Introduction: Abnormalities in mineral and bone metabolism, particularly
phosphocalcic metabolism, are common in renal failure and are associated with a
significant morbidity and mortality. The regulation of phosphocalcic metabolism
is subject to a particularly precise and complex control of parathormone (PTH)
and vitamin D. Assessment of vitamin D and parathyroid hormone concentrations
would help to improve the medical management of patients with chronic kidney
disease and ensure a better quality of life.Methods: The study population consisted of 138 individuals including 46 non-dialysis
renal failure patients, 46 chronic hemodialysis patients and 46 non-renal
failure volunteers to serve as controls. Serum Parathyroid hormone and Vitamin
D concentrations were measured using the Vidas automated system.Results: 25-hydroxyvitamin D concentrations in controls (65 ± 2.41 nmol/L) and
dialysis patients (70 ± 3.03 nmol/L) were significantly higher than those in
CKD patients (48 ± 3.34 nmol/L). On the other hand, the mean values of
Parathyroid hormone in dialysis patients (312 ± 36.22 pg/mL) and CKD patients
(117 ± 10.68 pg/mL) were very high compared to that in controls (25 ± 2.34
pg/mL).Conclusion: Secondary hyperparathyroidism is common in renal failure. Parathyroid
hormone and 25-hydroxyvitamin D assays would be adequate for better management
of chronic renal failure.
References
[1]
Mills, K.T., Xu, Y., Zhang, W., Bundy, J.D., Chen, C.S., Kelly, T.N., Jing, C. and Jiang, H. (2015) A Systematic Analysis of Worldwide Population-Based Data on the Global Burden of Chronic Kidney Disease in 2010. Kidney International, 88, 950-957.
https://doi.org/10.1038/ki.2015.230
[2]
Stanifer, J.W., Muiru, A., Jafar, T.H. and Patel, U.D. (2016) Chronic Kidney Disease in Low- and Middle-Income Countries. Nephrology Dialysis Transplantation, 31, 868-874.
[3]
Delanaye, P., Bouquegneau, A., Krzesinski, J.M., Cavalier, E., Guillaume, J., Urena-Torres, P. and Souberbielle, J.C. (2014) Place de la vitamine D native en dialyse. Néphrologie & Thérapeutique, 11, 5-15.
https://doi.org/10.1016/j.nephro.2014.10.004
[4]
Bouillon, R. (2018) Extra-Skeletal Effects of Vitamin D. Frontiers of Hormone Research, 50, 72-88. https://doi.org/10.1159/000486072
[5]
Blaine, J., Chonchol, M. and Levi, M. (2015) Renal Control of Calcium, Phosphate, and Magnesium Homeostasis. Clinical Journal of the American Society of Nephrology, 10, 1886-1887.
[6]
Moe, S.M. and Drüeke, T.B. (2003) Management of Secondary Hyperparathyroidism: The Importance and the Challenge of Controlling Parathyroid Hormone Levels without Elevating Calcium, Phosphorus, and Calcium-Phosphorus Product. American Journal of Nephrology, 23, 369-379. https://doi.org/10.1159/000073945
[7]
Melamed, M.L., Astor, B., Michos, E.D., Hostetter, T.H., Powe, N.R. and Muntner, P. (2009) 25-hydroxyvitamine D niveaux, race et progression de la maladie rénale. Journal of the American Society of Nephrology, 20, 2631-2639.
[8]
Deyhimi, F., Arabieh, M. and Parvin, L. (2006) Optimization of the Emerson Trinder Enzymatic Reaction by Response Surface Methodology. Biocatalysis and Biotransformation, 24, 263-271. https://doi.org/10.1080/10242420600661943
[9]
Abrouki, E.F. (2013) The D Dimers: Dosage Techniques. Ph.D. Thesis, Mohammed V-Souissi University, Rabat.
[10]
Levey, A.S., Stevens, L.A., Schmid, C.H., Zhang, Y.L., Castro, A.F., Feldman, H.I., Kusek, J.W., Eggers, P., Van Lente, F., Greene, T. and Coresh, J. (2009) A New Equation to Estimate Glomerular Filtration Rate. Annals of Internal Medicine, 150, 604-612.
[11]
Mondé, A.A., Kouamé-Koutouan, A., Lagou, D.A., Camara-Cissé, M., Achy, B.O., Tchimou, L., Djessou, P. and Sess, E.D. (2013) Variations du calcium, du phosphore et de la parathormone au cours de l’insuffisance rénale chronique (IRC) en Cote d’Ivoire. Medecine Nucléaire, 37, 451-454.
https://doi.org/10.1016/j.mednuc.2013.09.017
[12]
Basile, C., Libutti, P., Turo, D.L.A., Vernaglione, L., Casucci, F., Losurdo, N., Teutonico, A. and Lomonte, C. (2012) Effect of Dialysate Calcium Concentrations on Parathyroid Hormone and Calcium Balance During a Single Dialysis Session Using Bicarbonate Hemodialysis: A Crossover Clinical Trial. American Journal of Kidney Diseases, 59, 92-101. https://doi.org/10.1053/j.ajkd.2011.08.033
[13]
Goltzman, D., Mannstadt, M. and Marcocci, C. (2018) Physiology of the Calcium-Parathyroid Hormone-Vitamin D Axis. Frontiers of Hormone Research, 50, 1-13. https://doi.org/10.1159/000486060
[14]
Riccardi, D. and Valenti, G. (2016) Localization and Function of the Renal Calcium-Sensing Receptor. Nature Reviews Nephrology, 12, 414-425.
[15]
Messa, P. and Alfieri, C.M. (2019) Secondary and Tertiary Hyperparathyroidism. Frontiers of Hormone Research, 51, 91-108. https://doi.org/10.1159/000491041
[16]
Messa, P. and Sherman, R.A. (2014) Should Dialysate Calcium Be Individualized? Seminars in Dialysis, 27, 4-7. https://doi.org/10.1111/sdi.12150
[17]
Martin, A., David, V. and Quarles, L.D. (2012) Regulation and Function of the FGF23/Klotho Endocrine Pathways. Physiological Reviews, 92, 131-155.
[18]
Ryyan, H. and Stuart, M.S. (2020) Secondary Hyperparathyroidism in a Patient with CKD. Clinical Journal of the American Society of Nephrology, 15, 1041-1043.
[19]
Adema, A.Y., Borst, M.H., Wee, P.M.T., Vervloet, M.G. and Nigram, C. (2014) Dietary and Pharmacological Modification of Fibroblast Growth Factor-23 in Chronic Kidney Disease. Journal of Renal Nutrition, 24, 143-150.
https://doi.org/10.1053/j.jrn.2013.09.001
[20]
Uwitonze, A.M., Murererehe, J., Ineza, M.C., Harelimana, E.I., Nsabimana, U., Uwambaye, P., Gatarayiha, A., Haqd, A. and Razzaque, M.S. (2017) Effects of Vitamin D Status on Oral Health. The Journal of Steroid Biochemistry and Molecular Biology, 175, 190-194. https://doi.org/10.1016/j.jsbmb.2017.01.020
[21]
Jean, G., Souberbielle, J.C. and Chazot, C. (2017) Vitamin D in Chronic Kidney Disease and Dialysis Patients. Nutriments, 9, Article No. 328.
https://doi.org/10.3390/nu9040328
[22]
Nigwekar, S.U., Tamez, H. and Thadhani, R.I. (2014) Vitamin D and Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD). BoneKEy Reports, 3, Article No. 498.
https://doi.org/10.1038/bonekey.2013.232
[23]
Jones, G., Prosser, D.E. and Kaufmann, M. (2014) Cytochrome P450-Mediated Metabolism of Vitamin D. Journal of Lipid Research, 55, 13-31.
https://doi.org/10.1194/jlr.R031534
[24]
Chang, S.K. and Soo, W.K. (2014) Vitamin D and Chronic Kidney Disease. The Korean Journal of Internal Medicine, 29, 416-427.
https://doi.org/10.3904/kjim.2014.29.4.416
[25]
Chesney, R.W. (2016) Interactions of Vitamin D and the Proximal Tubule. Pediatric Nephrology, 31, 7-14. https://doi.org/10.1007/s00467-015-3050-5
[26]
Kuro, O.M. (2018) Klotho and Endocrine Fibroblast Growth Factors: Marker of Chronic Kidney Disease Progression and Cardiovascular Complications? Nephrology Dialysis Transplantation, 34, 15-21. https://doi.org/10.1093/ndt/gfy126
[27]
Chitalia, N., Recio-Mayoral, A., Kaski, J.C. and Banerjee, D. (2012) Vitamin D Deficiency and Endothelial Dysfunction in Non-Dialysis Chronic Kidney Disease Patients. Atherosclerosis, 220, 265-268.
https://doi.org/10.1016/j.atherosclerosis.2011.10.023
[28]
Negrea, L. (2018) Active Vitamin D in Chronic Kidney Disease: Getting Right Back Where We Started from? Kidney Diseases, 5, 59-68.
https://doi.org/10.1159/000495138
