Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis
BackgroundPeritonitis is considered as one of the most serious complications that cause hospitalization in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). There is limited evidence on the impact of the parathyroid hormone (PTH) on the first peritoneal dialysis (PD)-associated p...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1081543/full |
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| author | Zihao Zhao Zihao Zhao Zihao Zhao Zihao Zhao Qianqian Yan Qianqian Yan Duopin Li Duopin Li Duopin Li Guangpu Li Guangpu Li Jingjing Cai Jingjing Cai Shaokang Pan Shaokang Pan Shaokang Pan Shaokang Pan Jiayu Duan Jiayu Duan Jiayu Duan Jiayu Duan Dongwei Liu Dongwei Liu Dongwei Liu Dongwei Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu |
| author_facet | Zihao Zhao Zihao Zhao Zihao Zhao Zihao Zhao Qianqian Yan Qianqian Yan Duopin Li Duopin Li Duopin Li Guangpu Li Guangpu Li Jingjing Cai Jingjing Cai Shaokang Pan Shaokang Pan Shaokang Pan Shaokang Pan Jiayu Duan Jiayu Duan Jiayu Duan Jiayu Duan Dongwei Liu Dongwei Liu Dongwei Liu Dongwei Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu |
| author_sort | Zihao Zhao |
| collection | DOAJ |
| description | BackgroundPeritonitis is considered as one of the most serious complications that cause hospitalization in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). There is limited evidence on the impact of the parathyroid hormone (PTH) on the first peritoneal dialysis (PD)-associated peritonitis episode. We aimed to investigate the influence of serum intact parathyroid hormone (iPTH) on peritonitis in patients undergoing PD.MethodsThis was a retrospective cohort study. Patients undergoing initial CAPD from a single center in China were enrolled. The baseline characteristics and clinical information were recorded. The primary outcome of interest was the occurrence of the first PD-associated peritonitis episode. Five Cox proportional hazard models were constructed in each group set. In group set 1, all participants were divided into three subgroups by tertiles of the serum concentration of iPTH; in group set 2, all participants were divided into three subgroups based on the serum concentration of iPTH with 150 pg/ml interval (<150, 150–300, and >300 pg/ml). Hazard ratios and 95% confidence intervals (CIs) were calculated for each model. The multivariate linear regression analysis elimination procedure assessed the association between the clinical characteristics at baseline and the iPTH levels. Restricted cubic spline models were constructed, and stratified analyses were also conducted.ResultsA total of 582 patients undergoing initial PD (40% women; mean age, 45.1 ± 11.5 years) from a single center in China were recruited. The median follow-up duration was 25.3 months. Multivariate Cox regression analysis showed that, in the fully adjusted model, a higher serum iPTH level (tertile 3, iPTH >300 pg/ml) was significantly associated with a higher risk of PD-associated peritonitis at 3 years [tertile 3: hazard ratio (HR) = 1.53, 95%CI = 1.03–2.55, p = 0.03; iPTH > 300 pg/ml: HR = 1.57, 95%CI = 1.08–2.27, p = 0.02]. The hazard ratio for every 100 pg/ml increase in serum iPTH level was 1.12 (95%CI = 1.05–1.20, p < 0.01) in the total cohort when treating iPTH as a continuous variable.ConclusionsAn elevated iPTH level was significantly associated with an increased risk of peritonitis in patients undergoing CAPD. |
| first_indexed | 2024-03-13T10:32:47Z |
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| language | English |
| last_indexed | 2024-03-13T10:32:47Z |
| publishDate | 2023-03-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-2b7f2be0d8bd4f01b47a3a3050fce7992023-05-18T09:05:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-03-011410.3389/fendo.2023.10815431081543Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysisZihao Zhao0Zihao Zhao1Zihao Zhao2Zihao Zhao3Qianqian Yan4Qianqian Yan5Duopin Li6Duopin Li7Duopin Li8Guangpu Li9Guangpu Li10Jingjing Cai11Jingjing Cai12Shaokang Pan13Shaokang Pan14Shaokang Pan15Shaokang Pan16Jiayu Duan17Jiayu Duan18Jiayu Duan19Jiayu Duan20Dongwei Liu21Dongwei Liu22Dongwei Liu23Dongwei Liu24Zhangsuo Liu25Zhangsuo Liu26Zhangsuo Liu27Zhangsuo Liu28Department of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, ChinaDepartment of Integrated Traditional and Western Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaResearch Institute of Nephrology, Zhengzhou University, Zhengzhou, ChinaHenan Province Research Center for Kidney Disease, Zhengzhou, ChinaKey Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, ChinaBackgroundPeritonitis is considered as one of the most serious complications that cause hospitalization in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). There is limited evidence on the impact of the parathyroid hormone (PTH) on the first peritoneal dialysis (PD)-associated peritonitis episode. We aimed to investigate the influence of serum intact parathyroid hormone (iPTH) on peritonitis in patients undergoing PD.MethodsThis was a retrospective cohort study. Patients undergoing initial CAPD from a single center in China were enrolled. The baseline characteristics and clinical information were recorded. The primary outcome of interest was the occurrence of the first PD-associated peritonitis episode. Five Cox proportional hazard models were constructed in each group set. In group set 1, all participants were divided into three subgroups by tertiles of the serum concentration of iPTH; in group set 2, all participants were divided into three subgroups based on the serum concentration of iPTH with 150 pg/ml interval (<150, 150–300, and >300 pg/ml). Hazard ratios and 95% confidence intervals (CIs) were calculated for each model. The multivariate linear regression analysis elimination procedure assessed the association between the clinical characteristics at baseline and the iPTH levels. Restricted cubic spline models were constructed, and stratified analyses were also conducted.ResultsA total of 582 patients undergoing initial PD (40% women; mean age, 45.1 ± 11.5 years) from a single center in China were recruited. The median follow-up duration was 25.3 months. Multivariate Cox regression analysis showed that, in the fully adjusted model, a higher serum iPTH level (tertile 3, iPTH >300 pg/ml) was significantly associated with a higher risk of PD-associated peritonitis at 3 years [tertile 3: hazard ratio (HR) = 1.53, 95%CI = 1.03–2.55, p = 0.03; iPTH > 300 pg/ml: HR = 1.57, 95%CI = 1.08–2.27, p = 0.02]. The hazard ratio for every 100 pg/ml increase in serum iPTH level was 1.12 (95%CI = 1.05–1.20, p < 0.01) in the total cohort when treating iPTH as a continuous variable.ConclusionsAn elevated iPTH level was significantly associated with an increased risk of peritonitis in patients undergoing CAPD.https://www.frontiersin.org/articles/10.3389/fendo.2023.1081543/fullcontinuous ambulatory peritoneal dialysis (CAPD)parathyroid hormoneperitonitisend-stage renal disease (ESRD)hazard ratio (HR) |
| spellingShingle | Zihao Zhao Zihao Zhao Zihao Zhao Zihao Zhao Qianqian Yan Qianqian Yan Duopin Li Duopin Li Duopin Li Guangpu Li Guangpu Li Jingjing Cai Jingjing Cai Shaokang Pan Shaokang Pan Shaokang Pan Shaokang Pan Jiayu Duan Jiayu Duan Jiayu Duan Jiayu Duan Dongwei Liu Dongwei Liu Dongwei Liu Dongwei Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu Zhangsuo Liu Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis Frontiers in Endocrinology continuous ambulatory peritoneal dialysis (CAPD) parathyroid hormone peritonitis end-stage renal disease (ESRD) hazard ratio (HR) |
| title | Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| title_full | Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| title_fullStr | Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| title_full_unstemmed | Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| title_short | Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| title_sort | relationship between serum ipth and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis |
| topic | continuous ambulatory peritoneal dialysis (CAPD) parathyroid hormone peritonitis end-stage renal disease (ESRD) hazard ratio (HR) |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1081543/full |
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