Naslov
Hypoparathyreoidism in hemodialysis patients

Autori
Pavlović, Draško ; Orlić, Lidija ; Samarđija, Goran ; Heinrich, Branko ; Jakić, Marko ; Sladoje-martinović Branka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Nephrology Dialysis Transplantation / - , 2003

Skup
Svjetski nefrološki kongres

Mjesto i datum
Berlin, Njemačka, 08.06.2003. - 12.06.2003

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
hypoparathyreoidism; hemodialysis

Sažetak
Dialysis patients typically have elevated levels of parathyroid hormone (PTH). High PTH levels have been considered detrimental to the health of dialysis patients. It is considered that the optimal level of PTH for dialysis patients, measurred by immunoradiometric assays is at least three times higher than that of people with normal renal function. The clinical significance of lower levels of PTH, i.e. hypoparathyroidism in dialysis patients is not known but it has been associated with adynamic bone disease, increased bone fractures and increased mortality. The risk factors, pathogenesis and incidence of hypoparathyroidism in dialysis patients is not yet completely known. The aim of this study was to determine the prevalence of hypoparathyroidism in haemodialysis patients, and if possible, to detect the risk factors for impaired PTH secretion, i.e. hypoparathyroidism. Four dialysis centers participated in this study. All patients were on 4 hours bicarbonate hemodialysis 3 times a week. Cellulose-based membranes were predominantly used. For the last four years, dialysate calcium concentration 1.5 mmol/l was used in all patients, before that it was 1.75 mmol/l. Most patients received calcium carbonate as a phosphate binder, oral calcitriol was administered in some of the patients at dosages of 0.25 to 0.5 μg. Intact PTH was measured by immunoradiometric assay (normal range 1-6 pmol/l) Serum levels of calcium, phosphorus, albumin and alkaline phosphatase were measured by standard methodology. Data about patient age, dialysis duration, menopause, and underlying renal disease were collected. Patients with subtotal parathyroidectomy or percutaneous alcochol inactivation of parathyroid glands were excluded. Absolute hypoparathyroidsm were defined as PTH<6.5 pmol/l and relative 6.6 to 20 pmol/l. The mean age of 231 patients included in the study was 58, 2 ±1.9 years. There were 130 females and 101 males, mean duration of hemodialysis was 5.7 ± 5.2 years. In 67 (29%) of the patients diabetes was the cause of chronic renal failure. The prevalence of hypoparathyroidism(absolute and relative) was 88 of 231 (38%) patients. Absolute hypoparathyroidism was found in 38 (16.4%) patients and relative in 50 (21.6%) patients. Although the prevalence of relative hypoparathyroidism was higher in male patients (28 of 50, or 56%) than in female (22 of 50, or 44%), the absolute hypoparathyroidism was more often seen in female patients (24 of 38, or 63%) than in male (14 of 38, or 37%). Low levels of PTH (<20 pmol/l) were detected in 35 (52%) of diabetic patients and absolute hyperparahyroidism was detected in 15 (22%) of them. No correlations with age, dialysis duration, calcitrol and phosphate binders therapy and low levels of PTH were found. Additional study is necessary to elucidate the prevalence, pathogenesis and clinical characteristics of hypoparathyroidism in dialysis patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA