INVESTIGATING THE ASSOCIATION BETWEEN ANEMIA AND MINERAL DYSREGULATION IN CHRONIC KIDNEY DISEASE: EMPHASIS ON IPTH, CALCIUM, AND PHOSPHORUS

Abstract

Anemia is a frequent complication of CKD chronic kidney disease and may be influenced by mineral metabolism disturbances beyond reduced erythropoietin production. This retrospective study evaluated 855 patients with biopsy-proven CKD at the Multan Institute of Kidney Diseases between January and June 2023 to investigate the relationship between hemoglobin, intact parathyroid hormone (iPTH), calcium, and phosphorus. Demographic and biochemical data were extracted from electronic records, and statistical analysis included Spearman’s correlation, Mann–Whitney U tests, and multiple linear regression. The cohort had a mean age of 48.3 ± 16.4 years and was predominantly male (60.9%). Mean hemoglobin was 9.83 ± 2.09 g/dl, with widespread anemia. Hemoglobin was negatively correlated with iPTH (r = –0.253, p < 0.001) and positively correlated with calcium (r = 0.292, p < 0.001), while correlation with phosphorus was weak and not significant. Males had significantly higher hemoglobin than females (p = 0.009), but no gender differences were observed in mineral parameters. In regression analysis, phosphorus (B = –0.175, p < 0.001) and calcium (B = +0.399, p < 0.001) were independent predictors of hemoglobin, whereas iPTH was not significant. The model explained 9.7% of hemoglobin variance. These findings suggest that calcium–phosphorus imbalance, rather than PTH alone, plays a key role in anemia severity in glomerulonephritis, underscoring the importance of mineral management in clinical care.