Role of Calcium and Phosphate Ionic Product as an Early Marker of Vascular Calcification to Predict Cardiac Risk in Chronic Kidney Disease: A Case-control Study
Introduction: Cardiovascular disease is the most leading cause of death in patients with Chronic Kidney Disease (CKD) and Vascular Calcification (CV) is one of the strongest predictors of cardiovascular risk. CV is a process characterised by thickening and loss of elasticity of muscular arteries...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2022-07-01
|
| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://www.njlm.net/articles/PDF/2622/52862_CE[Ra1]_F[SH]_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Cardiovascular disease is the most leading cause of
death in patients with Chronic Kidney Disease (CKD) and Vascular
Calcification (CV) is one of the strongest predictors of cardiovascular
risk. CV is a process characterised by thickening and loss of elasticity
of muscular arteries walls which occurs in two distinct sites, the intimal
associated with atherosclerotic plaques and medial calcification is
characterised by vascular stiffening and arteriosclerosis with adverse
clinical outcomes leading to cardiovascular mortality. Disturbed
mineral metabolism such as increased serum phosphorus and ionic
product may be one such risk factor and is emerging as a principle
modifier of CV in the CKD subjects.
Aim: To determine serum phosphorus and calcium in CKD
patients and to compare with calcium phosphorus ionic product
as an early independent marker of CV in CKD to predict cardiac
mortality.
Materials and Methods: This was duration based case-control
study conducted in Department of Nephrology, Vydehi Institute
of Medical Sciences and Research Centre, Karnataka, India.
Fifty cases of CKD presented in stage 3, 4 and 5 and 50 healthy
individuals as controls between the age group 21-78 years were
included. Serum levels of calcium, and phosphorous were analysed
in autoanalyser, Ca x P ionic product was calculated, estimated
Glomerular Filtration Rate (eGFR) was calculated by Modification
of Diet in Renal Disease (MDRD) formula. All measured variables
were compared with eGFR and compared between cases and
controls. The results were presented as a mean±Standard
Deviation (SD) and p-value <0.05 was considered as significant.
Results: Mean age of cases were 47.74±11.01 years and
45.66±11.46 years were of controls. Clinically, confirmed CKD
was found more in male patients 31 (62%) compared to female 19
(38%). eGFR (mL/min) cases (14.12±10.72) and (102.97±27.46) in
control, Serum Creatinine were 7.04±5.34 mg/dL in cases which
was significantly more compared to control (0.84±0.20 mg/dL).
Serum Calcium (Ca) 8.11±1.09 mg/dL in cases less compared
with control 9.31±0.42 mg/dL, indicating hypocalcaemia.
Serum Phosphrous (P) 5.29±1.83 mg/dL) in CKD suggesting
hyperphosphatemia compared to control (3.27±0.54 mg/dL).
Calcium Phosphorus Ionic Product was 46.91±14.77 in cases,
elevated in CKD as compared to control (30.46±5.03). Statistically,
significant result was found between serum phosphorus and
calcium phosphorus ionic product (p<0.05), well compared with
eGFR of stage 3, 4 and 5 CKD patients.
Conclusion: Hyperphosphatemia and elevated calciumphosphate ionic product is an early independent marker of
calcification to predict cardiovascular risk in late stages of CKD |
|---|---|
| ISSN: | 2277-8551 2455-6882 |