The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus
BACKGROUND: In patients with end-stage CKD, receiving renal replacement therapy (RRT) with programmed hemodialysis (HD), the severity of complications is associated with metabolic disturbances: accumulation of uremic toxins, nephrogenic anemia, secondary hyperparathyroidism (SHPT), extraskeletal cal...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Endocrinology Research Centre
2023-01-01
|
| Series: | Сахарный диабет |
| Subjects: | |
| Online Access: | https://www.dia-endojournals.ru/jour/article/view/12958 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849327359397724160 |
|---|---|
| author | I. S. Maganeva A. K. Eremkina A. P. Miliutina S. A. Martynov A. S. Severina R. H. Salimkhanov M. I. Evloeva M. Sh. Shamkhalova M. V. Shestakova N. G. Mokrysheva |
| author_facet | I. S. Maganeva A. K. Eremkina A. P. Miliutina S. A. Martynov A. S. Severina R. H. Salimkhanov M. I. Evloeva M. Sh. Shamkhalova M. V. Shestakova N. G. Mokrysheva |
| author_sort | I. S. Maganeva |
| collection | DOAJ |
| description | BACKGROUND: In patients with end-stage CKD, receiving renal replacement therapy (RRT) with programmed hemodialysis (HD), the severity of complications is associated with metabolic disturbances: accumulation of uremic toxins, nephrogenic anemia, secondary hyperparathyroidism (SHPT), extraskeletal calcification, impaired clearance and rhythm of hormone secretion.AIM: To evaluate the main biochemical and hormonal parameters, and manifestations of mineral bone disease (MBD) in patients receiving RRT with HD, before and after hemodialysis, taking into account the presence or absence of diabetes mellitus.MATERIALS AND METHODS: We divided all patients receiving RRT with HD in two groups: #1 (n=24) — patients with DM, #2 (n=16) — patients without DM. All of them had their blood analyzed before and immediately after the HD. Data analysis was performed with the Statistica 13 (StatSoft, USA). A prognostically significant model was considered at p<0.05.RESULTS: The level of iPTH, both at baseline and after HD, was lower in group #1 (p<0.001). The level of alkaline phosphatase (AP) was significantly higher in group #2 (p=0.012). In both groups before HD, a high incidence of hypocalcemia was detected (according to albumin-corrected calcium in group #1 in 58.3%, in group #2 in 43.7% of cases, p = 0.366) and hyperphosphatemia (in 66.7% and in 43 .7% of cases, respectively, p=0.151). Hypocalcemia after HD in group #1 persisted in 14%, in group #2 — in 20% of cases (p>0.05); hyperphosphatemia in group #1 was completely leveled, in group #2 it persisted in 7% of cases (p=0.417). Prior to the HD session, group #1 had significantly higher levels of RAGE, glucagon, immunoreactive insulin (IRI), cortisol, and glucose than after the HD session (p<0.05). In group #2, after HD, the levels of glucagon, IRI and cortisol significantly decreased (p<0.05), and the level of 3-nitrotyrosine (3-HT) increased significantly (p=0.026). In group #1, fibrocalcinosis of the heart valves according to ECHO and calcification of the arteries of the lower extremities according to ultrasonic doplerography were more common than in group #2 (42% vs 25%, p<0.001 and 75% vs 37.5%, p=0.018, respectively). (χ2)). Compression fractures occurred with the same frequency in both groups (60%). A decrease in bone mineral density (BMD) to the level of osteopenia was noted more often in group #1 (50% vs 18.8%), and osteoporosis was more common in group #2 (68.8% vs 33.3%) (p<0.001, χ2).CONCLUSION: The low level of PTH in group #1 may reflect the effect of diabetes on calcium-phosphorus metabolism. Patients with DM have an increased risk of renal osteodystrophy with a low bone turnover because of a number of metabolic factors inherent in diabetes. At the same time, the dynamics of phosphorus and calcium indicators during the HD procedure were similar. |
| format | Article |
| id | doaj-art-ab043f3f660e4dc087ac88de9c66acc9 |
| institution | Kabale University |
| issn | 2072-0351 2072-0378 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Endocrinology Research Centre |
| record_format | Article |
| series | Сахарный диабет |
| spelling | doaj-art-ab043f3f660e4dc087ac88de9c66acc92025-08-20T03:47:54ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782023-01-0125651252210.14341/DM1295810993The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitusI. S. Maganeva0A. K. Eremkina1A. P. Miliutina2S. A. Martynov3A. S. Severina4R. H. Salimkhanov5M. I. Evloeva6M. Sh. Shamkhalova7M. V. Shestakova8N. G. Mokrysheva9Endocrinology Research CentreEndocrinology Research CentreEndocrinology Research Centre; Pirogov Russian National Research Medical UniversityEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreEndocrinology Research CentreBACKGROUND: In patients with end-stage CKD, receiving renal replacement therapy (RRT) with programmed hemodialysis (HD), the severity of complications is associated with metabolic disturbances: accumulation of uremic toxins, nephrogenic anemia, secondary hyperparathyroidism (SHPT), extraskeletal calcification, impaired clearance and rhythm of hormone secretion.AIM: To evaluate the main biochemical and hormonal parameters, and manifestations of mineral bone disease (MBD) in patients receiving RRT with HD, before and after hemodialysis, taking into account the presence or absence of diabetes mellitus.MATERIALS AND METHODS: We divided all patients receiving RRT with HD in two groups: #1 (n=24) — patients with DM, #2 (n=16) — patients without DM. All of them had their blood analyzed before and immediately after the HD. Data analysis was performed with the Statistica 13 (StatSoft, USA). A prognostically significant model was considered at p<0.05.RESULTS: The level of iPTH, both at baseline and after HD, was lower in group #1 (p<0.001). The level of alkaline phosphatase (AP) was significantly higher in group #2 (p=0.012). In both groups before HD, a high incidence of hypocalcemia was detected (according to albumin-corrected calcium in group #1 in 58.3%, in group #2 in 43.7% of cases, p = 0.366) and hyperphosphatemia (in 66.7% and in 43 .7% of cases, respectively, p=0.151). Hypocalcemia after HD in group #1 persisted in 14%, in group #2 — in 20% of cases (p>0.05); hyperphosphatemia in group #1 was completely leveled, in group #2 it persisted in 7% of cases (p=0.417). Prior to the HD session, group #1 had significantly higher levels of RAGE, glucagon, immunoreactive insulin (IRI), cortisol, and glucose than after the HD session (p<0.05). In group #2, after HD, the levels of glucagon, IRI and cortisol significantly decreased (p<0.05), and the level of 3-nitrotyrosine (3-HT) increased significantly (p=0.026). In group #1, fibrocalcinosis of the heart valves according to ECHO and calcification of the arteries of the lower extremities according to ultrasonic doplerography were more common than in group #2 (42% vs 25%, p<0.001 and 75% vs 37.5%, p=0.018, respectively). (χ2)). Compression fractures occurred with the same frequency in both groups (60%). A decrease in bone mineral density (BMD) to the level of osteopenia was noted more often in group #1 (50% vs 18.8%), and osteoporosis was more common in group #2 (68.8% vs 33.3%) (p<0.001, χ2).CONCLUSION: The low level of PTH in group #1 may reflect the effect of diabetes on calcium-phosphorus metabolism. Patients with DM have an increased risk of renal osteodystrophy with a low bone turnover because of a number of metabolic factors inherent in diabetes. At the same time, the dynamics of phosphorus and calcium indicators during the HD procedure were similar.https://www.dia-endojournals.ru/jour/article/view/12958mineral and bone disordershyperparathyroidismdiabetes mellitushemodialysisosteoporosisextraskeletal calcification |
| spellingShingle | I. S. Maganeva A. K. Eremkina A. P. Miliutina S. A. Martynov A. S. Severina R. H. Salimkhanov M. I. Evloeva M. Sh. Shamkhalova M. V. Shestakova N. G. Mokrysheva The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus Сахарный диабет mineral and bone disorders hyperparathyroidism diabetes mellitus hemodialysis osteoporosis extraskeletal calcification |
| title | The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| title_full | The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| title_fullStr | The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| title_full_unstemmed | The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| title_short | The structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage, taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| title_sort | structure of mineral and bone disorders in patients with сhronic kidney disease of the 5th dialysis stage taking into account the presence or absence of a diagnosis of type 1 diabetes mellitus |
| topic | mineral and bone disorders hyperparathyroidism diabetes mellitus hemodialysis osteoporosis extraskeletal calcification |
| url | https://www.dia-endojournals.ru/jour/article/view/12958 |
| work_keys_str_mv | AT ismaganeva thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT akeremkina thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT apmiliutina thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT samartynov thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT asseverina thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT rhsalimkhanov thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mievloeva thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mshshamkhalova thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mvshestakova thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT ngmokrysheva thestructureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT ismaganeva structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT akeremkina structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT apmiliutina structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT samartynov structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT asseverina structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT rhsalimkhanov structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mievloeva structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mshshamkhalova structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT mvshestakova structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus AT ngmokrysheva structureofmineralandbonedisordersinpatientswithshronickidneydiseaseofthe5thdialysisstagetakingintoaccountthepresenceorabsenceofadiagnosisoftype1diabetesmellitus |