The Importance Calcium Phosphorus Product in Renal Insufficiency

Hale Aral 1, Alev Kural 2, Pınar Demir 3, Füsun Erdenen 4, Şennur Köse 4, Anıl Barak Dolgun 5, Berrin Berçik İnal 1
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1 Sağlık Bakanlığı, İstanbul Fatih Kamu Hastaneler Birliği Genel Sekreterliği, İstanbul Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Bölümü, İstanbul, Türkiye
2 Sağlık Bakanlığı, İstanbul Bakırköy Kamu Hastaneler Birliği Genel Sekreterliği, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Bölümü, İstanbul, Türkiye
3 Sağlık Bakanlığı, Balıkesir Kamu Hastaneler Birliği Genel Sekreterliği, Manyas Devlet Hastanesi, Balıkesir, Türkiye
4 Sağlık Bakanlığı, İstanbul Fatih Kamu Hastaneler Birliği Genel Sekreterliği, İstanbul Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, Istanbul, Türkiye
5 Hacettepe Universitesi, Tıp Fakültesi, Biyoistatistik Bölümü, Ankara, Türkiye
EUR J BASIC MED SCI, Volume 4, Issue 1, pp. 1-6.
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High serum phosphorus (P) levels in chronic renal failure (CRF) lead to parathyroid hormone (PTH) resistance of skeletal system. Serum calcitriol level increases and calcium (Ca) reabsorbtion from intestine decreases. Because of these abnormalities calcifications occur in soft tissues and perivascular tissues. Cardiovascular complications occur and high CaxP product levels seen in laboratory results. Our aim was to find out the critical level of CaxP product in different treatment groups of patients with CRF. CRF patients who did not require dialysis before (preD, N=36), chronic renal disease patients on peritoneal dialysis (PD, N=36), chronic renal disease patients receiving hemodialysis treatment (HD, N=35), renal transplant patients (Tx, N=36), and healthy individuals (N=30) evaluated for the study. Total of 173 patients (77 male, 96 female) included to the study. Patients body mass indexes calculated. Blood levels of PTH, Ca, P and cystatin C (CysC) levels were measured (Siemens Healthcare Diagnostics, USA). Kolmogorov-Smirnov test is used to check the normality of data among groups. One Way Analysis of Variance is used for normally distributed groups. For non-normally distributed data, Kruskal Wallis Analysis of Variance is used for comparison of groups. Associations between categorical variables are assessed using the cross-tables and Chi-squared tests. The Receiver operating characteristics (ROC) analysis is used to measure the performance of biochemical parameters in detecting kidney dysfunction. Greater than 1mg/dL CysC levels accepted as renal dysfunction. The cut-off value for CaxP product was obtained as 37.535. Area under the ROC curve was 0.678 (p=0.002), the sensitivity and specificity were 0.573 and 0.800, respectively. Median value of all groups for CaxP was found as 37.730; very near the cut-off value (37.535). There was a significant difference in CysC levels between the two groups of dialysis according to cut-off value of 37.535. (p<0.05) In our study according to ROC analysis results, CaxP product critical value for all the patients which grouped according to treatment modalities is 37,535. In serum Ca and P parameters show high measurement performance and CaxP value is easy to access. The critical value that we found in our study groups should be confirmed for detection of renal failure and cardiovascular complications in future research.


Aral H, Kural A, Demir P, Erdenen F, Köse Ş, Barak Dolgun A, et al. The Importance Calcium Phosphorus Product in Renal Insufficiency. Eur J Basic Med Sci. 2014;4(1):1-6.


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