Mineral bone disorders in children with chronic kidney disease in a teaching hospital in Addis Ababa, Ethiopia

Abstract

Background: Metabolic bone disease (MBD) in children with chronic kidney disease (CKD) is associated with high morbidity and mortality, and it has been reported that it starts early in the course of the disease and worsens as the kidney damage progresses. Therefore, we aimed to determine the magnitude and pattern of mineral bone disease among patients with chronic kidney disease on follow-up at the pediatric renal clinic of Tikur Anbessa Specialized Hospital in Addis Ababa. Methods: An institution-based cross-sectional study with retrospective data collection was conducted on 86 children with CKD from stages 1 to 5. The study was conducted at Tikur Anbessa Specialized Hospital, Department of Pediatrics and Child Health, renal unit, from September 2024 to February 2025. Blood levels of Ca, P, PTH, alkaline phosphatase, and 25-Hydroxyvitamin D (25 OHD) were checked from patient records, and the prevalence of MBD according to the stages of CKD was assessed.   Results:  The age range is from 6 months to 15 years, including 53 males and 33 females, with a male-to-female ratio of 1.6:1. The prevalence of hypocalcemia increased with CKD stages: 12.2%, 36.8%, and 71.3% for stages 3, 4, and 5, respectively. Similarly, hyperphosphatemia was observed in 24.4%, 21.1%, and 42.9% of patients across stages 3, 4, and 5. The prevalence of hyperparathyroidism was 79.3%, 86.7%, and 100% at stages 3, 4, and 5. The prevalence of high total alkaline phosphatase increased from 4% to 21.1% and 28.6% across those stages. Similarly, the prevalence of low 25-OHD rose significantly with increasing CKD stage: 71.1%, 73.7%, and 100% at stages 3, 4, and 5.  Conclusion: The results demonstrated that mineral bone disorders are common in Ethiopian children with CKD in a single facility, beginning in the early stages and worsening as the disease progresses