Association between acute kidney injury and mineral bone disease

Background Acute kidney injury (AKI) is frequently associated with mineral and endocrine disturbances, yet limited data exist regarding the prevalence and impact of these abnormalities in critically ill patients. This study aimed to evaluate the relationship between AKI and mineral bone disease parameters, including serum calcium, vitamin D, phosphorus, and parathyroid hormone. Patients and methods A prospective study was conducted at Assiut University Hospitals between November 2021 and November 2023. A total of 400 patients with AKI were enrolled and stratified into stages I ( n =200), II ( n =150), and III ( n =50) according to KDIGO criteria. Clinical, biochemical, and outcome data were collected. Results A total of 400 patients with AKI were included: stage I (50%), stage II (37.5%), and stage III (12.5%). Baseline characteristics were comparable across groups. Renal function markers significantly worsened with advancing AKI stage ( P <0.001). Serum calcium and vitamin D levels were significantly lower in stage III, with higher rates of hypocalcemia (18%) and vitamin D deficiency (24%) ( P <0.001). Phosphorus and parathyroid hormone showed no significant differences. Mortality increased significantly with AKI severity (5, 8, and 22% for stages I–III; P =0.01), alongside longer hospital stay. Nonsurvivors had significantly lower vitamin D and higher deficiency rates ( P <0.001). Conclusion Vitamin D deficiency and hypocalcemia are common in critically ill patients with AKI, especially in advanced stages. These abnormalities may influence patient outcomes, particularly survival. Multicenter trials and long-term follow-up studies are needed to investigate further the prognostic value and therapeutic potential of correcting mineral disorders in AKI.