RESUMO
Objective To evaluate the effects on the mineral bone disorder using different calcium concentration citrate-based dialysate in maintenance hemodialysis (MHD) patients.To compare the concentrations of intact parathyroid hormone(PTH) with biointact PTH(1-84) in these patients.Methods Citrate dialysate with different calcium concentration (DCa 1.75,DCa 1.5,DCa 1.25 mmol/L)were used in turn in 15 stable MHD patients each week.Serum tCa and iCa were measured by automatic biochemistry analyzer.The concentrations of iPTH and bio-iPTH were compared.Results (1) The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis,and PTH did not change significantly as compared to those findings before the dialysis.With the DCa 1.5 citrate dialysate,serum iCa and tCa were kept stable and PTH level was increased.With DCa 1.25 citrate dialysate,serum iCa and tCa decreased significantly and PTH decreased.(2)iPTH and bioPTH had excellent correlations.Variation of bio-iPTH was more correlated with the changes of calcium than iPTH.Conclusions Serum levels of iPTH,tCa and iCa can be kept stable in MHD patients treated with DCa 1.75 ~ 1.5 citrate dialysate.Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.
RESUMO
To measure hardness of bone density, and study its relationship with serum calcium, phosphorus, Calcitonin levels and urine calcium level.Pre-designed questionnaire is used to reveal any risk factors associated with osteoporosis and also BMI is evaluated based on measurements of weight, height, bust and waist circumference. Study participants were measured their bone mass density of wrist and shin by ultrasound ( Sunlight MiniOmni, Beammed, USA). Serum calcium and phosphorus levels were analyzed by automatedbiochemical analyzer, Integra 800, according to the adhered protocol to the machine. New, clean urine containers were distributed to participant a day before urine test day and middle part of urine is collected into the container. The urine calcium level was analyzed by automated biochemical analyzer, Cobas Integra 800, according to the machine protocol. Calcitonin level was analyzed by ELISA kit by Eu cardio company of United States.Total of 80 people ages 26 to 87 from Ulaanbaatar were participated for this study. 29 (36.3%) ofthem were males whereas, 51 (63.8%) of them were females. Serum calcium average level was2.0+-0.2mmol/L, serum phosphorus average level was 0.8+-0.1mmol/L while urine calcium level was 3.9+-2.5mmol/L. According to our result, bone mass density was related to age (r=-0.495), serum calcium level has statistically important relationship (p<0.05) with bone mass density (r=-0.326), age(r=0.277), serum phosphorus (r=0.351), and urine calcium level (r=-0.316). Measurement above did not have statistically important relationship with Calcitonin level.Osteoclast might be dominating in osteoporosis since bone mass density is decreasing while serum calcium level is increasing along with aging.