Relation between Calcium, Phosphorus, Calcium- Phosphorus Index and iPTH in Chronic Kidney Disease Patients

Background: The disturbance in homeostasis of calcium, phosphorus, vitamin D, and parathyroid hormone are frequently seen in chronic kidney disease patients. It is vital for physician to know the relation among them to treat chronic kidney disease patients.    The main objective of the study is to 1) gather and analyze the data from chronic  kidney disease patients undergoing dialysis to find out intact parathyroid hormone status 2) the relation between level of serum calcium, serum phosphorus, calcium-phosphorus index and serum intact parathyroid hormone in Nepalese population.  Methods: Verbal consent was taken from all the participants. Eighty participants between the age of 29 and 70 years with chronic kidney disease having indication of emergency hemodialysis were included in this study. Serum calcium, and phosphorus were measured by Fully Automatic Biochemistry Analyzer, and serum intact parathyroid hormone (iPTH) was measured using Chemi Luminescence Immuno Assay (CLIA) method. Results: There is positive correlation between high calcium – phosphorus index and raised serum intact parathyroid hormone (r= 0.30).The relation is also true for serum calcium level and serum intact parathyroid hormone (r= 0.38). There is weak negative correlation between serum phosphorus and serum intact parathyroid hormone (r= -0.03). Conclusions:  In Chronic kidney disease patients, high serum calcium or calcium – phosphorus index associated with raised level of serum intact parathyroid hormone and reverse is true for increased serum phosphate level. The relation may guide physician to suspect hyperparathyroidism in chronic kidney disease patients and manage the complications related to hyperparathyroidism like renal mineral bone disease, anemia resistant to erythropoietin. Keywords: Calcium; calcium phosphorus index; intact parathyroid hormone; Nepalese population; phosphorus.