-MBD prevalence in Pakistani patients are limited. We performed cross-sectional research at the Pakistan Air Force (PAF) Hospital in Islamabad to ascertain the incidence of bone and mineral density anomalies in CKD patients. Consecutive sampling was used to recruit 117 patients (ages 30-80) with an estimated CKD-MBD prevalence of ~68%, based inclusion criteria. All patients got dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine and hip, as well as blood calcium, phosphate, 25-hydroxyvitamin D, and intact parathyroid hormone. Data were evaluated to determine the prevalence of osteoporosis (T-score ≤ -2.5), osteopenia (T-score -1 to -2.5), and laboratory abnormalities. In the dataset, 38% of patients had osteopenia and 39% had osteoporosis (total prevalence: 77%). 27% of patients had hypocalcemia (<8.5 mg/dL), 49% had hyperphosphatemia (>4.5 mg/dL), 72% had vitamin D insufficiency (<20 ng/mL), and 40% had high iPTH levels (>300 pg/mL). Osteoporosis prevalence was greater in late CKD stages and among females. These results are consistent with prior observations from comparable settings [1, 2]. Clinically, the high incidence of CKD-MBD emphasizes the need of frequent BMD measurement and metabolic monitoring in CKD patients. The study's shortcomings include the single-center design. Additional large-scale investigations including bone biopsies are required