Renal osteodystrophy in End Stage Renal Disease patients in a center in South East of Iran: A cross- sectional study

Abstract

Background Renal osteodystrophy is a set of metabolic bone disorders occurs in patients with chronic kidney disease. Aim This study aimed to investigate the causes of renal osteodystrophy in hemodialysis patients in Zabol, in south east of Iran. Methods A total of 60 patients with End Stage Renal disease (ESRD), aged between 11-85 years entered this cross-sectional study. Patients were evaluated through a questionnaire, for age, sex, marital status, education level, occupation, income -as personal factors- cause of kidney disease, co-morbidities -as disease related factors- duration of dialysis, the number of dialysis per week, number of visits by specialists and medications -as dialysis based subjects. Blood samples were taken for determination of serum calcium, phosphorus, alkaline phosphatase, creatinine, albumin, total protein, parathyroid hormone and blood sugar. Vitamin D level and PTH level were used to determine bone disease. Data were analyzed using SPSS 21 software. Results This study showed that 48 patients (80%) were diagnosed with renal osteodystrophy. About half of the patients (47%) had osteofibrosis, 7% and 26% of subjects had a dynamic bone disease and osteomalacia, respectively. There was no statistically significant relationship between the presence of renal osteodystrophy and age (P = 0.7), gender (P = 0.3), marital status (P = 0.4), educational level (P = 0.4), occupation (P = 0.4), income (P = 0.2), duration of dialysis (P = 0.4), the number of dialysis per week (P = 0.45), number of visits (P = 0.7), underlying disease (P=0.35) and medications (P=0.3). Overall, PTH level was significantly higher in osteodystrophic patients comparing other ESRD patients (P < 0.001). Conclusions The study found that the high prevalence of renal osteodystrophy in our patients is not due to the interventions that happen after starting hemodialysis.