Clinical and functional characteristics of mineral and bone disorders in chronic kidney disease

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Abstract

Objective. Evaluation of the indicators of mineral and bone disorders, as well as central aortic pressure (CAP) at the pre-dialysis stages of chronic kidney disease (CKD).

Material and methods. The study included 108 middle-aged patients with CKD (53.6±14.9 years), 66 (61.1%) men and 42 (38.9%) women. All patients with CKD underwent general clinical and biochemical examinations to determine the parameters of mineral metabolism - calcium, phosphorus, parathyroid hormone (PTH), vitamin D, alkaline phosphatase levels. The CAD levels and lipid metabolism were assessed. Estimated glomerular filtration rate (eGFR) was determined by the CKD-EPI method based on serum creatinine level. The total sample was divided into two groups: group 1 - CKD with GFR>60 ml/min/1.73 m2 (n=33); group 2 - patients CKD with GFR ≤60 ml/min/1.73 m2 (n=75), and the patients of both groups were comparable in age.

Results. In the group of patients with CKD and eGFR≤60 ml/min/1.73 m2 (n=75), the following changes were recorded: arterial hypertension and stable angina were detected significantly more often (P<0.05); the systolic and diastolic blood pressure (BP) and CAP levels were significantly higher, and the of hemoglobin (Hb) concentration and the peripheral red blood cell count were significantly lower (p<0.05). A significant decrease in the blood high-density lipoprotein cholesterol, an increase in the uric acid, fibrinogen, phosphorus and PTH levels were noted in patients with CKD complicated by renal failure. An increase in the PTH level was found to correlate with a decrease in the filtration function of the kidneys (r=-0.4988; P<0.05) and an increase in the blood serum phosphorus concentration (r=-0.5066; P<0.05). A significant negative relationship was found between the Hb and PTH concentrations (r=-0.4086; P<0.05). A direct correlation was found between the PTH level and the fibrinogen concentrations (r=0.6849; P<0.05), blood C-reactive protein (CRP) level (r=0.5905; P<0.05), as well as the CAP level (r=0.5640; P<0.05).

Conclusion. In patients with CKD, mineral and bone disorders are accompanied by a deterioration in central hemodynamic parameters, the development of a pro-inflammatory status, anemia, hyperuricemia, and dyslipidemia.

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About the authors

Ilkhom T. Murkamilov

I.K. Akhunbaev Kyrgyz State Medical Academy; Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin

Author for correspondence.
Email: murkamilov.i@mail.ru
ORCID iD: 0000-0001-8513-9279

Dr.Sci. (Med.), Associate Professor at the Department of Faculty Therapy, I.K. Akhunbayev KSMA, Associate Professor at the Department of Therapy № 2, KRSU named after B.N. Yeltsin

Kyrgyzstan, Bishkek; Bishkek

Viktor V. Fomin

Sechenov University

Email: fomin_vic@mail.ru
ORCID iD: 0000-0002-2682-4417

Dr. Sci. (Med.), Professor, Corresponding Member of the RAS, Head of the Department of Faculty Therapy № 1, Institute of Clinical Medicine n.a. N.V. Sklifosovsky, Vice-Rector for Innovation and Clinical Activities, Sechenov University

Russian Federation, Moscow

Zhamila A. Murkamilova

Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin

Email: murkamilovazh.t@mail.ru
ORCID iD: 0000-0002-7653-0433

Postgraduate Student in specialty “General Medicine”, Department of Therapy № 2, KRSU named after. B.N. Yeltsin

Kyrgyzstan, Bishkek

Aziza I. Sabirova

Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin

Email: azizasabirova@bk.ru
ORCID iD: 0000-0001-8055-6233

Cand.Sci. (Med.), Acting Associate Professor at the Department of Surgical Dentistry, KRSU named after B.N. Yeltsin

Kyrgyzstan, Bishkek

Ibragim S. Sabirov

Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin

Email: sabirov_is@mail.ru
ORCID iD: 0000-0002-8387-5800

Dr.Sci. (Med.), Professor, Head of the Department of Therapy № 2, Medical Faculty of the KRSU named after. B.N. Yeltsin

Kyrgyzstan, Bishkek

Furkat A. Yusupov

Osh State University

Email: furcat_y@mail.ru
ORCID iD: 0000-0003-0632-6653

Dr. Sci. (Med.), Professor, Head of the Department of Neurology, Neurosurgery and Psychiatry, Medical Faculty, Osh State University, Chief Neurologist of the Southern Region of Kyrgyzstan

Kyrgyzstan, Osh

Toktobay I. Maanaev

National Hospital under the Ministry of Health of the Kyrgyz Republic

Email: murkamilov.i@mail.ru
ORCID iD: 0000-0003-4758-4982

Cand.Sci. (Med.), Chief Physician of the National Hospital under the Ministry of Health of the Kyrgyz Republic

Kyrgyzstan, Bishkek

Omurbek T. Zakirov

Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin

Email: omurbekkarasuu@gmail.com

Resident Medical Practitioner, Faculty of Medicine, KRSU named after. B.N. Yeltsin

Kyrgyzstan, Bishkek

Kamranbey A. Gasanov

South Kazakhstan Medical Academy

Email: gassanov_k@mail.ru
ORCID iD: 0000-0003-0173-8851

first-year resident physician, South Kazakhstan Medical Academy

Kazakhstan, Shymkent

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