Renal Osteodystrophy in End Stage Renal Failure Patients on Maintenance Haemodialysis Visiting at Tertiary Care Hospital, Karachi

Objective: To determine the frequency of different patterns of renal osteodystrophy in end stage renal failure patients on maintenance haemodialysis visiting at tertiary care Hospital, Karachi.

Methodology: A Cross sectional study was conducted at Nephrology Department, Jinnah Postgraduate Medical Center, Karachi from April to October 2009. Fifty-six (56) patients on maintenance hemodialysis were included through non-probability purposive sampling. Various biochemical parameters of renal osteodystrophy were included in the current study. Serum corrected calcium, phosphate, and alkaline phosphatase and iPTH levels. Chi square test was used to determined frequency of renal osteodystrophy in ESRD patients.

Results: Mean age was 45.85 ± 13.5 years. 34 (61%) were male and 22 (39%) were female. Renal osteodystrophy was found in 89%. The most common type was secondary hyperparathyroidism (Osteitis Fibrosa Cystica) in 32%. Hypophosphatemia was observed in 62% while hypercalcaemia in only 7%. Osteomalacia was common in adolescent age group (66%), Osteitis Fibrosa Cystica (OFC) in adult group (36%) while mixed variety in elder group (50%). Similarly OFC was the most common pattern in both genders.

Conclusion: In the present study it was concluded that the prevalence of renal osteodystrophy was significantly increased. Secondary hyperparathyroidism (Osteitis Fibrosa Cystica) is the most common pattern of ROD followed by mixed osteodystrophy and adynamic bone disease.