Phosphocalcic Profile of Chronic Kidney Disease at Libreville

Introduction: As kidney function declines towards the more severe stages of chronic kidney disease (CKD), the interactions between kidney, intestine and bone become increasingly unstable. CKD with mineral and bone disorders and secondary hyperparathyroidism would be developing. The aim of this study was to determine the phosphocalcic profile of CKD patients in Libreville.

Materials and Methods: This was a cross sectional study with 89 CKD patients recruited. A blood sample was taken to measure PTH, vitamin D, FGF-23 by ELISA method; calcium, magnesium, fasting blood glucose, phosphate and creatinine by spectrophotometer.

Results: Mean phosphorus levels were 1.3 ± 0.5 mmol/L and hormone levels 81.8 ± 26.2 pg/mL and 27.5 ± 5.0 ng/mL for PTH and vitamin D respectively. Significant hyperphosphatemia was found among 43 (48.3%; p=0.0135) patients. There were 59 (66.3%) subjects with hypovitaminosis D p=0.0000. Less than 50% of patients had normal blood glucose levels (p=0.0034). PTH was 99.4 ± 16.4 pg/mL in dialysis patients and 61.7 ± 20.3 pg/mL in non-dialysis patients, with a p=0.0000. Vitamin D levels were significantly higher in patients without calcium supplementation (29.5 ± 5.0 ng/mL) than in those with supplementation (25.1 ± 4.0 ng/mL, p= 0.0000).

Conclusion: Phosphate levels remained high in our study population. Vitamin D deficiency was found in the majority of our patients. It would be advisable to readjust the management of these patients in order to minimize the effects of hyperphosphatemia and improve life quality.