Abstract:
Background: Chronic Kidney Disease (CKD) is a progressive
disease which takes from months to years depending on many
factors. Treatment of CKD aims at slowing progression as long
as possible with better quality of life. Hyperphosphatemia and
secondary hyperparathyroidism (SHPT) are major complications
of CKD. They have been associated with higher morbidity and
mortality, which led to the assumption that their correction could
reduce complications and CKD progression. Aim: to study the
possible role of controlling of secondary hyperparathyroidism
and hyperphosphatemia on slowing progression of chronic
kidney disease in patients with chronic kidney disease stage 3
and stage 4.Materials & Methods: This prospective cohort
multicenter study included 200 patients with stage 3–4 CKD;
recruited from nephrology departments and outpatient clinics in
Benha university hospitals and Benha health insurance hospital.
Participants underwent baseline measurement of CKD-MBD
biomarkers and updated at each study visit, scheduled at a
monthly interval over a 6-month follow-up. Ethical guidelines of
our institutions were considered and consent was obtained from
participants .Results: In this study on 200 CKD patients of stage
3-4, it was found that the lower phosphate and PTH levels at the
initial measurement and after 6 months were significantly
associated with slower CKD progression. In addition, the use of
cinacalcet, phosphate binders and alphacalcidol were
significantly associated with slower CKD progression.
Conclusion: The control of secondary hyperparathyroidism
(SHPT) and hypophosphatemia are independently associated
with slowing chronic kidney disease progression in CKD
patients’ stage 3-4, which encourages their early control to delay
loss of renal function in this population