Changes in serum calcium, phosphate, albumin and parathyroid hormone before and after hemodialysis in Sudanese patients with end-stage renal failure

ABSTRACT

To determine the concentrations of serum parathyroid hormone [PTH] and bone minerals and their association before and after hemodialysis. A cross sectional study was done on patients with end-stage renal disease [ESRD] on treatment with maintenance hemodialysis [HD]. Levels of serum calcium, phosphate, urea, creatinine, albumin, and intact parathormone [iPTH] were measured. The total number of patients studied was 50 [40 males; 10 females], the mean age was 40.3 +/- 26.5 years, and the average duration on hemodialysis [HD] was 53 months. Serum PTH level was significantly lower after hemodialysis treatment; it was 945.8 +/- 995.9pg/ml and 781.7 +/- 928.1 pg/ml before and after HD respectively, but still over the normal range. Serum phosphate concentration was remarkably differ before and after HD [5.59 +/- 1.8 mg/ml vs 4.38 +/- 1.2 mg/ml respectively]. In contrast, the mean value of serum calcium concentration was changed significantly after HD [6.7 +/- 1.5 mg/dl] compared with the level before HD [5.6 +/- 6.7 mg/dl]. PTH correlated positively with phosphate [r=0.30, p=0.03], and negatively with calcium [r=-0.299, p=0.04] levels. A significant decrease in serum urea and creatinine levels was reported after HD. Serum albumin showed no significant difference before and after HD. PTH was remarkably decreased post dialysis in our patients with definite increased serum Ca[+]. There is no significant difference between PTH and patient's age, sex and duration in HD Sudanese patients