Correlation of Serum Phosphate, Calcium and Parathyroid Hormone Level with Carotid Intimal-Medial Thickness in Patients on Maintenance Hemodialysis

Author(s): Samira Khatun, Madhabi Karmaker, Khaleda Akhter, Farnaz Nobi, Shanjida Sultana Juthy.

Background: Cardiovascular disease is a leading cause of mortality and morbidity in hemodialysis patients. Disordered calcium-phosphorus metabolism is a major contributor to vascular calcification. This study investigates the correlation of serum phosphate, calcium, and parathyroid hormone (PTH) levels with carotid intimal-medial thickness (CIMT), a marker of atherosclerosis. Aim of the study: To assess the correlation between serum phosphate, calcium, and PTH levels with CIMT in patients on maintenance hemodialysis. Methods: This cross-sectional study included 80 maintenance hemodialysis patients at the Department of Nephrology in Dhaka Medical College Hospital, Dhaka, Bangladesh, for one year from May 2021 to April 2022. Clinical data were recorded using a structured questionnaire. CIMT was measured via B-mode ultrasonography, and serum phosphate, calcium, and intact PTH levels were analyzed. Data were statistically analyzed using SPSS 26.0. Result: The mean age of participants was 43±11.3 years, with a male predominance (1.42:1). The mean CIMT was 0.59±0.11 mm and was significantly higher in males (p=0.030) and diabetic patients (p<0.001). CIMT positively correlated with age, BMI, serum phosphate, and serum calcium levels but not with iPTH. Conclusion: CIMT in hemodialysis patients positively correlates with serum phosphate, calcium, age, and BMI. Emphasis on correcting hyperphosphatemia may help prevent vascular calcification and progression of arteriosclerosis.