The analysis of bone mineral salt metabolism and bone density detection on chronic kidney disease / 中国医师进修杂志

ABSTRACT

Objective To discuss the relationship between bone mineral salt metabolism index change and bone density in different stage of chronic kidney disease (CKD).Methods Three hundred and forty-five non-dialysis patients with CKD were enrolled in this study.According to the serum creatinine (SCr),glomerular filtration rate (GFR),they were divided into stage 1-5.CKD 1 had 75 cases,CKD 2 had 65 cases,CKD 3 had 65 cases,CKD 4 had 65 casès,CKD 5 had 75 cases.The level of blood calcium (Ca),phosphorus (P) and SCr were detected by ion selective electrode method.The level of urea nitrogen (BUN) was detected by picric acid method.The level of intact parathyroid hormone (iPTH) and 1,25 (OH)2VitD3 were detected by chemiluminescence.Results With the decline of renal function,the level of iPTH and blood P increased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(289.6578 + 187.7945),(482.0667 + 232.2065) μ g/L vs.(77.8431 + 52.9760) μ g/L and (1.6938 + 0.1960),(2.6034 ± 0.5986) mmol/L vs.(1.3833 ± 0.4068) mmol/L,P ＜ 0.05].The level of blood Ca and 1,25 (OH)2VitD3 decreased gradually,especially in stage CKD 4 and CKD 5,and compared with stage CKD 1,there were significantly differences [(1.9185 +0.4633),(1.8293 ± 0.3075) mmol/L vs.(2.0893 + 0.2245) mmoi/L and (10.0892 + 0.2638),(7.6058 +0.4356) ng/L vs.(18.0036 + 0.3218) ng/L,P ＜ 0.05].With the decline of renal function,the proportion of osteoporosis also gradually increased,especially in stage CKDS,and compared with stage CKD 1 and CKD 2,there was significantly difference [60.00％ (45/75) vs.20.00％ (15/75),23.08％ (15/65),P ＜ 0.05].Conclusion With the decline of renal function,the level of blood P and iPTH increase,and blood Ca,1,25(OH)2VitD3,bone density decrease,especially in stage CKD 4 and CKD 5 patients.