PRE- AND POST-HEMODIALYSIS CHANGES IN BONE MINERAL METABOLISM AND ELECTROLYTES IN CHRONIC KIDNEY DISEASE PATIENTS: A PAIRED COMPARATIVE STUDY

Abstract

Chronic kidney disease (CKD) has been associated with abnormalities in the mineral metabolism of bone and serum biochemical abnormalities, especially in hemodialysis patients. These abnormalities result in renal osteodystrophy and higher numbers of clinical complications. Monitoring bone mineral and selected biochemical parameters is essential for effective management. A paired pre–post comparative study with a control group was conducted among 15 CKD patients receiving maintenance hemodialysis and 20 age- and sex-matched healthy controls. Blood samples were collected from CKD patients before and after a single hemodialysis session, while controls were sampled once. Serum calcium (Ca), phosphorus (Phos), alkaline phosphatase (ALP), vitamin D, sodium (Na⁺) and potassium (K⁺) were measured using the appropriate biochemical tests. Data were analysed statistically using ANOVA, paired t-tests, and Pearson's correlation; p < 0.05 was considered significant. Hemodialysis patients showed significantly lower serum calcium and higher phosphorus and ALP levels compared with controls (p < 0.05). Vitamin D levels were reduced in dialysis patients but not statistically significant (p = 0.067). Sodium and potassium levels were significantly lower in CKD patients and showed further reduction post-dialysis (p < 0.05). Pre-dialysis ALP showed a significant negative correlation with calcium levels (r = -0.577, p = 0.024), while post-dialysis trends were similar but weaker and not statistically significant. Hemodialysis significantly affects bone mineral metabolism markers and serum electrolytes in patients with CKD. These findings highlight the importance of routine biochemical monitoring for optimal management and the prevention of complications.