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Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 47-52

Correlation of serum phosphate with carotid intimal-medial thickness in children with chronic kidney disease

1 DGHS, Mohakhali, Dhaka, Bangladesh, Bangladesh
2 Shahid Ziaur Rahman Medical College and Hospital, Bogura, Bangladesh
3 Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
4 Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Correspondence Address:
Dr. Farhana Rahman
DGHS, Mohakhali, Dhaka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/pnjb.pnjb_16_22

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Background: Hyperphosphatemia is a complication of advanced chronic kidney disease (CKD). Increased serum phosphate concentration is a significant risk factor for vascular calcification, which is an advanced form of atherosclerosis. Medial deposition of calcium and phosphorus and the resulting increase in vascular stiffness further contribute to the high prevalence of hypertension. Carotid ultrasound imaging is a useful adjunct for assessment of arterial wall thickness in patients with CKD. Objective: To assess the correlation of serum phosphate with carotid intimal-medial thickness in children with CKD. Materials and Methods: This cross sectional study was carried out in the Department of Pediatric Nephrology and Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2018 to December 2019. All the CKD patients with stage III-V aged 2–18 years of both sexes attending the Out-patient and Inpatient Department, BSMMU were enrolled in this study. Patients were diagnosed by history, clinical examination and relevant investigations. The glomerular filtration rate (GFR) was calculated from serum creatinine using Revised Schwartz formula. All participants underwent measurement of carotid intimal- medial thickness(CIMT) by using B mode ultrasonography (Philips, Affiniti 30; USA) with 7.5MHz transducer. Results: Total 43 patients were studied (26 male, 17 female). Mean phosphorous level significantly increased with the advancement of disease. As the stage of CKD increases the mean CIMT also increases. There were moderate positive correlation between serum inorganic phosphate and CIMT in stage III CKD (r = 0.500) and stage V(ND) CKD (r = 0.511) and strong positive correlation in stage IV CKD (r = 0.719) and negligible negative correlation in stage V(D) CKD (r = - 0.057). In multiple regression analysis, serum phosphate was significant(β= 0.673, p= <0.0001) and independent risk factor for increased CIMT in addition to other independent risk factors, including serum calcium and serum PTH. Conclusion: Higher serum phosphate level was one of the significant and independent factor associated with increased CIMT in children with advanced stages of CKD.

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