Parathormone (PTH) and electrolytes in end stage renal
disease (ESRD) and hemodialysis (HD) patients.
Focus on magnesium
Coordinator: Gliga Mirela MD,PhdFirst author: Cirstea IulianaAuthors: Niculiseanu Stela
Chronic kidney disease
Kidney damage or decreased glomerular filtration rate (GFR) of less than 60 ml/min/1,73m2
for three or more months.(WHO)
Stage I: eGFR > 90 ml/min/1,73m2
• Stage II: eGFR = 60 - 89 ml/min/1,73m2
• Stage III: eGFR = 30 - 59 ml/min/1,73m2
End stage renal disease(ESRD)
• Stage IV:e GFR = 15 - 29 ml/min/1,73m2
• Stage V: eGFR < 15 ml/min/1,73m2
Magnesium involved in all major cellular processes important role in bone formation,muscle contraction homeostasis → kidney plays an important role
http://ckj.oxfordjournals.org/content/5/Suppl_1/i15.full
Electroytes in ESRD
eGFR declines – electrolytes imbalances develops Mg ² excretion increases with decreasing of
glomerular filtration rate (GFR) eGFR < 30 ml/min/1.73m ² → hypermagnesemia
develops
hyperkalemia K+ > 5 mEq / l ( eGFR <10 mL/min/1.73 m2 )
fractional excretion of phosphate decrease increase in the serum phosphate level
decrease in serum calcium concentration.
PTH in ESRD
Secondary hyperparathyroidism• increase in the serum concentration of PTH• due to hypocalcaemia, consequent to
phosphate retention• Literature: PTH → main regulator of calcium
phosphate, magnesium and potassium homeostasis.
Aim of the study
• To evaluate the relationship between PTH levels and serum Mg+2,Ca+2 and P levels and to correlate them with the disease’s progression.
Matherial and method• Retrospective ,comparative study
• 75 patients admitted to the nephrology department of Mures County Clinical Emergency Hospital
• Two groups: A: ESRD group B: dialysis group
• parameters studied: age,serum Mg+2,Ca+2 ,P levels and estimated glomerular filtration rate (eGFR)
• Statistical study – SPSS software: → t student test → Pearson chi square test
Conclussions• Patients with higher serum Mg+2 levels tend to
have a lower PTH levels,therefore, controlling this two parameters is of major importance in both ESRD and HD patients.
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