Assessment of Calcium and Phosphorus levels in Hemodialysis patients Pre and Post Hemodialysis at the kidney center in Tarhuna city, Libya

Abstract

Chronic kidney disease (CKD) is associated with disturbances in calcium and phosphorus metabolism due to the progressive loss of renal function. Hemodialysis is commonly used in patients with end-stage renal disease (ESRD) to maintain metabolic balance; however, it may influence serum calcium and phosphorus levels. Therefore, this study aimed to evaluate serum calcium and phosphorus levels in patients with renal failure before and after hemodialysis. A paired pre–post analytical study was conducted on 60 patients receiving hemodialysis. Serum calcium and phosphorus levels were measured immediately before and after dialysis. Data were analyzed using IBM SPSS Statistics version 22. Normality of difference scores was assessed using the Shapiro–Wilk test. The paired samples t-test was used for normally distributed variables, while the Wilcoxon signed-rank test was applied for non-normally distributed variables. Effect sizes were calculated using Cohen’s d and r. A two tailed p-value < 0.05 was considered statistically significant. Serum phosphorus levels demonstrated a statistically significant reduction following hemodialysis (4.21 ± 0.97 mg/dL vs. 3.11 ± 0.74 mg/dL; mean difference = 1.10 mg/dL; 95% CI: 0.95–1.25; t (59) = 14.74, p < 0.001; Cohen’s d = 1.90), indicating a very large effect size. Serum calcium levels also showed a statistically significant decrease after dialysis (Wilcoxon Z = −6.06, p < 0.001), with a large effect size (r = 0.78). However, the magnitude of change in calcium levels was modest compared to phosphorus. Researchers concluded that Hemodialysis significantly reduces serum phosphorus levels with a substantial therapeutic effect and produces a statistically significant, though comparatively smaller, reduction in serum calcium levels. These findings highlight the strong impact of hemodialysis on phosphorus control and its important role in managing mineral imbalance in patients with chronic kidney disease