Journal of AdvancedMedical and Dental Sciences Research

Background: Alkaline phosphatase (ALP) consists of enzymes that catalyze the hydrolysis of phosphate esters in an alkaline environment. This study was conducted to assess the role of ALP level in hemodialysis patients. Materials & Methods: The present retrospective study was conducted on patients on hemodialysis therapy. It comprised of 205 patients (male- 110, female- 95). In all patients, venous blood was obtained before starting dialysis session. Analysis of serum albumin, AST, urea nitrogen, ALT, ALP, Ca, C- reactive protein was done as normal laboratory process.  Serum PTH was also assessed. Results: Out of 205 patients, 110 were males and 95 were females. The difference was non significant (P- 0.2). In patients with ALP < 236 IU/l, diabetes was seen in 46%, CVS in 15% and cerebrovascular disease in 12% cases. In patients with ALP > 236 IU/l, diabetes was seen in 38%, CVS in 8% and cerebrovascular disease in 7% cases. The difference was non- significant (P > 0.05). Peripheral vascular disease was seen in 3% cases and 7% in patients with ALP < 236 IU/l and ALP > 236 IU/l respectively. Mean hemoglobin level was 11.4 gm% and 10.6 gm% in both groups respectively. Serum albumin level was 3.8 g/dL and 3.6 g/dL respectively. The difference was non- significant (P > 0.05). 15 patients and 16 patients were HCV +ve in both groups respectively. Mean C- reactive protein was 0.4mg/dl and 0.8mg/dl in both groups respectively. Mean arterial blood pressure was 105.24 mm Hg and 102.4 mmHg respectively. The difference was non- significant (P > 0.05). Serum calcium was 9.5mg.dl and 9.3mg/dl in both groups. Serum phosphorus was 5.6 and 5.1 mg/dl, serum parathyroid hormone was 156 pg/ml and 245 pg/dl. Serum phosphorus more than 5.5 mg/dl was seen in 65 and 42 patients, serum calcium phosphorus product (mg/dl) was seen in 57 and 52, serum calcium phosphorus product > 55 mg/dl2 was seen in 54 and 31 respectively. Conclusion: High baseline serum ALP levels were more associated with increased mortality of chronic HD patients ALP may play important role as target for the treatment of HD patients.
Key words: Alkaline phosphatase, Serum phosphorus, Hemodialysis