Abstract
Introduction: Mineral and bone disorder is a clinical condition characterized by biochemical alterations, bone abnormalities, and vascular calcification.
Objectives: To analyze the biochemical alterations involved in mineral and bone disorder in children and adolescents with chronic kidney disease (CKD) undergoing hemodialysis at a University Hospital in Maranhão.
Materials and Methods: Analytical longitudinal study conducted at the Nephrology Unit of the University Hospital of the Federal University of Maranhão. Data collection was performed through sociodemographic questionnaires, electronic medical records, and the biochemical examination information system of 16 pediatric patients undergoing hemodialysis treatment. Vitamin D was evaluated at one time point, and calcium, phosphorus, and PTH at two time points. Data were organized in a database using Microsoft Office Excel 2013 spreadsheet. Statistical analysis was performed using Stata® version 14.0. The STATA® version 14 program was used, the Wilcoxon test was applied, and a significance level of 5% was adopted.
Results: There was gender equality, with an age range between 3 and 17 years old, and predominantly brown and black skin color (81.2%). Congenital malformation (18.8%), CKD secondary to heart disease (25%), and of unknown cause (43.8%) were the most frequent etiologies. The most commonly used medications were calcitriol, sevelamer, and calcium carbonate. Biochemical findings revealed adequate vitamin D levels, variation in serum calcium levels (normocalcemia and hypocalcemia), hyperphosphatemia, and high PTH. There was a statistical difference in calcium levels between September and December (P=0.006).
Conclusion: After data analysis, it was possible to identify adequate serum levels of vitamin D and variations in calcium levels when comparing the collected months, showing statistical significance. Phosphorus and PTH were above the ideal parameters most of the time, which can be challenging for dietary and medication treatment.