PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients
Introduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality remains unknown. Methods:...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Publicações Ciência e Vida
2022-10-01
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| Series: | Revista Portuguesa de Nefrologia e Hipertensão |
| Subjects: | |
| Online Access: | https://cdn02.spnefro.pt/pjnh/85/05Nefro363Original1.pdf |
| _version_ | 1811256427060133888 |
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| author | Marisa Roldão Rachele Escoli Hernâni Gonçalves Flora Sofia Karina Lopes Paulo Santos |
| author_facet | Marisa Roldão Rachele Escoli Hernâni Gonçalves Flora Sofia Karina Lopes Paulo Santos |
| author_sort | Marisa Roldão |
| collection | DOAJ |
| description | Introduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum
intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality
remains unknown.
Methods: We conducted a retrospective study of incident HD patients, who were categorized into 4 groups according to iPTH serum level:
<150 pg/mL, 150-300 pg/mL, 301-600 pg/mL and >600 pg/mL. All-cause and cardiovascular mortality over a mean follow-up of 3 years was
assessed using standard survival methods.
Results: One hundred and forty-nine patients were included. Patients with low iPTH presented low serum albumin, phosphorus, and bonespecific alkaline phosphatase (BAP), increased c-reactive protein (CRP) and higher serum bicarbonate (p<0.05). Those with iPTH <150 pg/mL
had an increased risk of all-cause and cardiovascular mortality, when compared to those with iPTH 301-600 pg/mL (HR: 0.59; 95% CI: 0.36-0.96;
p=0.035) and iPTH >600 pg/mL (HR: 0.39; 95% CI: 0.20-0.78; p=0.008), even after adjusting for potential confounding factors as age, albumin,
and comorbidities (diabetes, congestive heart failure (CHF), and hypertension).
Discussion: PTH levels were associated with all-cause and cardiovascular mortality risk in our cohort of incident HD patients. Our results
suggest that patients with low iPTH at HD initiation had an increased mortality risk, which may reflect a frail group of patients with anorexia,
sarcopenia, malnutrition, and inflammation. |
| first_indexed | 2024-04-12T17:40:58Z |
| format | Article |
| id | doaj.art-f4d8332bb4d0428298324d40310820c9 |
| institution | Directory Open Access Journal |
| issn | 0872-0169 2183-1289 |
| language | English |
| last_indexed | 2024-04-12T17:40:58Z |
| publishDate | 2022-10-01 |
| publisher | Publicações Ciência e Vida |
| record_format | Article |
| series | Revista Portuguesa de Nefrologia e Hipertensão |
| spelling | doaj.art-f4d8332bb4d0428298324d40310820c92022-12-22T03:22:49ZengPublicações Ciência e VidaRevista Portuguesa de Nefrologia e Hipertensão0872-01692183-12892022-10-0136315616010.32932/pjnh.2022.10.202PTH Serum Levels and Mortality Risk among Incident Hemodialysis PatientsMarisa Roldão0https://orcid.org/0000-0002-0448-0203Rachele Escoli1https://orcid.org/0000-0002-2962-0794Hernâni Gonçalves2https://orcid.org/0000-0003-0156-9840Flora Sofia3https://orcid.org/0000-0003-4026-3174Karina Lopes4https://orcid.org/0000-0003-2606-3272Paulo Santos5https://orcid.org/0000-0003-3912-7247Department of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalDepartment of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, PortugalIntroduction: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) is a major complication in hemodialysis (HD) patients. Serum intact parathyroid hormone (iPTH) has been associated with prognosis in these patients, however, the optimal range to reduce mortality remains unknown. Methods: We conducted a retrospective study of incident HD patients, who were categorized into 4 groups according to iPTH serum level: <150 pg/mL, 150-300 pg/mL, 301-600 pg/mL and >600 pg/mL. All-cause and cardiovascular mortality over a mean follow-up of 3 years was assessed using standard survival methods. Results: One hundred and forty-nine patients were included. Patients with low iPTH presented low serum albumin, phosphorus, and bonespecific alkaline phosphatase (BAP), increased c-reactive protein (CRP) and higher serum bicarbonate (p<0.05). Those with iPTH <150 pg/mL had an increased risk of all-cause and cardiovascular mortality, when compared to those with iPTH 301-600 pg/mL (HR: 0.59; 95% CI: 0.36-0.96; p=0.035) and iPTH >600 pg/mL (HR: 0.39; 95% CI: 0.20-0.78; p=0.008), even after adjusting for potential confounding factors as age, albumin, and comorbidities (diabetes, congestive heart failure (CHF), and hypertension). Discussion: PTH levels were associated with all-cause and cardiovascular mortality risk in our cohort of incident HD patients. Our results suggest that patients with low iPTH at HD initiation had an increased mortality risk, which may reflect a frail group of patients with anorexia, sarcopenia, malnutrition, and inflammation. https://cdn02.spnefro.pt/pjnh/85/05Nefro363Original1.pdfchronic kidney disease-mineral and bone disorder/etiologyparathyroid hormonerenal dialysis/adverse effects |
| spellingShingle | Marisa Roldão Rachele Escoli Hernâni Gonçalves Flora Sofia Karina Lopes Paulo Santos PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients Revista Portuguesa de Nefrologia e Hipertensão chronic kidney disease-mineral and bone disorder/etiology parathyroid hormone renal dialysis/adverse effects |
| title | PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
| title_full | PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
| title_fullStr | PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
| title_full_unstemmed | PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
| title_short | PTH Serum Levels and Mortality Risk among Incident Hemodialysis Patients |
| title_sort | pth serum levels and mortality risk among incident hemodialysis patients |
| topic | chronic kidney disease-mineral and bone disorder/etiology parathyroid hormone renal dialysis/adverse effects |
| url | https://cdn02.spnefro.pt/pjnh/85/05Nefro363Original1.pdf |
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