HIPERPARATIROIDISME SEKUNDER PADA PENDERITA GAGAL GINJAL Hubungannya dengan lama hemodialisis, kadar kalsium dan fosfat plasma serta adanya diabetes melitus

Secondary hyperparathyroidism is a condition characterized by hyperactivity and increase secretion of parathyroid gland as a compensatory mechanism to maintain phosphate, calsium and calcitriol plasma level within normal range in a renal failure patients. In this condition, the level of parathyroid hormone was increased up to 2 – 3 times normal level to maintain normal bone turnover. This proccess was affected by phosphate, calcium and calcitriol serum level and so do duration of dialysis and the present of diabetes melitus. This study was conducted to investigate the correlation between duration of hemodialysis, plasma level of calcium and phosphate, the present of diabetes mellitus with secondary hyperparathyroidism on renal failure patients (glomerulus filtration rate < 15 mg/min/m2 body surface). This is an observational study with cross sectional approach. Seventy eight renal failure patients which were on hemodialysis procedure in RS Akademis Jaury, RS. Wahidin Sudirohusodo, RS. Labuang Baji dan RS. Stella Maris were collected between March 2006 – January 2007. Secondary hyperparathyroidism was defined if intact parathyroid hormone (iPTH) level > 65 pg/mL . Those with prior history (less than 4 weeks) of calcium and vitamin D supplementation or phosphate binder were excluded from this study. Result of this study informed that 82,23% patients had iPTH level > 65 pg/mL with mean age was 50,34 ± 12,43 year old and mean duration of hemodialysis was 21,85 ± 24,44 months. There were a significant correlation between level of iPTH with duration of hemodialysis (r = 0,237; p = 0,000) and between phosphate and iPTH plasma level (r=0,156; p = 0,001), but the correlation between calsium and iPTH plasma level was not statistically significant. Due to renal failure diabetic patients, the level of iPTH was statistically lower than non -diabetic group (p=0,01). From this study, we can conclude that there were a correlation between each variable, ie. duration of hemodialysis, calcium and phosphate plasma level, the present of diabetes melitus with iPTH plasma level.