Serum Calcium Levels in Chronic Kidney Disease Patient Stratified By Body Mass Index

Anthoni Anthoni, Rudi Supriyadi, Siti Nur Fatimah

Abstract


Background: Most of the chronic kidney disease (CKD) patients have low blood calcium levels, yet hypercalcemia has a worse outcome in CKD patients. Interestingly, CKD patients with higher body mass index (BMI) have better outcomes. This study aimed to elucidate the difference in blood calcium levels stratified by BMI categories in patients with CKD.

Methods: The study was conducted using a comparative analytical cross-sectional study design. Patients with CKD (n100), aged over 18 years old were included, Patients with the following were excluded: the history of hemodialysis, history of antioxidants, calcium and vitamin D supplement consumption, history of infection and malignancy. BMI of patients was categorized into underweight (<18.5 kg/m2), normal (8.5-22.9 kg/m2), and overweight or obese (≥23 kg/m2). Data were analyzed to compare blood calcium in different categories of BMI (Kruskal-Wallis test).

Results: The age of patients with CKD included in this study had median age of 61 years old, predominantly was men (57%). The blood calcium level of CKD patients was on the lower border of the normal range. Median BMI was 23.48 kg/m2, of which 53% was categorized as overweight or obese. There was a trend that overweight/obese patients had higher blood calcium levels than underweight and normal-weight patients, however, no statistically significant difference between the BMI category (p=0.982).

Conclusions: The blood calcium level in chronic kidney disease varies across the BMI category, however, no correlation with the BMI.


Keywords


Blood calcium; body mass index; chronic kidney disease

Full Text:

PDF

References


Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2017;7:1–59.

Glassock RJ, Rule AD. Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease. Nephron. 2016;134(1):25-9.

Pusat Data dan Informasi Kementerian Kesehatan RI. Situasi Penyakit Ginjal Kronis. Jakarta; 2017.

Kementerian Kesehatan RI. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia. 2013.

Neuen BL, Chadban SJ, Demaio AR, et al. Chronic kidney disease and the global NCDs agenda. BMJ Glob Health. 2017;2(2):e000380.

Dhondup T, Qian Q. Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure. Blood Purif. 2017;43(1-3):179-88.

Zoccali C, Vanholder R, Massy ZA, et al. The systemic nature of CKD. Nat Rev Nephrol. 2017;13(6):344-58.

Hill Gallant KM, Spiegel DM. Calcium Balance in Chronic Kidney Disease. Curr Osteoporos Rep. 2017;15(3):214-21.

Shanahan CM, Crouthamel MH, Kapustin A, et al. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circ Res. 2011;109(6):697-711.

Kalantar-Zadeh K, Streja E, Kovesdy CP, et al. The obesity

paradox and mortality associated with surrogates of body size and muscle mass in patients receiving hemodialysis. Mayo Clin Proc. 2010;85(11):991-1001.

Kopple JD, Feroze U. The effect of obesity on chronic kidney disease. J Ren Nutr. 2011;21(1):66-71.

Mafra D, Guebre-Egziabher F, Fouque D. Body mass index, muscle and fat in chronic kidney disease: questions about survival. Nephrol Dial Transplant. 2008;23(8):2461-6.

Bonanni A, Mannucci I, Verzola D, et al. Protein-energy wasting and mortality in chronic kidney disease. Int J Environ Res Public Health. 2011;8(5):1631-54.

Rahimlu M, Shab-Bidar S, Djafarian K. Body Mass Index and All-cause Mortality in Chronic Kidney Disease: A Dose-response Meta-analysis of Observational Studies. J Ren Nutr. 2017;27(4):225-32.

Garland JS, Holden RM, Hopman WM, et al. Body mass index, coronary artery calcification, and kidney function decline in stage 3 to 5 chronic kidney disease patients. J Ren Nutr. 2013;23(1):4-11.

Inaguma D, Koide S, Takahashi K, et al. Relationship between serum calcium level at dialysis initiation and subsequent prognosis. Ren Replace Ther. 2017;3(1):2.

Blaine J, Chonchol M, Levi M. Renal control of calcium, phosphate, and magnesium homeostasis. Clin J Am Soc Nephrol. 2015;10(7):1257-72.

Dalfardi O, Jahandideh D, Omrani GH. The correlation of serum calcium level and obesity; is there any explanation?. GMJ. 2013;2(1):26-31.

Rontoyanni VG, Avila JC, Kaul S, et al. Association between obesity and serum 25 (OH) D concentrations in older Mexican adults. Nutrients. 2017;9(2):97.




DOI: https://doi.org/10.15850/amj.v6n2.1516

Article Metrics

Abstract view : 1376 times
PDF - 437 times



 This Journal indexed by

                  

          

 

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats