Features of calcium-phosphorus metabolism disorders in patients with diabetes mellitus undergoing maintenance hemodialysis

Calcium-phosphorus metabolism disorders are an important clinical problem in patients with chronic kidney disease undergoing maintenance hemodialysis. This study aimed to evaluate the features of calcium-phosphorus metabolism disorders in patients with diabetes mellitus undergoing maintenance hemodialysis and to analyze their relationship with the duration of hemodialysis therapy and glycemic level. A single-center prospective study included 43 patients with diabetes mellitus receiving maintenance hemodialysis. The mean age of the participants was 61.0 ± 11.7 years; men accounted for 55.8% and women for 44.2%. Type 2 diabetes mellitus was verified in 95.3% of patients, and type 1 diabetes mellitus in 4.7%. The mean duration of hemodialysis was 20.5 ± 22.1 months, and the mean random blood glucose level was 12.15 ± 6.59 mmol/L. Laboratory assessment revealed disorders of the main parameters of mineral metabolism in all patients. The mean total calcium level was 1.66 ± 0.30 mmol/L, with hypocalcemia observed in 92.0% of patients. The mean phosphorus level was 2.20 ± 0.74 mmol/L, and hyperphosphatemia was detected in 84.6% of patients. The mean parathyroid hormone level was 634.24 ± 302.68 pg/mL, indicating pronounced secondary hyperparathyroidism. Patients undergoing hemodialysis for more than 12 months had higher phosphorus and parathyroid hormone levels. A positive correlation was found between hemodialysis duration and parathyroid hormone level, as well as between phosphorus and parathyroid hormone levels. No statistically significant association was found between blood glucose level and parathyroid hormone concentration. The findings indicate pronounced calcium-phosphorus metabolism disorders in diabetic patients undergoing maintenance hemodialysis and emphasize the need for regular monitoring of calcium, phosphorus, and parathyroid hormone levels.