Disorders of mineral metabolism and arterial stiffness in elderly patients with chronic kidney disease in combination with cardiovascular disease

The aim of the study was to investigate the parameters of mineral metabolism and their relation to arterial stiffness in elderly patients at predialysis stages of chronic kidney disease (CKD) in combination with cardiovascular disease. Cross sectional study was conducted in 115 patients (55 men) aged 83.3±4.4 years with stages 1-4 CKD of whom 36 patients had stage 4 CKD; 43 patients had stage 3 CKD; and 36 patients had stages 1-2 CKD (control group). Intact parathyroid hormone (iPTH), phosphates, calcium, and total alkaline phosphatase levels were determined. Arterial stiffness was studied in ankle brachial sphygmography; pulse wave velocity (PWV) was determined. Patients with stages 3 and 4 CKD demonstrated significant increase in iPTH (58.8±33.22 pg/ml and 108.8±67.61 pg/ml) and PWV (18.6±2.32 m/s and 20.8±3.54 m/s). Patients with stage 4 CKD showed significant reduction in calcium and increase in phosphate and total alkaline phosphatase levels. No correlation between PWV and parameters of calcium phosphorus metabolism was found. Development of calcium phosphorus metabolism in elderly patients with cardiovascular disorders and progression of CKD stage was associated with increase in arterial stiffness.