ESPN 50th Annual Meeting

ESPN 2017


 
Assessment of laboratory abnormalities in renal osteodystrophy and its relation with the stage of chronic kidney disease
NASRIN ESFANDIAR 1 MOSTAFA SHARIFIAN 1 ATIYEH TAHERI 1

1- PEDIATRIC NEPHROLOGY RESEARCH CENTER, MOFID CHILDREN’S HOSPITAL, SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES, TEHRAN, IRAN.
 
Introduction:

Introduction: The final result of chronic kidney disease (CKD) without considering the type of kidney disease is progression to kidney failure and its complications such as renal osteodystrophy, cardiovascular, endocrine, neurologic, acid-base disorders, electrolyte disorders and anemia. Mineral bone disease could be assessed with laboratory abnormalities and radiologic findings. The purpose of this study was assesssing the laboratory abnormalities in renal osteodystrophy and finding a relation with the stage of CKD.

Material and methods:

  A cross-sectional study was performed on 104 children between 1 month to 17 years old who were admitted to the nephrology ward of Mofid hospital. They were evaluated by history taking, physical examination, blood and urine analysis, ultrasound and echocardiography. According to the glomerular filtration and KDOQI instruction, patients were divided into 5 groups: results were expressed using SPSS statistics and p<0.05 was considered statistically significant.

Results:

Out of 104 cases, 65 patients (62.5%) were male and 39 (37.5%) were female. The age range was 1 month to 17 years old and the mean age was 7.15. Four patients (3.8%) were at stage 1, 14 patients (13.5%) were at stage 2, 15 patients(14.4%) at stage 3 and 71 patients (68.3%) at stages 4 and 5. The most common etiology of CKD was neurogenic bladder with 19 patients (18.2%) ,then glomerular diseases such as nephrotic syndrome and lupus with 15 patients(14.2%) , obstructive uropathy with 12 patients (11.5%) , reflux nephropathy and atypical HUS each with 10 patients (9.6%) , polycystic kidney disease with 5 patients (4.8%)  and other etiologies (like malignancies, nephronophthisis and Bardet- Beidl sundrome) formed 12.5%.Twenty patients (19.9%) had unknown etiology. Eighty two patients (78.8%) had anemia, 30 patients (28.8%) had hypocalcemia, 30 patients (28.8%) had hyperphosphstemia, 75 patients (72.1%) had metabolic acidosis and 34 patients (32.6%) had high alkaline phosphatase. Seventy two patients (69.2%) were insufficient or defficient for 25 (OH) vitamine D. Twelve patients (11.5%) were treated with hemodialysis, 30 patients(28.8%) with peritoneal dialysis and 7 patients (6.7%) underwent renal transplantation.A significant correlation between uric acid and 25 (OH) vitamine D level and CKD stages (P=0.018) and  between 25(OH) vitamine D and PTH level (P=0.016) was found.

Conclusions:

The prevalance of CKD complications in children is high and assessment of patients in early stages for early treatment is advised.