Serum parathyroid hormone and its association with renal function in patients with chronic kidney disease

Introduction: Chronic Kidney Disease (CKD) is a global health problem which involves progressive loss of renal function over a span of time. Kidneys play a major role in homeostasis of various metabolites and a loss of kidney function may lead to their severe derangement. One such derangement is an increase in serum phosphorus levels followed by decreased calcium levels. This imbalance in the levels of serum calcium and phosphorus further leads to hyperparathyroidism. Aim: The present study was planned to assess the serum parathyroid hormone (PTH) levels of patients with CKD (stage 4 & 5) and to explore its association with the declining renal function. Materials and Methods: 50 CKD patients (stage 4 & 5) were enrolled for the study based on pre defined inclusion and exclusion criteria. 50 age and gender matched healthy controls were also included. Renal function tests (RFT) i.e. urea. Creatinine, uric acid and eGFR and iPTH were estimated for all enrolled subjects. Results obtained were compared among CKD patients and healthy controls. Further the correlation of iPTH with urea, creattinine, uric acid and eGFR was also evaluated. Result: Serum iPTH levels were significantly higher in the CKD patients group (P= 0.000). iPTH also showed a significant correlation with urea (r= 0.362), creatinine (r= 0.475) and eGFR (r= -0.503). Conclusion: Decline of kidney function leads to increased S. iPTH levels and an imbalance of Ca and Phosphorus homeostasis. This may result in development of complications like bone-mineral disease. Early screening of PTH levels in CKD patients can be helpful in timely patient management and in averting such complications.