Relation of Calcium-Phosphate Levels and Severity of Diabetic Kidney Disease on Hypertension Case in Non-Dialysis Patients in Dr. Soetomo General Teaching Hospital, Surabaya, Indonesia

Abstract

Diabetic kidney disease develops at approximately 40% of patients who are diabetic. Diabetic kidney disease is characterized by a decline in glomerular filtration rate (GFR). The diminished GFR arises phosphate retention which is a key early step in a pathologic cascade leading to vascular calcification and an increase in hypertension. The study aims to analyzed relation of calcium-phosphate levels and severity of diabetic kidney disease on hypertension case in non-dialysis patients and be able to inhibit the progression of diabetic kidney disease in non-dialysis patients by controlling calcium-phosphate levels and hypertension. Blood and urine samples were examined and recorded. Serum calcium and serum phosphate in blood sample, protein urea contents in urea sample and also hypertension were checked and examined. Serum creatinine used to determine severity level of disease using MDRD Formula. Data analysis was carried out using MARS 2.0 version and validated by SPSS software v.26 for Windows. With every increase in the severity of diabetic kidney disease, there was a decrease in calcium. Calcium levels dropped from 8.7 to 7.4 at the highest severity. The increase in the severity of diabetic kidney disease occurred starting at phosphate levels of 2.5 where the levels would increase along with the severity. Hypertension began to occur at the level 2 of severity. Every one increase in the severity, it was followed by an increase in hypertension of 0.7. Therefore, this study found that calcium-phosphate levels cause hypertension through the severity of diabetic kidney disease. Phosphate levels increase dan calcium levels decrease as the increase of the severity diabetic kidney disease.