Assessment of Serum Phosphate Levels in Chronic Kidney Disease Patients Across Different Stages of Kidney Disease.

OBJECTIVE

This study aims to determine the serum phosphate level in patients diagnosed with chronic kidney disease (CKD) across different stages of the disease in a tertiary care hospital in Peshawar.

MATERIALS AND METHODS

This cross-sectional study was conducted in the Nephrology Department at Lady Reading Hospital, Peshawar, from August 2024 to January 2025. Over a six-month period, participants were recruited using a non-probability convenience sampling technique. The sample size of 296 was calculated using the WHO sample size calculator, with a 5% margin of error. The study included patients aged 18 years and older, of both sexes, diagnosed with any stage of CKD. Patients with acute kidney injury or significant disorders affecting phosphorus metabolism (e.g., primary hyperparathyroidism or malignancies) were excluded.

RESULTS

A total of 296 patients with CKD from various etiologies were included in this study, consisting of 124 males (41.9%) and 172 females (58.1%). The age distribution was as follows: 20-39 years (17.6%), 40-49 years (26.7%), 50-59 years (29.4%), and ≥60 years (26.4%), with a mean age of 50.26 ± 12.14 years. Among the participants, 12.8% had CKD stage 2, 23% had stage 3, 33.4% had stage 4, and 30.7% had stage 5. Of the 296 patients, 77 (26%) were receiving hemodialysis, while 219 (74%) were on conservative management. The overall incidence of hyperphosphatemia was 56% (166 participants). Stage-wise, hyperphosphatemia was observed in 31.5% of CKD stage 2, 38.2% of stage 3, 72.7% of stage 4, and 61.5% of stage 5 patients.

CONCLUSION

The study has shown a higher burden of hyperphosphatemia among CKD patients, with an overall incidence of 56%. The prevalence of hyperphosphatemia increased with advancing CKD stages, peaking at CKD stage 4 (72.7%) and continuously remaining high in stage 5 (61.5%). These results stressed the need for early detection and effective management of hyperphosphatemia, particularly in the later stages of CKD, to lessen its associated complications. Moreover, the demographic distribution, with a mean age of 50.26 ± 12.14 years and a female predominance (58.1%), reflects the need for targeted interventions tailored to this patient population.