Background: Patients with chronic
kidney disease are suffering from different
electrolytes and hormonal
changes.
The effect of calcium,
phosphorus
and parathyroid hormone
(PTH) levels as risk factors for
Cryptosporidium
infection have not
been
studied before.
Aim : To estimate the incidence of
Cryptosporidium infection among hemodialysis
patients and its relation to
calcium,
phosphorus and iPTH levels. Patients and Methods : Seventy
nine hemodialysis patients attending the hemodialysis Unit at Mansoura
Urology and Nephrology Center and
Mansoura University Hospital, and
80 apparently healthy controls were
recruited in this study. All studied
groups were subjected to history taking
and clinical examination. Stool
samples
were examined macroscopically
and microscopically and modified
Kinyoun's acid fast stain for detection
of intestinal coccidian was
used.
Blood samples were collected
for
estimation of iPTH, calcium,
phosphorous,
serum creatinine and
plasma
urea.
Results : among the 79 hemodialysis
patients 49.4% had intestinal parasites. The most prevalent parasite
was Cryptosporidium (40.5%).
The
duration and efficiency of hemodialysis
played a role in the increased
incidence of parasitic infection
(P= 0.031, 0.004 respectively),
iPTH
level played additional role
(P=0.002).
Efficiency of hemdialysis
was
the most predictor risk factor for
intestinal
parasitic infection among
hemodialysis
patients (OR =0.19,
CI=0.05-0.82,
P=0 0.02).
Conclusions : Cryptosporidium is
a common parasitic infection in hemodialysis
patients, special stain
should
routinely used in stool examination
for its detection. Improving the
efficiency
of hemodialysis may help < br />to
reduce the incidence of parasitic
infections.
The iPTH is associated
with
increased incidence of Cryptosporidium
infection and this needs further
studies to confirm its role.