ASSOCIATION OF MINERAL METABOLISM BIOMARKERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND RENAL TRANSPLANT RECIPIENTS: A SINGLE-CENTRE PROSPECTIVE STUDY
DOI:
https://doi.org/10.61751/ijmmr/2.2024.57Keywords:
biomolecular indicators, mineral bone disorder, hormonal imbalance in kidney disease, 1,25-dihydroxyvitamin DAbstract
Abstract. Holistic assessment of mineral bone disorder parameters, including serum calcium, phosphorus, parathyroid hormone, and 1,25-dihydroxyvitamin D, can predict renal outcomes in kidney transplant recipients, though results have varied. This study aimed to evaluate the biochemical parameters of mineral bone disorder in patients with chronic kidney disease and renal transplant recipients. A total of 78 patients with chronic kidney disease, 24 post-renal transplant recipients, and 28 control cases were included, with a mean age of 48.24 years. The predominant cause of chronic kidney disease was chronic glomerulonephritis, followed by diabetes and hypertension. Serum levels of calcium, phosphorus, parathormone, and vitamin D3 were assessed. Patients with chronic kidney disease exhibited a mean serum calcium level of 8.37 mg/dL and phosphorus level of 4.25 mg/dL, while post-transplant patients had mean levels of 8.17 and 4.15 mg/dL, respectively. A significant reduction in serum parathyroid hormone levels was observed post-transplant (mean 8.13 U/dL) compared to patients with chronic kidney disease (mean 24.39 U/dL). No significant changes were noted in vitamin D3 levels after transplantation. Regression analysis revealed an insignificant relationship between serum calcium and phosphorus levels and parathyroid hormone levels. This study highlights the biochemical imbalances associated with chronic kidney disease and the impact of renal transplantation on parathyroid hormone levels, emphasising the need for regular monitoring and management of mineral bone disorder parameters in these patient populations
Received: 08.07.2024 | Revised: 23.10.2024 | Accepted: 26.11.2024
References
Hu L, Napoletano A, Provenzano M, Garofalo C, Bini C, Comai G, et al. Mineral bone disorders in kidney disease patients: The ever-current topic. Int J Mol Sci. 2022;23(20):12223. DOI: 10.3390/ijms232012223
Fernández-Villabrille S, Martín-Carro B, Martín-Vírgala J, Rodríguez-Santamaria MDM, Baena-Huerta F, Muñoz-Castañeda JR, et al. Novel biomarkers of bone metabolism. Nutrients. 2024;16(5):605. DOI: 10.3390/nu16050605
Hsu CY, Chen LR, Chen KH. Osteoporosis in patients with CKDs: A systemic review. Int J Mol Sci. 2020;21(18):6846. DOI: 10.3390/ijms21186846
Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M, et al. Prevalence of chronic kidney disease in Asia: A systematic review and analysis. BMJ Glob Health. 2022;7(1):e007525. DOI: 10.1136/bmjgh-2021-007525
Hasparyk UG, Vigil FMB, Bartolomei VS, Nunes VM, Simões E Silva AC. Chronic kidney disease – mineral bone disease biomarkers in kidney transplant patients. Curr Med Chem. 2022;29(31):5230–53. DOI: 10.2174/0929867329666220318105856
Major RW, Shepherd D, Medcalf JF, Xu G, Gray LJ, Brunskill NJ. The kidney failure risk equation for prediction of end stage renal disease in uk primary care: An external validation and clinical impact projection cohort study. PLoS Med. 2019;16(11):e1002955. DOI: 10.1371/journal.pmed.1002955
Bover J, Bailone L, López-Báez V, Benito S, Ciceri P, Galassi A, et al. Osteoporosis, bone mineral density and CKD-MBD: Treatment considerations. J Nephrol. 2017;30(5):677–87. DOI: 10.1007/s40620-017-0404-z
Yadav AK, Tiwana S, Steel M, Ramachandran R, Kaski JC, Jha V, Banerjee D. Vitamin D deficiency, endothelial function and bone biomarkers in post-kidney transplantation patients from North India. Int Urol Nephrol. 2019;51(1):181–6. DOI: 10.1007/s11255-018-2014-7
Kovesdy CP, Mucsi I, Czira ME, Rudas A, Ujszaszi A, Rosivall L, et al. Association of serum phosphorus level with anemia in kidney transplant recipients. Transplantation. 2011;91(8):875–82. DOI: 10.1097/tp.0b013e3182111edf
Doi Y, Hamano T, Ichimaru N, Tomida K, Obi Y, Fujii N, et al. Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients. Sci Rep. 2020;10(1):13766. DOI: 10.1038/s41598-020-70709-4
Rastogi A, Bhatt N, Rossetti S, Beto J. Management of hyperphosphatemia in end-stage renal disease: A new paradigm. J Ren Nutr. 2020;31(1):21–34. DOI: 10.1053/j.jrn.2020.02.003
Conley M, Campbell KL, Hawley CM, Lioufas NM, Elder GJ, Badve SV, et al. Relationship between dietary phosphate intake and biomarkers of bone and mineral metabolism in Australian adults with chronic kidney disease. J Ren Nutr. 2021;32(1):58–67. DOI: 10.1053/j.jrn.2021.07.004
Kim CS, Bae EH, Ma SK, Han SH, Lee KB, Lee J, et al. Chronic kidney disease – mineral bone disorder in Korean patients: A report from the Korean cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD). J Korean Med Sci. 2017;32(2):240–8. DOI: 10.3346/jkms.2017.32.2.240
Komaba H, Tanaka M, Fukagawa M. Treatment of chronic kidney disease – mineral and bone disorder (CKD-MBD). Int Med. 2008;47(11):989–94. DOI: 10.2169/internalmedicine.47.1051
Li F, Ye X, Yang G, Huang H, Bian A, Xing C, et al. Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease. Ren Fail. 2023;45(1):2210227. DOI: 10.1080/0886022x.2023.2210227
Malyszko J, Koc-Zorawska E, Kozminski P, Matuszkiewicz-Rowinska J, Malyszko JS. Underrecognition and underestimation of disturbances in calcium-phosphate balance in kidney transplant recipients. Trans Proc. 2018;50(6):1790–3. DOI: 10.1016/j.transproceed.2018.02.155
Fusaro M, Barbuto S, Gallieni M, Cossettini A, Sartò GVR, Cosmai L, et al. Real-world usage of chronic kidney disease – mineral bone disorder (CKD-MBD) biomarkers in nephrology practices. Clin Kidney J. 2023;17(1):sfad290. DOI: 10.1093/ckj/sfad290
Nakai K, Fujii H, Ishimura T, Fujisawa M, Nishi S. Incidence and risk factors of persistent hyperparathyroidism after kidney transplantation. Transplant Proc. 2017;49(1):53–6. DOI: 10.1016/j.transproceed.2016.10.011
Smout D, Jørgensen HS, Cavalier E, Evenepoel P. Clinical utility of bone turnover markers in patients with chronic kidney disease. Curr Opin Nephrol Hypertens. 2022;31(4):332–8. DOI: 10.1097/mnh.0000000000000798
Lalayiannis AD, Crabtree NJ, Ferro CJ, Askiti V, Mitsioni A, Biassoni L, et al. Routine serum biomarkers, but not dual-energy X-ray absorptiometry, correlate with cortical bone mineral density in children and young adults with chronic kidney disease. Nephrol Dial Transplant. 2020;36(10):1872–81. DOI: 10.1093/ndt/gfaa199
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Gaurav Vohra, Nagamahendran Rajendran, Anju Kumari
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
