Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis
IntroductionLow serum parathyroid hormone (PTH) and secondary hyperparathyroidism (SHPT) are very common in patients undergoing hemodialysis. However, it remains unclear which of these has a lower mortality.ObjectiveIn this study, we compared outcomes between hemodialysis patients with low PTH and t...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.869330/full |
| _version_ | 1811255304390705152 |
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| author | Wang Guo Huixian Zhang Yamei Zhang Hongdong Huang Wenhu Liu Zongli Diao |
| author_facet | Wang Guo Huixian Zhang Yamei Zhang Hongdong Huang Wenhu Liu Zongli Diao |
| author_sort | Wang Guo |
| collection | DOAJ |
| description | IntroductionLow serum parathyroid hormone (PTH) and secondary hyperparathyroidism (SHPT) are very common in patients undergoing hemodialysis. However, it remains unclear which of these has a lower mortality.ObjectiveIn this study, we compared outcomes between hemodialysis patients with low PTH and those with SHPT.MethodsThis was a multi-center, retrospective, matched cohort study. Median intact PTH (iPTH) was used as the cutoff for allocating participants to low PTH (iPTH<100 pg/mL) and SHPT groups (iPTH ≥600 pg/mL). Sex, diabetes, age, and dialysis vintage were matched between the groups. The primary outcome was all-cause death at 72 months.ResultsThe study cohort comprised 2282 patients (1166 in each study group). Prior to matching, the primary outcome occurred in 429/1166 patients (36.79%) in the low PTH group and in 284/1116 (25.45%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.423). The hazard ratio for low PTH versus SHPT was 1.08 (95% confidence interval, 0.90–1.30). Propensity matching created 619 pairs of patients. Baseline characteristics, including age, sex, diabetes, and dialysis vintage were comparable between the groups. The primary outcome occurred in 195/619 patients (31.50%) in the low PTH group and in 193/619 (31.18%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.43). The adjusted hazard ratio for low PTH versus SHPT was 1.10 (95% confidence interval, 0.87–1.39).ConclusionsHemodialysis patients with low PTH have similar all-cause death rates to the rates for those with SHPT. |
| first_indexed | 2024-04-12T17:21:54Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-12T17:21:54Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-9f288bdc41444675a5492734c8b9ad042022-12-22T03:23:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-05-011310.3389/fendo.2022.869330869330Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched AnalysisWang GuoHuixian ZhangYamei ZhangHongdong HuangWenhu LiuZongli DiaoIntroductionLow serum parathyroid hormone (PTH) and secondary hyperparathyroidism (SHPT) are very common in patients undergoing hemodialysis. However, it remains unclear which of these has a lower mortality.ObjectiveIn this study, we compared outcomes between hemodialysis patients with low PTH and those with SHPT.MethodsThis was a multi-center, retrospective, matched cohort study. Median intact PTH (iPTH) was used as the cutoff for allocating participants to low PTH (iPTH<100 pg/mL) and SHPT groups (iPTH ≥600 pg/mL). Sex, diabetes, age, and dialysis vintage were matched between the groups. The primary outcome was all-cause death at 72 months.ResultsThe study cohort comprised 2282 patients (1166 in each study group). Prior to matching, the primary outcome occurred in 429/1166 patients (36.79%) in the low PTH group and in 284/1116 (25.45%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.423). The hazard ratio for low PTH versus SHPT was 1.08 (95% confidence interval, 0.90–1.30). Propensity matching created 619 pairs of patients. Baseline characteristics, including age, sex, diabetes, and dialysis vintage were comparable between the groups. The primary outcome occurred in 195/619 patients (31.50%) in the low PTH group and in 193/619 (31.18%) in the SHPT group. There were no significant differences in all-cause death between the groups according to multivariable Cox regression (P=0.43). The adjusted hazard ratio for low PTH versus SHPT was 1.10 (95% confidence interval, 0.87–1.39).ConclusionsHemodialysis patients with low PTH have similar all-cause death rates to the rates for those with SHPT.https://www.frontiersin.org/articles/10.3389/fendo.2022.869330/fulllow parathyroid hormonesecondary hyperparathyroidismhemodialysisall-cause deathcardio-cerebrovascular death |
| spellingShingle | Wang Guo Huixian Zhang Yamei Zhang Hongdong Huang Wenhu Liu Zongli Diao Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis Frontiers in Endocrinology low parathyroid hormone secondary hyperparathyroidism hemodialysis all-cause death cardio-cerebrovascular death |
| title | Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis |
| title_full | Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis |
| title_fullStr | Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis |
| title_full_unstemmed | Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis |
| title_short | Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis |
| title_sort | low parathyroid hormone versus secondary hyperparathyroidism and survival in patients undergoing hemodialysis a propensity matched analysis |
| topic | low parathyroid hormone secondary hyperparathyroidism hemodialysis all-cause death cardio-cerebrovascular death |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.869330/full |
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